Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Education and Research Hospital, 06110, Ankara, Turkey.
Department of Cardiology, Hacettepe University Faculty of Medicine, Sıhhiye, 06100, Ankara, Turkey.
J Geriatr Cardiol. 2014 Jun;11(2):106-12. doi: 10.3969/j.issn.1671-5411.2014.02.013.
Multidetector computed tomography (MDCT) coronary angiography represents one of the most exciting technological revolutions in cardiac imaging and it has been increasingly used in the diagnosis of coronary artery disease. The purpose of this study is to investigate the effect of age and coronary plaque calcification on diagnostic accuracy of MDCT.
The patients were examined by using dual-source MDCT and conventional coronary angiography. MDCT results were analyzed with regard to the severity (> 50% stenosis) and morphology (non-calcified, mixed, or calcified) of coronary atherosclerotic plaques evaluated in a 16-segment model.
In total, 181 patients (94 men and 87 women) with 2,687 coronary artery segments were examined with MDCT. Ninety three patients were older than 65 years of age (group A, 42 men) and 88 were younger (group B, 52 men). Two-hundred nine coronary artery segments (7.2%) were excluded because of small distal coronary vessel segments and/or motion artifacts. The overall number of segments with non-diagnostic image quality was similar in both groups of patients. Of the 2,687 evaluated segments, 157 (5.8%) were significantly diseased, and 144 of them were correctly detected by MDCT. Diagnostic evaluation showed that the sensitivity, positive predictive value, specificity, and negative predictive value were 89.5%, 62.5%, 96.0%, and 99.2%, respectively in group A, and 95.2%, 64.8%, 97.5%, and 99.8% in group B, respectively. In addition, detailed segment-based analyses in coronary segments with non-calcified, mixed and calcified plaques in both groups were similar diagnostic accuracy.
Very high diagnostic accuracy observed in this study suggests that MDCT coronary angiography could be a suitable diagnostic tool for not only younger patients but also for older patients.
多排螺旋 CT（MDCT）冠状动脉成像代表了心脏成像领域最令人兴奋的技术革命之一，它已越来越多地用于诊断冠状动脉疾病。本研究旨在探讨年龄和冠状动脉斑块钙化对 MDCT 诊断准确性的影响。
患者采用双源 MDCT 和常规冠状动脉造影进行检查。使用 16 节段模型评估冠状动脉粥样硬化斑块的严重程度（>50%狭窄）和形态（非钙化、混合或钙化），对 MDCT 结果进行分析。
共对 181 例患者（94 例男性和 87 例女性）的 2687 个冠状动脉节段进行了 MDCT 检查。93 例患者年龄大于 65 岁（A 组，42 例男性），88 例患者年龄小于 65 岁（B 组，52 例男性）。由于远端冠状动脉小血管段和/或运动伪影，209 个冠状动脉节段（7.2%）被排除在外。两组患者的非诊断性图像质量节段数相似。在评估的 2687 个节段中，157 个（5.8%）节段明显患病，MDCT 正确检测出 144 个节段。诊断评估显示，A 组的敏感性、阳性预测值、特异性和阴性预测值分别为 89.5%、62.5%、96.0%和 99.2%，B 组分别为 95.2%、64.8%、97.5%和 99.8%。此外，在两组患者的非钙化、混合和钙化斑块的冠状动脉节段中，基于节段的详细分析显示出相似的诊断准确性。
本研究观察到非常高的诊断准确性表明，MDCT 冠状动脉成像不仅适用于年轻患者，也适用于老年患者。
