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计算机断层扫描对肥厚型心肌病合并冠状动脉疾病的诊断性能。

Diagnostic performance of computed tomography for detection of concomitant coronary disease in hypertrophic cardiomyopathy.

机构信息

Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China, 100029.

出版信息

Eur Radiol. 2015 Mar;25(3):767-75. doi: 10.1007/s00330-014-3465-6. Epub 2014 Oct 31.

DOI:10.1007/s00330-014-3465-6
PMID:25358595
Abstract

OBJECTIVES

To evaluate the diagnostic performance of computed tomography (CT) in patients with hypertrophic cardiomyopathy (HCM) and suspected coexistent coronary artery diseases (CADs).

METHODS

Sixty patients were enrolled in this study. Cardiac CT examination included CT coronary angiography (CTCA) and delayed enhancement CT. CT performance in evaluation of the coronary artery was assessed and compared with that of catheter-based coronary angiography (CA). The left ventricle (LV) wall thickness, functional indices and myocardial delayed enhancement (MDE) were measured via cardiac magnetic resonance (CMR) and CT images.

RESULTS

Compared with catheter-based CA, CTCA produced a 100 % (24/24) sensitivity, a 94.4 % (34/36) specificity, a 92.3 % (24/26) positive predictive value and a 100 % (34/34) negative predictive value. CT-measured LV wall thickness and functional indices were correlated with those measured via CMR (P < 0.01), though the CT-measured values were smaller than the CMR-measured values. Bland-Altman analysis showed the volume of the focal MDE determined via CT was slightly smaller than that determined using CMR (mean difference: 0.3 cm(3)).

CONCLUSIONS

For patients with HCM and suspected coexistent CAD, this comprehensive cardiac CT protocol can be helpful in ruling out coronary stenosis and can provide information regarding morphology, function and tissue characterization of the LV myocardium.

摘要

目的

评估计算机断层扫描(CT)在肥厚型心肌病(HCM)合并疑似并存冠状动脉疾病(CAD)患者中的诊断性能。

方法

本研究纳入 60 例患者。心脏 CT 检查包括 CT 冠状动脉造影(CTCA)和延迟强化 CT。评估 CT 对冠状动脉的评估性能,并与基于导管的冠状动脉造影(CA)进行比较。通过心脏磁共振(CMR)和 CT 图像测量左心室(LV)壁厚度、功能指数和心肌延迟强化(MDE)。

结果

与基于导管的 CA 相比,CTCA 的敏感性为 100%(24/24),特异性为 94.4%(34/36),阳性预测值为 92.3%(24/26),阴性预测值为 100%(34/34)。CT 测量的 LV 壁厚度和功能指数与 CMR 测量的结果相关(P<0.01),但 CT 测量的数值小于 CMR 测量的数值。Bland-Altman 分析显示 CT 测定的局灶性 MDE 体积略小于 CMR 测定的体积(平均差值:0.3 cm3)。

结论

对于 HCM 合并疑似并存 CAD 的患者,这种综合心脏 CT 方案有助于排除冠状动脉狭窄,并可提供 LV 心肌形态、功能和组织特征的信息。

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Heart Vessels. 2015 Jan;30(1):28-35. doi: 10.1007/s00380-013-0452-9. Epub 2013 Dec 11.
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Assessment of myocardial fibrosis and coronary arteries in hypertrophic cardiomyopathy using combined arterial and delayed enhanced CT: comparison with MR and coronary angiography.应用联合动脉期和延迟强化 CT 评估肥厚型心肌病的心肌纤维化和冠状动脉:与 MR 和冠状动脉造影的比较。
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