在严重钙化患者中使用128层双源计算机断层扫描进行冠状动脉计算机断层血管造影。
Coronary computed tomography angiography using 128-slice dual-source computed tomography in patients with severe calcification.
作者信息
Sato Suguru, Horii Yosuke, Yoshimura Norihiko, Yagi Takuya, Aoyama Hidefumi
机构信息
Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata-City, Niigata, 951-8510, Japan.
出版信息
Jpn J Radiol. 2017 Aug;35(8):432-439. doi: 10.1007/s11604-017-0650-y. Epub 2017 May 26.
PURPOSE
To compare coronary computed tomography angiography (CTA) and coronary angiography (CAG) with regard to luminal graphic definition of calcified segments using 128-slice dual-source computed tomography (DSCT), specifically for patients with an Agatston score >400.
MATERIALS AND METHODS
Of 1148 consecutive patients who underwent coronary CTA using a 128-slice DSCT, 132 subjects had severe calcification with an Agatston score >400. Thirty-nine of the 132 patients who had undergone CAG within 3 months before or after coronary CTA were included. We investigated the distribution of calcification, and we visually evaluated significant stenosis in the calcified and all segments. Results were compared with CAG.
RESULTS
The target group in this study had a very high mean Agatston score of 1771 ± 1724. Results for sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 247 calcified vs all 325 segments were as follows: sensitivity 93.2 vs 92.2%, specificity 83.9 vs 87.5%, PPV 70.8 vs 69.6%, and NPV 96.7 vs 97.3%, respectively.
CONCLUSION
128-slice DSCT has potential for evaluation of calcified segments in the lumen, even in patients whose Agatston score exceeds 400.
目的
使用128层双源计算机断层扫描（DSCT），比较冠状动脉计算机断层血管造影（CTA）和冠状动脉造影（CAG）在钙化节段管腔图像清晰度方面的差异，特别是针对阿加斯顿评分>400的患者。
材料与方法
在1148例连续接受128层DSCT冠状动脉CTA检查的患者中，132例患者有严重钙化，阿加斯顿评分>400。其中39例在冠状动脉CTA检查前或后3个月内接受了CAG检查的患者被纳入研究。我们研究了钙化的分布情况，并对钙化节段和所有节段的显著狭窄进行了视觉评估。将结果与CAG进行比较。
结果
本研究中的目标组平均阿加斯顿评分非常高，为1771±1724。247个钙化节段与所有325个节段的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）结果如下：敏感性分别为93.2%和92.2%，特异性分别为83.9%和87.5%，PPV分别为70.8%和69.6%，NPV分别为96.7%和97.3%。
结论
即使对于阿加斯顿评分超过400的患者，128层DSCT在评估管腔内钙化节段方面也具有潜力。
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