Department of Health and Radiation Research, National Center for Radiation Research and Technology (NCRRT), Egyptian Atomic Energy Authority (EAEA), Cairo, Egypt.
Curr Med Imaging. 2021;17(4):517-523. doi: 10.2174/1573405616666201023142030.
The study aimed to estimate the relationship between Coronary Calcium Scoring (CCS) and the presence of different degrees of obstructive coronary artery disease (CAD) to avoid unnecessary examinations and hence unnecessary radiation exposure and contrast injection.
Coronary Calcium Scoring (CCS) is a test that uses x-ray equipment to produce pictures of the coronary arteries to determine the degree of its narrowing by the build-up of calcified plaques. Despite the lack of definitive data linking ionizing radiation with cancer, the American Heart Association supports widely that practitioners of Computed tomography Coronary Angiography (CTCA) should keep "patient radiation doses as low as reasonably achievable but consistent with obtaining the desired medical information".
Data obtained from 275 CTCA examinations were reviewed. Radiation effective doses were estimated for both CCS and CTCA, and measures to keep them as low as possible were presented. CCS and Framingham risk estimates were compared to obtain the final results of CTCA to detect sensitivity and specificity of each one in detecting obstructive lesions.
CCS is a strong discriminator for obstructive CAD with high sensitivity and specificity and correlates well with the degree of obstruction even more than Framingham risk estimate, which has high sensitivity and low specificity.
CCS helps to reduce the effective radiation dose if properly evaluated to skip unnecessary CTCA if obstructive lesions are unlikely, and this as a test does not use contrast material, thus harmful effect on the kidney will be avoided as most of the coronary atherosclerotic patients have renal problems.
本研究旨在评估冠状动脉钙化评分（CCS）与不同程度阻塞性冠状动脉疾病（CAD）之间的关系，以避免不必要的检查，从而避免不必要的辐射暴露和造影剂注射。
冠状动脉钙化评分（CCS）是一种使用 X 射线设备对冠状动脉进行成像的检查，以确定钙盐斑块堆积导致其狭窄的程度。尽管没有明确的数据将电离辐射与癌症联系起来，但美国心脏协会广泛支持，认为计算机断层冠状动脉造影（CTCA）的从业者应“将患者的辐射剂量降至尽可能低，但要与获得所需的医学信息一致”。
回顾了 275 例 CTCA 检查获得的数据。对 CCS 和 CTCA 的辐射有效剂量进行了估计，并提出了将其降至最低的措施。比较了 CCS 和 Framingham 风险评估，以获得 CTCA 的最终结果，以检测每一种检测阻塞性病变的敏感性和特异性。
CCS 是阻塞性 CAD 的有力鉴别指标，具有较高的敏感性和特异性，与阻塞程度的相关性甚至比 Framingham 风险评估更好，后者具有较高的敏感性和较低的特异性。
如果对 CCS 进行适当评估，认为阻塞性病变不太可能，则有助于降低有效辐射剂量，如果跳过不必要的 CTCA，因为大多数冠状动脉粥样硬化患者都有肾脏问题，因此可以避免造影剂对肾脏的有害影响。
