Budoff M J, Georgiou D, Brody A, Agatston A S, Kennedy J, Wolfkiel C, Stanford W, Shields P, Lewis R J, Janowitz W R, Rich S, Brundage B H
Department of Medicine, Division of Cardiology, Harbor-UCLA Medical Center, Calif., USA.
Circulation. 1996 Mar 1;93(5):898-904. doi: 10.1161/01.cir.93.5.898.
Ultrafast computed tomography (CT), by acquiring images of the proximal coronary arteries, detects coronary calcifications and has been demonstrated to be highly sensitive for the detection of coronary artery disease in many small studies. The aim of this study was to determine the relationship between ultrafast CT scanning and coronary angiography in a large number of symptomatic patients.
The study population consisted of 710 patients from six participating centers. A multivariate logistic regression model was used to evaluate the individual contributions of age, number of calcified vessels, and the calcium score for the probability of angiographically significant disease. Of the 710 patients enrolled, 427 patients had significant angiographic disease, and coronary calcification was detected in 404, yielding a sensitivity of 95%. Of the 23 patients without calcifications, 19 (83%) had single-vessel disease at angiography. Of the 283 patients without angiographically significant disease, 124 had negative ultrafast CT coronary studies, for a specificity of 44%. An increasing number of vessels with calcification present on ultrafast CT was found to increase specificity for the presence of obstructive coronary artery disease in at least one vessel (P < .0001). As the log of the calcium score increases, the probability of multivessel obstructive disease increases (P < .0001).
Ultrafast CT scanning is an noninvasive, non-exercise-dependent test with an excellent sensitivity for the detection of coronary artery disease. The presence of calcifications in multiple vessels and in younger populations correlates with higher specificities for obstructive disease, making ultrafast CT coronary scanning a very useful diagnostic test.
超速计算机断层扫描（CT）通过获取近端冠状动脉图像来检测冠状动脉钙化，并且在许多小型研究中已被证明对检测冠状动脉疾病具有高度敏感性。本研究的目的是确定大量有症状患者中超速CT扫描与冠状动脉造影之间的关系。
研究人群包括来自六个参与中心的710名患者。使用多变量逻辑回归模型来评估年龄、钙化血管数量和钙积分对血管造影显示显著疾病概率的个体贡献。在纳入的710名患者中，427名患者有显著的血管造影疾病，404名检测到冠状动脉钙化，敏感性为95%。在23名无钙化的患者中，19名（83%）在血管造影时有单支血管疾病。在283名无血管造影显著疾病的患者中，124名超速CT冠状动脉检查结果为阴性，特异性为44%。发现超速CT上出现钙化的血管数量增加会提高至少一支血管存在阻塞性冠状动脉疾病的特异性（P <.0001）。随着钙积分对数的增加，多支血管阻塞性疾病的概率增加（P <.0001）。
超速CT扫描是一种非侵入性、不依赖运动的检查，对检测冠状动脉疾病具有出色的敏感性。多支血管以及较年轻人群中存在钙化与阻塞性疾病的更高特异性相关，这使得超速CT冠状动脉扫描成为一种非常有用的诊断检查。
