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双螺旋CT扫描显示冠状动脉无钙化:老年女性冠状动脉造影正常的预测指标?

Absence of coronary calcification on double-helical CT scans: predictor of angiographically normal coronary arteries in elderly women?

作者信息

Shemesh J, Tenenbaum A, Fisman E Z, Apter S, Rath S, Rozenman J, Itzchak Y, Motro M

机构信息

Cardiac Rehabilitation Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel.

出版信息

Radiology. 1996 Jun;199(3):665-8. doi: 10.1148/radiology.199.3.8637984.

DOI:10.1148/radiology.199.3.8637984
PMID:8637984
Abstract

PURPOSE

To test the hypothesis that angiographically normal coronary arteries in elderly women are identifiable by the absence of coronary calcification on double-helical computed tomographic (CT) scans.

MATERIALS AND METHODS

Forty-eight consecutive women (age range, 60-76 years) underwent coronary angiography for chest pain evaluation, as well as double-helical CT. Thirty women (mean age, 65 years +/- 5) had coronary artery disease (CAD), defined as any angiographic disease, and 18 women (mean age, 66 years +/- 4) had angiographically normal coronary arteries.

RESULTS

Women with angiographically normal coronary arteries had lower coronary calcification scores than those of patients with CAD: 5.7 +/- 11 versus 580 +/- 634, respectively (P = .0004). Seven women with angiographically normal coronary arteries demonstrated mild coronary calcification (score < 50). Of the 11 women without coronary calcification, none had CAD. Thus, the absence of coronary calcification on double-helical CT scans in elderly women was predictive of angiographically normal coronary arteries with 61% sensitivity, 100% specificity, and 85% accuracy.

CONCLUSION

Double-helical CT is an accurate, noninvasive modality for diagnosing angiographically normal coronary arteries in elderly symptomatic women.

摘要

目的

检验如下假设,即通过双螺旋计算机断层扫描(CT)未发现冠状动脉钙化可识别老年女性血管造影正常的冠状动脉。

材料与方法

连续48名女性(年龄范围60 - 76岁)因胸痛评估接受冠状动脉造影及双螺旋CT检查。30名女性(平均年龄65岁±5岁)患有冠状动脉疾病(CAD),定义为任何血管造影显示的疾病,18名女性(平均年龄66岁±4岁)血管造影显示冠状动脉正常。

结果

血管造影显示冠状动脉正常的女性冠状动脉钙化评分低于CAD患者:分别为5.7±11和580±634(P = .0004)。18名血管造影显示冠状动脉正常的女性中有7名表现为轻度冠状动脉钙化(评分<50)。在11名无冠状动脉钙化的女性中,无人患有CAD。因此,老年女性双螺旋CT扫描未发现冠状动脉钙化对血管造影显示冠状动脉正常具有预测性,敏感性为61%,特异性为100%,准确性为85%。

结论

双螺旋CT是诊断有症状老年女性血管造影显示冠状动脉正常的一种准确、无创的方法。

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