Teng W, Wong N D, Abrahamson D, Gardin J M
Department of Medicine, University of California, Irvine 92717, USA.
Coron Artery Dis. 1996 May;7(5):383-9. doi: 10.1097/00019501-199605000-00009.
Electron beam computed tomography has become an increasingly popular technology to noninvasively screen for coronary artery calcium as a marker of atherosclerotic burden. Coronary artery calcium is invariably associated with atherosclerosis, and the amount (volume, mass, or calculated 'score') of calcium is directly associated with age, male gender, and other cardiovascular risk factors. Coronary artery calcium is highly sensitive and moderately specific for the identification of angiographically significant disease. Recent reports also show a direct association between the amount of coronary calcium and the risk of combined new coronary events and revascularization in previously asymptomatic individuals, and hard coronary events among symptomatic patients. Coronary artery screening by electron beam computed tomography is a cost-effective tool compared with other diagnostic modalities when the pre-test likelihood of disease is low to moderate. Although some reports have shown significant retest variability in calcium scores obtained from repeated scans, and in the individual relationship between angiographic disease and coronary calcium quantity, such variability may be minimized by averaging results from two or more consecutive scans, techniques to minimize respiratory motion artifact, and possibly the use of thicker scan slice thicknesses. Serial scanning by electron beam computed tomography is also being investigated as a noninvasive tool for following the effects of medical or lifestyle intervention for controlling cardiovascular risk factors or disease. At present, coronary artery scanning by electron beam computed tomography may be most appropriately utilized in screen patients with established coronary risk factors or known or suspected coronary disease, and in combination with established diagnostic testing to confirm the presence of suspected coronary disease.
电子束计算机断层扫描已成为一种越来越受欢迎的技术，用于无创筛查冠状动脉钙化，作为动脉粥样硬化负荷的标志物。冠状动脉钙化总是与动脉粥样硬化相关，钙化的量（体积、质量或计算出的“分数”）与年龄、男性性别和其他心血管危险因素直接相关。冠状动脉钙化对识别血管造影显示的显著疾病具有高度敏感性和中等特异性。最近的报告还显示，冠状动脉钙化的量与既往无症状个体发生新的冠状动脉事件和血运重建的综合风险以及有症状患者发生严重冠状动脉事件之间存在直接关联。当疾病的预测试验可能性为低至中等时，与其他诊断方法相比，通过电子束计算机断层扫描进行冠状动脉筛查是一种具有成本效益的工具。尽管一些报告显示，从重复扫描获得的钙分数以及血管造影疾病与冠状动脉钙量之间的个体关系存在显著的重测变异性，但通过对两次或更多次连续扫描的结果进行平均、尽量减少呼吸运动伪影的技术以及可能使用更厚的扫描层厚，可以将这种变异性降至最低。电子束计算机断层扫描的连续扫描也正在作为一种无创工具进行研究，以跟踪医学或生活方式干预对控制心血管危险因素或疾病的效果。目前，电子束计算机断层扫描冠状动脉扫描最适用于筛查有既定冠状动脉危险因素或已知或疑似冠状动脉疾病的患者，并与既定的诊断测试相结合，以确认疑似冠状动脉疾病的存在。
