摘要
目的探讨64层螺旋 CT(MDCT)冠状动脉成像的图像质量及诊断冠状动脉病变的准确性。方法 105例患者(包括高心率、冠状动脉钙化及肥胖病例,但除外房颤病例)作 MDCT 冠状动脉成像,并与常规冠状动脉造影对照。分析 MDCT 图像质量及对冠状动脉病灶的显示情况。结果每例均对冠状动脉的13个节段进行分析(共1365个节段)。1144个节段能满足管腔评价,221个节段因钙化严重(153个节段)或运动伪影(68个节段)无法满足管腔评价。105例中钙化积分中位数为154(范围0～1983);87例钙化积分<1000,中位数105(范围0～994);18例钙化积分≥1000,中位数1477(范围1115～1983)。MDCT 发现≥50%狭窄总的敏感度、特异度、阳性预测值、阴性预测值分别为85.7%、97.9%、93.0%、95.5%。当评价局限在钙化积分<1000的患者时,MDCT 发现≥50%狭窄的敏感度、特异度、阳性预测值、阴性预测值分别为96.0%、98.9%、95.3%、99.0%。临床正确诊断率(发现或排除至少1个有意义病灶)为92.4%(97/105)。结论对非选择性病例,MDCT 可提供高诊断准确性的冠状动脉图像。
Objective To evaluate the image quality of 64-muhi detector computed tomography （MDCT） and the clinical accuracy in detecting coronary artery lesions. Methods One hundred and five patients were studied by MDCT. The results were compared with invasive coronary angiography （ICA） . Patients were excluded for atrial fibrillation, but not for high heart rate, coronary calcification, or obesity. MDCT was analyzed with regard to image quality and presence of coronary artery lesions. Results The data evaluation of the image quality was based on a total of 1365 segments （ 13 coronary segments for each patient）, of which 1144 segments were considered to have diagnostic image quality, but 221 segments （16.2%） could not be sufficiently evaluated because of severe calcifications （153 segments） and motion artifacts （68 segments）. The median calcium score [ Agatston score equivalent （ASE） ] was 154 （range 0-1983）. 87 of the 105 patients had an ASE of less than 1,000 [median 105 （range 0-994） ], and 18 patients had an ASE greater than 1000 [ median 1477 （ range 1115-1983） ]. For detecting lesions with 50% or greater narrowing （without any exclusion criteria）, the overall sensitivity, specificity, positive predictive value, and negative predictive value were 85.7%, 97.9%, 93.0%, and 95.5%, respectively. When limiting the number of patients to those with a calcium score of less than 11300 ASE, the threshold-corrected sensitivity for lesions with 50% or greater narrowing was 96.0% ; specificity, 98.9% ; positive predictive value, 95.3% ; and negative predictive value, 99.0%. Conclusion Our results indicate high quantitative and qualitative diagnostic accuracy of 64-slice MSCT in comparison to QCA in a broad spectrum of patients.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2006年第9期984-987,共4页
Chinese Journal of Radiology
