The diagnostic accuracy of 256-row computed tomographic angiography compared with invasive coronary angiography in patients with suspected coronary artery disease
The diagnostic accuracy of 256-row computed tomographic angiography compared with invasive coronary angiography in patients with suspected coronary artery disease
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DOI：
10.1093/eurheartj/ehq072
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发表时间：
2010-08-01
影响因子：
39.3
通讯作者：
Shyu, Kou-Gi
中科院分区：
文献类型：
--
作者：
Chao, Shu-Ping;Law, Wai-Yip;Shyu, Kou-Gi
评价256排CT血管造影（CTA）对疑似冠心病（CAD）患者的诊断准确性。近年来，通过CTA对冠状动脉进行无创成像的应用越来越多。256排CTA的准确性尚未研究。我们试图评估256排CTA与有创冠状动脉造影（伊卡）在诊断和评估CAD方面的准确性。我们前瞻性地评估了104名接受CTA然后接受伊卡的连续个体。狭窄>= 50%被认为是阻塞性的。比较CTA和伊卡对梗阻性狭窄的诊断准确性。使用受试者工作特征曲线下面积（AUC）评价CTA相对于伊卡的诊断准确性。共86例患者患有梗阻性CAD。根据伊卡检测狭窄≥ 50%的CTA患者分析显示AUC为0.744 [95%置信区间（CI），0.572-0.916]，灵敏度为98.8%，特异性为50%，阳性预测值（PPV）为92.4%，阴性预测值（NPV）为87.5%。基于节段的分析显示AUC为0.915（95% CI，0.847-0.982），灵敏度为93.5%，特异性为95%，PPV为77.6%，NPV为98.7%。基于血管的分析显示AUC为0.887（95% CI，0.808-0.966），灵敏度为94.3%，特异性为87.3%，PPV为82.7%，NPV为95.9%。256行CTA是CAD的高灵敏度测试，具有较高的预测价值。256-行CTA可能是检测冠状动脉狭窄和排除疑似患者CAD的潜在替代方法。
To assess the diagnostic accuracy of 256-row computed tomographic angiography (CTA) in patients with suspected coronary artery disease (CAD). Non-invasive imaging of the coronary artery by CTA has increasingly been used in recent years. The accuracy of 256-row CTA has not yet been studied. We sought to assess the accuracy of 256-row CTA compared with invasive coronary angiography (ICA) in the diagnosis and assessment of CAD.We prospectively evaluated 104 consecutive individuals who accepted CTA and then underwent ICA. The presence of stenosis >= 50% was considered obstructive. The diagnostic accuracy of CTA for detecting obstructive stenosis was compared with that of ICA. The area under the receiver-operating-characteristic curve (AUC) was used to evaluate the diagnostic accuracy of CTA relative to ICA. A total of 86 patients had obstructive CAD. The patient-based analysis of CTA for detecting stenosis >= 50% according to ICA revealed an AUC of 0.744 [95% confidence interval (CI), 0.572-0.916], with a sensitivity of 98.8%, a specificity of 50%, a positive predictive value (PPV) of 92.4%, and a negative predictive value (NPV) of 87.5%. The segment-based analysis revealed an AUC of 0.915 (95% CI, 0.847-0.982), with a sensitivity of 93.5%, a specificity of 95%, a PPV of 77.6%, and an NPV of 98.7%. The vessel-based analysis revealed an AUC of 0.887 (95% CI, 0.808-0.966), with a sensitivity of 94.3%, a specificity of 87.3%, a PPV of 82.7%, and an NPV of 95.9%.256-Row CTA is a highly sensitive test of CAD and has a high predictive value. 256-Row CTA may be a potential alternative to detect coronary artery stenosis and rule out CAD in suspected patients.