Detection of coronary artery stenoses with thin-slice multi-detector row spiral computed tomography and multiplanar reconstruction
Detection of coronary artery stenoses with thin-slice multi-detector row spiral computed tomography and multiplanar reconstruction
复制标题
DOI：
10.1161/01.cir.0000055738.31551.a9
复制
发表时间：
2003-02-11
期刊：
影响因子：
37.8
通讯作者：
Achenbach, S
中科院分区：
文献类型：
--
作者：
Ropers, D;Baum, U;Achenbach, S
背景-我们分析了多排螺旋CT（MDCT）的准确性，使用16层CT扫描仪，提高了空间和时间分辨率，以及常规术前β受体阻滞剂用于检测冠状动脉狭窄。方法和结果-77例疑似冠心病患者进行了MDCT研究（12x0.75 mm横截面，420 ms旋转，100 mL造影剂IV，5 mL/s）。心率高于60/min的患者在扫描前接受50 mg阿替洛尔。在轴位MDCT图像和多平面重建中，评估直径≥ 1.5 mm的所有冠状动脉和侧支是否存在直径缩小超过50%的狭窄。与有创冠状动脉造影相比，MDCT正确分类了41例患者中的35例（85%）至少有1处冠状动脉狭窄，并正确检测了78处冠状动脉病变中的57处（73%）。排除了308支冠状动脉中的38支后MDCT（12%）分类为不可评价的病变（77例患者的左主干、左前降支、左回旋支和右冠状动脉），检出62处病变中的57处，208处动脉中的194处正确识别为无狭窄（敏感性：92%;特异性：93%;准确性：93%;阳性和阴性预测值：79%和97%）。结论：空间分辨率提高的MDCT冠状动脉造影和术前口服β-阻断允许以高精度和低比率的不可评估动脉检测冠状动脉狭窄。
Background-We analyzed the accuracy of multi-detector row spiral computed tomography (MDCT) using a 16-slice CT scanner with improved spatial and temporal resolution, as well as routine premedication with beta-blockers for detection of coronary stenoses.Methods and Results-Seventy-seven patients with suspected coronary disease were studied by MDCT (12x0.75-mm cross-sections, 420 ms rotation, 100 mL contrast agent IV at 5 mL/s). Patients with a heart rate above 60/min received 50 mg atenolol before the scan. In axial MDCT images and multiplanar reconstructions, all coronary arteries and side branches with a diameter of 1.5 mm or more were assessed for the presence of stenoses exceeding 50% diameter reduction. In comparison to invasive coronary angiography, MDCT correctly classified 35 of 41 patients (85%) as having at least 1 coronary stenosis and correctly detected 57 of 78 coronary lesions (73%). After excluding 38 of 308 coronary arteries (left main, left anterior descending, left circumflex, and right coronary artery in 77 patients) classified as unevaluable by MDCT (12%), 57 of 62 lesions were detected, and absence of stenosis was correctly identified in 194 of 208 arteries (sensitivity: 92%; specificity: 93%; accuracy: 93%; positive and negative predictive values: 79% and 97%).Conclusions-MDCT coronary angiography with improved spatial resolution and premedication with oral beta-blockade permits detection of coronary artery stenoses with high accuracy and a low rate of unevaluable arteries.