QUANTIFICATION OF CORONARY-ARTERY CALCIUM USING ULTRAFAST COMPUTED-TOMOGRAPHY
QUANTIFICATION OF CORONARY-ARTERY CALCIUM USING ULTRAFAST COMPUTED-TOMOGRAPHY
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DOI：
10.1016/0735-1097(90)90282-t
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发表时间：
1990-03-15
影响因子：
24
通讯作者：
DETRANO, R
中科院分区：
文献类型：
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作者：
AGATSTON, AS;JANOWITZ, WR;DETRANO, R
超快速计算机断层扫描用于检测和量化584名受试者（平均年龄48 ± 10岁）的冠状动脉钙水平。10年），有（n = 109）和无（n = 475）临床冠状动脉疾病。还对50名接受荧光透视和超快计算机断层扫描的患者进行了评价。从近端冠状动脉获得20个连续的3 mm切片。根据检测到的钙化病变的数量、面积和Hounsfield配对断层扫描峰值数量计算总钙评分。在88名受试者由两名读者独立评分，观察者之间的协议是优秀的，在70个相同的总分。超高速计算机断层扫描比荧光透视更敏感，分别在90%和52%的患者中检测到冠状动脉钙化。有临床冠状动脉疾病的患者与无临床冠状动脉疾病的患者之间的平均总钙评分存在显著差异（p < 0.0001）：年龄30 - 39岁，5分对132分;年龄40 - 49岁，27分对291分;年龄50 - 59岁，83分对462分;年龄60 - 69岁，187分对786分。根据每十年的几个总钙评分计算临床冠状动脉疾病的敏感性、特异性和预测值。对于40至49岁和50至59岁的年龄组，总分为50的敏感性分别为71%和74%，特异性分别为91%和70%。对于60至69岁的年龄组，总分为300的敏感性为74%，特异性为81%。0分的阴性预测值在40 - 49岁、50 - 59岁和60 - 69岁年龄组分别为98%、94%和100%。超快速计算机断层扫描是检测和定量冠状动脉钙的极好工具。
Ultrafast computed tomography was used to detect and quantify coronary artery calcium levels in 584 subjects (mean age 48 .+-. 10 years) with (n = 109) and without (n = 475) clinical coronary artery disease. Fifty patients who underwent fluoroscopy and ultrafast computed tomography were also evaluated. Twenty contiguous 3 mm slices were obtained of the proximal coronary arteries. Total calcium scores were calculated based on the number, areas and peak Hounsfield coputed tomographic numbers of the calcific lesions detected. In 88 subjects scored by two readers independently, interobserver agreement was excellent with identical total scores obtained in 70. Ultrafast computed tomography was more sensitive than fluoroscopy, detecting coronary calcium in 90% versus 52% of patients. There were significant differences (p < 0.0001) in mean total calcium scores for those with versus those without clinical coronary artery disease by decade: 5 versus 132, aged 30 to 39 years; 27 versus 291, age 40 to 49 years; 83 versus 462, aged 50 to 59 years, and 187 versus 786, aged 60 to 69 years. Sensitivity, specificity and predictive values for clinical coronary artery disease were calculated for several total calcium scores in each decade. For age groups 40 to 49 and 50 to 59 years, a total score of 50 resulted in a sensitivity of 71% and 74% and a specificity of 91% and 70%, respectively. For age group 60 to 69 years, a total score of 300 gave a sensitivity of 74% and a specificity of 81%. The negative predictive value of a 0 score was 98%, 94% and 100% for age groups 40 to 49, 50 to 59 and 60 to 69 years, respectively. Ultrafast computed tomography is an excellent tool for detecting and quantifying coronary artery calcium.