Initial experience with 64-slice cardiac CT: non-invasive visualization of coronary artery bypass grafts.
Initial experience with 64-slice cardiac CT: non-invasive visualization of coronary artery bypass grafts.
复制标题
64 层心脏 CT 初步体验：冠状动脉旁路移植术的无创可视化。
作者：
G. Pache;U. Saueressig;A. Frydrychowicz;D. Foell;N. Ghanem;E. Kotter;A. Geibel;C. Bode;M. Langer;T. Bley
旨在
本研究的目的是评价使用64层计算机断层扫描（CT）技术评估冠状动脉旁路移植术的诊断准确性。
方法和结果
应用Siemens Sensation 64层螺旋CT扫描机对31例可疑冠心病患者的96个旁路进行了CT冠状动脉造影，并与有创冠状动脉造影（伊卡）进行了比较。尽管给予β受体阻滞剂，但心率不规则或心率过快的患者未被排除在研究之外。CT可显示所有旁路移植物和94%的远端旁路移植物闭塞，不可评价的远端动脉闭塞是由于金属夹材料或钙化伪影所致。CT检测到42例旁路移植物闭塞和3例明显狭窄，并经伊卡证实。两个静脉移植物被遗漏，一个动脉移植物无法用伊卡评估，但两者都被多层CT清楚地描绘。一个假阴性和两个假阳性CT结果导致敏感性为97.8%，特异性为89.3%，阳性预测值为90%，阴性预测值为97.7%。
结论
最先进的64层CT冠状动脉血管造影术在评估动脉和静脉旁路移植物狭窄方面具有较高的诊断准确性。
AIMS
The aim of this study was to evaluate the diagnostic accuracy in the assessment of coronary artery bypass grafts using 64-slice computed tomography (CT) technology.
METHODS AND RESULTS
CT coronary angiography was performed for 96 bypasses in 31 patients with suspected coronary artery disease using a Siemens Sensation 64-slice CT-scanner and compared with invasive coronary angiography (ICA). Patients with an irregular or fast heart rate despite beta-blocker administration were not excluded from the study. All bypass grafts and 94% of the distal bypass anastomoses could be visualized by CT, non-evaluable distal arterial anastomoses were either due to clip material or calcification artefacts. Forty-two bypass graft occlusions and three significant stenoses were detected by CT and confirmed by ICA. Two venous grafts were missed and one arterial graft was not evaluable with ICA, but both were clearly depicted by multi-slice CT. One false negative and two false positive CT-findings resulted in a sensitivity of 97.8%, a specificity of 89.3%, a positive predictive value of 90%, and a negative predictive value of 97.7%.
CONCLUSION
State-of-the-art 64-slice CT coronary angiography demonstrates high diagnostic accuracy in the assessment of arterial and venous bypass graft stenoses.