Diagnostic accuracy of non-invasive 64-slice CT coronary angiography in patients with stable angina pectoris
Diagnostic accuracy of non-invasive 64-slice CT coronary angiography in patients with stable angina pectoris
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DOI：
10.1007/s00330-005-0041-0
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发表时间：
2006-03-01
影响因子：
5.9
通讯作者：
Cademartiri, F
中科院分区：
文献类型：
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作者：
Pugliese, F;Mollet, NRA;Cademartiri, F
多层计算机断层扫描（CT）是一种新兴的技术，用于无创检测冠状动脉狭窄。虽然4层扫描仪的诊断准确性是有限的，但16层CT成像仪由于提高了时间和空间分辨率而显示出有希望的结果。这些技术进步促使我们评价64层CT冠状动脉造影术与侵入性定量冠状动脉造影术（QCA）在检测显著狭窄（定义为管腔直径减小>= 50%）方面的诊断性能。35例稳定型心绞痛患者在常规冠状动脉造影术前接受了64层扫描仪（机架旋转时间330 ms，单个探测器宽度0.6 mm）进行的CT冠状动脉造影术。心率> 70次/分的患者口服100 mg美托洛尔。以5 ml/s的速率将100 ml碘浓度为400 mgl/ml的造影剂注入肘前静脉。使用团注追踪技术触发CT扫描。64层螺旋CT诊断乳腺癌的敏感性、特异性、阳性预测值和阴性预测值分别为99%、96%、78%和99%。在每例患者基础上获得的值分别为100%、90%、96%和100%。当转介导管是可疑的，CT冠状动脉造影可以识别正常血管造影的受试者，并不断减少不必要的侵入性手术的数量。
Multislice computed tomography (CT) is an emerging technique for the non-invasive detection of coronary stenoses. While the diagnostic accuracy of 4-slice scanners was limited, 16-slice CT imagers showed promising results due to increased temporal and spatial resolution. These technical advances prompted us to evaluate the diagnostic performance of 64-slice CT coronary angiography in the detection of significant stenoses (defined as >= 50% luminal diameter reduction) versus invasive quantitative coronary angiography (QCA). Thirty-five patients with stable angina pectoris underwent CT coronary angiography performed with a 64-slice scanner (gantry rotation time 330 ms, individual detector width 0.6 mm) prior to conventional coronary angiography. Patients with heart rates > 70 beats/min received 100 mg metoprolol orally. One hundred millilitres of contrast agent with an iodine concentration of 400 mgl/ml were injected at a rate of 5 ml/s into the antecubital vein. The CT scan was triggered with the bolus tracking technique. The sensitivity, specificity and the positive and negative predictive values of 64-slice CT were 99%, 96%, 78% and 99%, respectively, on a per-segment basis. The values obtained on a per-patient basis were 100%, 90%, 96% and 100%, respectively. When referral to catheterisation is questionable, CT coronary angiography may identify subjects with normal angiograms and consistently decrease the number of unnecessary invasive procedures.