Evaluation of coronary stenosis and calcification by spiral CT

Abstract

From October 2004 to July 2005, 33 patients aging 43－81 years (14 males, 19 females) with diagnosed or suspected coronary artery disease who were treated at the Department of Cardiology, Affiliated Hospital of Xuzhou Medical College, were enrolled in this study for 16-slice multislice spiral computed tomography (MSCT) coronary angiography by using retrospective ECG gating with 0.4 s gantry rotation time. The results were compared with those obtained from the coronary artery angiography. A total of 396 coronary artery segments were evaluated in 33 patients, 344 (86.9%) of which were assessable. The sensitivity, specificity, positive predictive value and negative predictive value for detection of ≥ 50% stenosis by 16-slice MSCT coronary angiography were 87.7%, 94.3%, 78.0% and 97.0% respectively. Of all the 33 patients, 26 of them were diagnosed as coronary artery disease by coronary angiography, and 7 of them were excluded from the disease. The result of 16-slice MSCT coronary angiography showed that, 59 segments with calcification were detected in the patients with coronary artery disease, whereas the segments without calcification were 215 in these patients. Whereas 3 segments with calcification were detected in patients without coronary artery disease, and the segments without calcification were 67 in those patients. There was significant difference between these two kinds of patients (P < 0.005). In detecting coronary stenosis, high sensitivity, specificity and accuracy can be achieved by using 16-slice MSCT coronary angiography as noninvasive morphologic method to filter coronary artery disease. In addition, it can also detect the difference of calcification in coronary artery between coronary artery disease and non-coronary artery disease. If calcification is serious, coronary artery angiography should be recommended.

摘要
选择2004－10/2005－07在徐州医学院附属医院心内科住院的临床诊断或疑诊冠心病的患者33例作16层螺旋CT冠状动脉成像。男14例，女19例；年龄范围43～81岁。采用回顾性心电门控、0.4 s/周扫描，其结果与冠状动脉造影对照。共评价33例患者的396个冠状动脉节段，可用于诊断者344个节段，约占86.9%。对符合评价条件的冠状动脉节段16层螺旋CT诊断≥ 50%狭窄的敏感性、特异性、阳性预测值、阴性预测值分别为：87.7%，94.3%，78.0%，97.0%。根据冠状动脉造影结果，冠心病26例，非冠心病7例，16层螺旋CT发现冠心病患者含钙化节段59个，无钙化节段215个，非冠心病受检者中检出含钙化节段3个，无钙化节段67个。两者比较差异显著（P < 0.005）。16层螺旋CT显示冠状动脉狭窄具有较高的敏感性、特异性和准确性，可以作为筛选冠状动脉病变的影像学诊断方法。16层螺旋CT可发现冠心病与非冠心病冠状动脉钙化的差异，钙化广泛者应建议冠状动脉造影检查。
关键词：体层摄影术，X线计算机；冠状血管造影术；冠状动脉狭窄

刘素堂，徐凯，李东野，夏勇，李绍东，李江山，王志荣，张超群，张辉.螺旋CT评估冠状动脉狭窄与钙化的价值[J].中国组织工程研究与临床康复，2007，11(1):178-179 [www.zglckf.com/zglckf/ejournal/upfiles/07-1/1k-178(ps).pdf]