采用16排多层计算机体层摄影冠状动脉造影术可提高诊断的精确性

作     者：Mollet N.R. Cademartiri F. Krestin G.P. 郝广华 

出 版 物：《世界核心医学期刊文摘（心脏病学分册）》 (Digest of the World Core Medical Journals(Cardiology))

年 卷 期：2005年第1卷第6期

页      面：56-57页

学科分类：0831[工学-生物医学工程（可授工学、理学、医学学位）] 100207[医学-影像医学与核医学] 1006[医学-中西医结合] 1002[医学-临床医学] 1001[医学-基础医学(可授医学、理学学位)] 08[工学] 1010[医学-医学技术（可授医学、理学学位）] 100106[医学-放射医学] 100602[医学-中西医结合临床] 10[医学] 

主　　题：计算机体层摄影 造影术 心脏扫描 非典型胸痛 严重病变 单支血管病变 稳定型心绞痛 管电流 管腔直径 阴性预测值 

摘      要：We sought to compare the diagnostic value of multi-slice computed tomography(MSCT)coronary angiography(CA)to detect significant stenoses( 50%lumen diameter reduction)-with that of invasive CA. The latest 16-row MSCT scanner has a faster rotation time(375 ms)and permits scanning with a higher X-ray tube current(500 to 600 mA)during MSCT CA when compared with previous scanners. We studied 51 patients(37 men, mean age 58.9±10.0 years)with stable angina or atypical chest pain. Patients with pre-scan heart rates 70 beats/min received oral beta-blockade. The heart was scanned after intravenous injection of 100 ml contrast(iodine content, 400 mg/ml). Mean scan time was 18.9±1.0 s. The MSCT scans were analyzed by two observers unaware of the results of invasive angiography, and all available coronary branches 2 mm were included. Invasive CA demonstrated normal arteries in 16%(8 of 51), non-significant disease in 21%(11 of 51), single-vessel disease in 37%(19 of 51), and multivessel disease in 26%(13 of 51)of patients. There were 64 significant lesions. Sensitivity, specificity, and positive and negative predictive values for detection of significant lesions on a segment-based analysis were 95%(61 of 64, 95%confidence interval [CI] 86 to 99), 98%(537 of 546, 95%CI 96 to 99), 87%(61 of 70, 95%CI 76 to 98), and 99%(537 of 540, 95%CI 98 to 99), respectively. All patients with angiographically normal coronary arteries or significant lesions were correctly identified. Three of 11 patients with 50%lesions were incorrectly classified as having single-vessel disease. The 16-row MSCT CA reliably detects significant coronary stenoses in patients with atypical chest pain or stable angina pectoris.