CAJ | 학술논문

目的探讨多层螺旋CT(MSCT)在心肌桥中的诊断能力.方法对51例临床怀疑为冠状动脉粥样硬化性心脏病的患者进行了MSCT、常规冠状动脉造影(CAG)以及血管内超声检查(将后2种检查方法统称为创伤性技术),共82支冠状动脉,其中的80支冠状动脉无明显伪影,可供评价.分别统计MSCT对心肌桥检出的敏感度、特异度和准确度.观察者间的一致件检验采用Cohen Kappa检验方法.结果CAG及血管内超声共发现26例心肌桥,所有心肌桥均发生于左前降支中段附近.MSCT正确检出26例前降支心肌桥巾的23例,其敏感度88%(23/26),特异度96%(52/54),准确度94%(75/80),2名医师对心肌桥的检出Kappa值为0.62.MSCT尚检出2例心肌桥,为创伤性技术所漏诊.将创伤性技术和MSCT综合结果作对照,则MSCT心肌桥检出的敏感度、特异度和准确度分别为89%(25/28)、91%(21/23)和90%(46/51).结论MSCT作为一种无创性成像方法应用于心肌桥的诊断,方法可行,结果可靠.
목적 탐토다층라선CT(MSCT)재심기교중적진단능력.방법 대51례림상부의위관상동맥죽양경화성심장병적환자진행료MSCT、상규관상동맥조영(CAG)이급혈관내초성검사(장후2충검사방법통칭위창상성기술),공82지관상동맥,기중적80지관상동맥무명현위영,가공평개.분별통계MSCT대심기교검출적민감도、특이도화준학도.관찰자간적일치건검험채용Cohen Kappa검험방법.결과CAG급혈관내초성공발현26례심기교,소유심기교균발생우좌전강지중단부근.MSCT정학검출26례전강지심기교건적23례,기민감도88%(23/26),특이도96%(52/54),준학도94%(75/80),2명의사대심기교적검출Kappa치위0.62.MSCT상검출2례심기교,위창상성기술소루진.장창상성기술화MSCT종합결과작대조,칙MSCT심기교검출적민감도、특이도화준학도분별위89%(25/28)、91%(21/23)화90%(46/51).결론MSCT작위일충무창성성상방법응용우심기교적진단,방법가행,결과가고.
Objective To investigate the ability of electrocardiogram-gated multislice CT(MSCT)in the diagnosis of myocardial bfidging.Methods Fifty-one patients(82 coronary arteries)with suspected coronary artery disease underwent multi-detector row CT,conventional coronary angiography and intravascular ultrasonography as well.The sensitivity,specificity and accuracy of MSCT for the detection of myocardial bridging were determined.The interobserver agreement was calculated by using Cohen's Kappa test.Results A total of 26 tunneled arteries exclusively located near the middle segment of left anterior descending coronary artery were found by coronary angiography and intravascular uhrasonography.Compared to the invasive methods,MSCT correctly detected 23 of 26 myocardial bridges with a sensitivity of 88%(23/26),specificity of 96%(52/54)and accuracy of 94%(75/80).The Kappa value for overall interobserver variation Was 0.62.Two myocardial bridges diagnosed by MSCT were missed with the invasive method.With the results of invasive and non-invasive methods combined as the standard of reference,the overall sensitivity.specificity,and accuracy of MSCT in detecting myocardial bridging were 89%(25/28),91%(21/23),and 90%(46/51),respectively.Conclusion As a non-invasive imaging modality,MSCT is feasible and reliable in the detection of myocardial bridging.