CAJ | 학술논문

目的:探讨双源CT冠状动脉成像(DSCTA)评价钙化斑块引起血管腔狭窄的准确性.方法:62例患者DSCTA显示冠状动脉一处或多处钙化斑块,并行冠状动脉造影(CAG)检查.钙化斑块大小分为小、中和大.使用各种后处理技术,以确定钙化斑块引起血管阻塞(狭窄管腔直径≥50%),无血管阻塞(狭窄管腔直径<50%),并与CAG比较.结果:DSCTA显示小钙化斑块122处,中44处,大86处.122处小钙化斑块,5%CAG显示有梗阻;44处中钙化斑块,14%梗阻;86大钙化斑块,42%有梗阻.DSCTA与CAG一致95%(116/122)小钙化斑块、91%(40/44)中钙化斑块、67%(58/86)大钙化斑块.DSCTA低估2例小钙化斑块血管腔狭窄,高估4例小钙化斑块、4例中钙化斑块、28例大钙化斑块血管腔狭窄.86处大钙化斑块引起的血管腔梗阻,DSCTA敏感性100%、特异性44%、阳性预测值56%、阴性预测值100%、准确性67%.结论 DSCTA准确显示90%以上小和中等大小钙化斑块血管阻塞病变,正确诊断约2/3大钙化斑块血管阻塞病变.判断错误通常是高估狭窄程度.
목적:탐토쌍원CT관상동맥성상(DSCTA)평개개화반괴인기혈관강협착적준학성.방법:62례환자DSCTA현시관상동맥일처혹다처개화반괴,병행관상동맥조영(CAG)검사.개화반괴대소분위소、중화대.사용각충후처리기술,이학정개화반괴인기혈관조새(협착관강직경≥50%),무혈관조새(협착관강직경<50%),병여CAG비교.결과:DSCTA현시소개화반괴122처,중44처,대86처.122처소개화반괴,5%CAG현시유경조;44처중개화반괴,14%경조;86대개화반괴,42%유경조.DSCTA여CAG일치95%(116/122)소개화반괴、91%(40/44)중개화반괴、67%(58/86)대개화반괴.DSCTA저고2례소개화반괴혈관강협착,고고4례소개화반괴、4례중개화반괴、28례대개화반괴혈관강협착.86처대개화반괴인기적혈관강경조,DSCTA민감성100%、특이성44%、양성예측치56%、음성예측치100%、준학성67%.결론 DSCTA준학현시90%이상소화중등대소개화반괴혈관조새병변,정학진단약2/3대개화반괴혈관조새병변.판단착오통상시고고협착정도.
Objective:To investigate how accurate of dual-source computed tomography coronary angiography (DSCTA) is in evaluating the degree of stenosis caused by calcified coronary artery plaques. Methods:62 patients who had one or more calcified coronary artery plaques of DSCCTA underwent CAG. The size of the calcified coronary artery plaques was graded subjectively as smal , moderate, or large. To determine whether the calcified lesions were obstructive (≥50%diameter narrowing) or nonobstructive (<50%diameter narrowing). Concordance with CAG was then determined. Resulds:Calcified coronary artery plaques were graded by DSCTCA as smal at 122 locations, moderate at 44 locations, and large at 86 locations. Of the 122 smal calcified coronary artery plaques, 5%were obstructive at CAG;of the 44 moderate-sized calcified coronary artery plaques, 14%were obstructive;and of the 86 large calcified coronary artery plaques, 42%were obstructive. Concordance between DSCTCA and CAG occurred in 116 of 122 (95%) smal calcified coronary artery plaques, 40 of 44 (91%) moderate-sized coronary artery plaques, and 58 of 86 (67%) large coronary artery plaques. DSCTCA underestimated the degree of stenosis in two smal calcified coronary artery plaque but overestimated the degree of stenosis in four smal , four moderate, and 28 large coronary artery plaques. In detecting obstructive lesions caused by the 86 large calcified coronary artery plaques, DSCTCA had a sensitivity of 100%, specificity of 44%, positive predictive value of 56%, negative predictive value of 100%, and accuracy of 67%. Conclusion:DSCTCA can be used to accurately predict the presence of obstructive disease in>90%of smal and moderate-sized calcified coronary artery plaques. With large calcified coronary artery plaques, DSCTCA correctly predicts the presence of obstructive disease in approximately two thirds of the cases. When errors occur, they are usual y due to overestimation of the degree of stenosis.