16層高解析電腦斷層攝影於冠狀動脈疾病診斷與追蹤的臨床醫學應用
Date Issued
2005-07-31
Date
2005-07-31
Author(s)
李文正
DOI
932314B002190
Abstract
PURPOSE: The amount of calcium deposition in coronary artery is correlated
with the risk of coronary artery disease. However, the usefulness of coronary calcium
scoring in clinical practice is not well established. Multidetector computed
tomography (MDCT) can noninvasively measure the total coronary calcium burden.
The purpose of this study is to determine the ability of low or intermediate calcium
score to diagnose the presence of significant coronary artery disease in different age
groups.
MATERIALS AND METHODS: In this prospective study, coronary calcium
scoring and angiography by MDCT (Lightspeed16, GE healthcare, Milwaukee) and
conventional angiography were performed in 89 consecutive patients with clinically
suspected coronary artery disease. Coronary calcium scoring were calculated on a
workstation (Advantage Workstation, GE healthcare, Milwaukee). Patients without
previous coronary intervention history were included for analysis. Conventional
angiography results were used to determine the presence of significant obstructive
coronary artery disease (luminal stenosis >50%).
RESULTS: A total of 89 patients underwent MDCT study, aged 60.6 ± 11.1
(mean ± SD). Receiver operating characteristic curve analysis was 0.804 ± 0.046 for
significant stenosis (>50% diameter). 54 patients with calcium score below 100 were
noted among the 89 patients(54/89, 60.7%). In this group, 9 out of the 32 patients
under 60 years old and 7 out of the 22 patients aged 60 or above were identified as
having significant obstructive coronary artery disease (28.1% vs 31.8%, respectively)
in both conventional and MDCT angiography. The mean calcium core was 27.2 ±
29.6 (<60 years old) and 66.3 ± 35.0 (≥60 years old), respectively. 16 patients with
calcium score between 100 and 400 were noted (16/89, 18.0%), of whom 4 out of the
5 patients under 60 years old and 3 out of the 11 patients aged 60 or above were
identified as having significant obstructive coronary artery disease (positive
predictive value 80.0% vs 27.2%, respectively).
CONCLUSION: A low coronary calcium score (<100) is not an ideal indicator
to exclude the presence of significant obstructive coronary artery disease for patients
having a high risk for coronary artery disease regardless of their age. For patients
aged 60 or more, a calcium score between 100 and 400 is not a sensitive marker for
the presence of significant obstructive coronary artery disease.
Subjects
computed tomography
coronary artery disease
calcification
angiography
Publisher
臺北市：國立臺灣大學醫學院放射線科
Type
journal article
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