https://scholars.lib.ntu.edu.tw/handle/123456789/201305
標題: | 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 | 作者: | 李文正 | 關鍵字: | 電腦斷層;冠狀動脈疾病;鈣化;血管攝影;computed tomography;coronary artery disease;calcification;angiography | 公開日期: | 31-七月-2005 | 出版社: | 臺北市:國立臺灣大學醫學院放射線科 | 摘要: | 冠狀動脈鈣質沉積的數量是很重要的冠狀動脈血管疾病指標,但是鈣質沉積 的血管卻不ㄧ定會引起症狀。16 層高解析度電腦斷層掃描機可以非侵入式的測 量冠狀動脈鈣化量。本研究目的在於分析低鈣化分數在不同年齡層是否可以有 效的排除冠狀動脈狹窄的可能性。 經由病患同意,本研究對於89 位疑似冠狀動脈疾病的病患進行16 層高解析 度電腦斷層掃描與傳統的冠狀動脈血管攝影。經由統計分析發現,使用鈣化分 數來預測冠狀動脈狹窄的ROC 曲線面積為0.804 ± 0.046。有54 位病患鈣化分 數低於100 分(54/89, 60.7%),而其中32 位60 歲以下的病患有9 位有顯著的冠 狀動脈狹窄,22 位60 歲以上的病患有7 位有顯著的冠狀動脈狹窄(28.1% vs 31.8%)。平均鈣化分數為27.2 ± 29.6 (<60 歲) 與 66.3 ± 35.0 (≥60 歲)。有54 位 病患鈣化分數介於100 至400 分(16/89, 18.0%),其中5 位60 歲以下的病患有4 位有顯著的冠狀動脈狹窄,11 位60 歲以上的病患有3 位有顯著的冠狀動脈狹 窄(80.0% vs 27.2%) 本研究發現,低鈣化分數(<100),並不能代表沒有顯著的冠狀動脈狹窄, 而60 歲以上的病患具有100 至400 分的鈣化程度,也不代表一定有顯著的冠狀 動脈狹窄。 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. |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/25440 | 其他識別: | 932314B002190 | Rights: | 國立臺灣大學醫學院放射線科 |
顯示於: | 醫學系 |
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932314B002190.pdf | 244.21 kB | Adobe PDF | 檢視/開啟 |
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