单排螺旋CT检查在冠状动脉钙化诊断中的应用价值分析

目的探讨单排螺旋CT检查在冠状动脉钙化诊断中的应用价值。方法选取2011年6月—2013年3月我院收治的疑似冠心病患者74例,均采用单排螺旋CT扫描机与冠状动脉造影检查,冠状动脉造影检查为诊断冠心病的"金标准",观察单排螺旋CT诊断冠状动脉钙化的特异度、敏感度与准确度。结果单排螺旋CT诊断冠状动脉钙化的敏感度为93.3%,特异度为86.2%,阳性预测值为91.6%,阴性预测值为89.3%。冠心病患者钙化积分为(226.7±167.9)分,高于非冠心病患者的(21.4±3.8)分(P0.05)。不同年龄患者冠状动脉钙化积分比较,差异有统计学意义(P0.05),其中75岁者高于66~75岁者高于51~65岁者高于≤50岁者(P0.05)。结论在冠状动脉钙化诊断中,单排螺旋CT检查具有较高的临床应用价值,且具有无创伤、操作简单、检出率高、安全准确等优点,不仅能早期诊断冠心病,还是筛查冠心病患者冠状动脉钙化的有效手段。     

冠状动脉钙化螺旋CT检查与冠脉造影的对比研究

目的：探讨螺旋CT对冠心病的诊断价值。方法：对38例疑诊冠心病的患进行螺旋CT和冠脉造影检查，并对两种检查的结果进行对比分析。结果：以冠脉造影结果为依据，螺旋CT检查冠脉钙化诊断冠心病的敏感性为86％，特异性为69％，准确性为78％。结论：螺旋CT检查冠脉钙化诊断冠心病的敏感性，准确性较好，简便、易行，无创伤，有临床推广的价值。     

多层螺旋CT量化冠状动脉钙化的评价

目的 :探讨多层螺旋 CT（multi- slice spiral CT,MSCT）量化冠状动脉钙化的临床价值。方法 :对 4 1例临床可疑冠心病患者进行 MSCT冠脉成像及其钙化的量化分析 ,并与选择性冠状动脉造影 （CAG）进行对照。结果 :MSCT对冠状动脉钙化显示清晰 ;MSCT冠状动脉造影 （multi- slice spiral CT coronary angiography,MSCTCA）对冠状动脉各分支显示良好 ,其狭窄程度与冠脉造影一致。结论 :MSCT可作为冠心病普查和冠脉术后复查的较好方法。     

多排螺旋CT对冠状动脉钙化的检测

冠状动脉钙化是冠状动脉粥样硬化病变标志之一,反映了粥样硬化斑块,特别是钙化斑块的存在和分布。在过去10余年里,大量电子束CT研究围绕冠状动脉钙化的临床价值、检测方法和可重复性以及冠状动脉钙化演变等热点课题而展开。随着多排螺旋CT的不断发展和普及,它在冠状动脉钙化检测方面的价值也在进行研究,该文就多排螺旋CT在这些方面研究现状作一综述。     

多排螺旋CT对冠状动脉钙化的检测

冠状动脉钙化是冠状动脉粥样硬化病变标志之一,反映了粥样硬化斑块,特别是钙化斑块的存在和分布。在过去10余年里,大量电子柬CT研究围绕冠状动脉钙化的临床价值、检测方法和可重复性以及冠状动脉钙化演变等热点课题而展开。随着多排螺旋CT的不断发展和普及。它在冠状动脉钙化检测方面的价值也在进行研究,该文就多排螺旋CT在这些方面研究现状作一综述。     

64层螺旋CT冠状动脉成像技术与冠心病的诊断

目的 探讨64层螺旋CT冠状动脉(冠脉)成像技术在冠心病诊断中的应用价值.方法 临床初诊疑为冠心病103例,既往无冠脉成形术和搭桥术史,行冠脉64层螺旋计算机断层摄影术(MSCT)后,回顾性分析重建心电门控轴位图像,对所有冠脉及其分支进行重建,计算冠脉钙化积分并估计管腔狭窄程度,来预测冠心病.冠脉造影确诊冠心病者80例,排除23例,根据造影结果判断MSCT对冠心病的预测价值.结果 (1)冠心病组的钙化积分明显高于同年龄段的非冠心病组;(2)两组的冠脉钙化积分均随着年龄的增长而增高;(3)钙化血管支以左前降支最多见,且随着钙化血管支数的增加,钙化积分逐渐增高;(4)64层MSCT具有较高的时间和空间分辨率,重建冠状动脉,直径>1.5 mm血管存在的>50%的狭窄,男性诊断敏感性为92.16%.特异性为83.33%,阳性预测值为89.36%,阴性预测值为88.89%;女性诊断敏感性为91.57%,特异性为92.30%,阳性预测值为88.46%,阴性预测值为90.32%.结论 在患者心率<80次/分钟时,64层MSCT即可获得较好的图像质量用于评价冠脉并判断其狭窄程度,是检查冠脉有无狭窄的无创伤性方法.     

电子束CT检测的冠状动脉钙化诊断冠心病的价值

目的:探讨电子束CT(EBCT)检测确定的冠状动脉钙化(CAC)诊断冠心病的价值。方法:同期行EBCT和ECG检查的临床怀疑或确诊的冠心病患者420例,其中:同期行超声心动图(UCG)检查195例,作选择性冠状动脉造影56例,作3种检查的有38例。结果:CAC率和积分(SC)在ECG、UCG各组中差异均有显著性(P<0.01~<0.001)。CAC、CS在冠脉造影显示的不同狭窄程度与病变支数各组中有显著差异(P<0.05~<0.01)。CAC诊断的敏感性、特异性和准确分别达到79.3％、74.1％、76.8％,均显著高于ECG、UCG组(P<0.05)。结论:EBCT检测的CAC诊断冠心病的准确性等指标高于ECG、UCG法。     

应用螺旋CT心脏扫描诊断中老年冠状动脉粥样硬化钙化的经验及意义

冠状动脉粥样硬化钙化（冠脉钙化）是冠心病的标志物，发现冠脉钙化对冠心病的早期诊断有一定意义。本文报告作者应用螺旋CT心脏扫描诊断中老年冠脉钙化的经验并探讨其临床意义。     

16层螺旋CT冠脉钙化积分在冠心病诊断中的价值

研究表明,冠状动脉钙化几乎仅发生于冠状动脉粥样硬化的部位,因此,冠状动脉钙化能可靠地反映冠状动脉粥样硬化的情况.冠状动脉钙化积分(coronary artery calcification score,CACS)可检测冠状动脉钙化,并对其作定量分析,对于发现冠状动脉粥样硬化的存在并在一定程度上评价冠状动脉硬化及狭窄情况有着重要的临床意义.多层螺旋CT (multislice spiral computed tomography,MSCT)是目前检测冠状动脉钙化的最佳手段.本研究利用16层螺旋CT结合回顾性心电门控技术,将钙化积分方法应用于CAD的诊断,并与选择性冠状动脉造影(selective coronary angiography,SCA)对照,评价多层螺旋CT对冠心病的诊断价值.     

64排螺旋CT诊断冠状动脉病变的临床价值

目的评价64排螺旋CT用于诊断冠状动脉病变的临床价值。方法连续入选66名冠心病患者，均行64排螺旋CT冠脉三雏成像和冠状动脉造影，以冠状动脉造影的结果为“金标准”，计算64排螺旋CT诊断冠状动脉病变的敏感性，特异性，假阳性率，假阴性率，阳性预测值，阴性预测值。结果对照冠状动脉造影，64排螺旋CT诊断冠脉病变的敏感性为93．02％，特异性为98．21％，假阳性率为1.79％，假阴性率为6．98％，阳性预测值为97．56％，阴性预测值为94．83％。结论64排螺旋CT对于诊断冠脉病变有较好的敏感性与特异性，可用于冠心病患者的筛查。但目前的技术水平和各项技术指标仍有待提高，还无法替代传统的血管造影。     

The impact of the menopause on coronary artery calcification examined by multislice computed tomography scanning

Background and aimsTo examine whether there is a difference in coronary artery calcification (CAC) scores between males and females aged above 50 years.Methods and resultsA total of 479 subjects aged between 40 and 70 years with no clinical or family history of cardiovascular disease (CVD) were enrolled for this study. All subjects were assessed by multislice CT scanning (MCTS), and the CAC scores obtained were assigned to one of four quartiles for further assessment and comparison. The main outcome evaluated was the percentage of high CAC scores and mean CAC scores, comparing males and females of different age groups.This study found that the percentage of high CAC scores increased markedly from 5% (40–49 age group) to 21.2% (50–59 age group) among females. The increase was significantly less when comparing males from different age groups (from 25% in the 40–49 age group to 31.2% in the 50–59 age group). Females had higher odds ratios (ORs) postmenopausally (4.3 in the 50–59 age group) than males in the same age group (1.6).ConclusionsThese initial findings seem to indicate that above 50 years of age, CAC is more dependent on age in females than in males, which might be due to the effect of the menopause.     

电子束CT检测冠状动脉钙化对诊断老年冠心病的价值

目的　探讨电子束CT检测冠状动脉钙化 (CAC)对诊断老年人冠心病的价值。方法　 2 2 9例老年患者行电子束CT检测CAC并计算每例的CAC总积分 ,行选择性冠状动脉造影以确定冠状动脉粥样硬化狭窄的有无及其程度。结果　 (1) 2 2 9例患者中 ,CAC检测阳性 2 2 0例 ,总阳性率 96 .0 7% ;造影显示有 2 13例存在不同程度的冠状动脉狭窄 ,其中 16 8例确诊为冠心病。 (2 )全组CAC诊断老年人冠心病的总体敏感性、特异性、阳性预测值和阴性预测值分别为 99%、13%、76 %和 89% ,诊断老年人冠状动脉粥样硬化的相应指标则分别为 97%、19%、94%和 33%。(3)老年男性组CAC诊断冠心病的敏感性较高特异性较低 ;老年女性则特异性较高而敏感性较低。综合考虑敏感性及特异性 ,对于老年男性 ,以CAC积分为 2 0 0作为诊断冠心病的分值较好 ,而对于老年女性则以 5 0作为诊断分值较佳。结论　电子束CT检测冠状动脉钙化对诊断老年人冠心病具有一定价值 ,但应结合性别和钙化分值进行综合分析。     

冠状动脉钙化与冠状动脉狭窄的相关性研究

目的探究冠心病患者冠状动脉钙化积分与冠状动脉狭窄的相关性。方法入选54例冠心病住院患者,年龄52～84岁,（平均68.47±9.35）岁;其中男性36例,女性18例,行16层螺旋计算机断层扫描,计算冠状动脉钙化积分,并与冠状动脉造影进行比较,分析冠状动脉总钙化积分及各冠状动脉节段（共分16个节段）钙化积分与冠状动脉造影所示冠脉狭窄程度的相关性,同时分析冠状动脉总钙化积分与年龄的相关性。结果冠状动脉总钙化积分与年龄呈正相关（r=0.372,P=0.009）、冠状动脉总钙化积分仅与部分冠状动脉节段狭窄程度呈正相关：RA（1#）、LAD（7#）、D1（9#）、LCX（11#）,（相关系数、P值分别为：r=0.499,P〈0.01;r=0.431,P〈0.01;r=0.440,P〈0.01;r=0.469,P〈0.01）。冠状动脉各节段钙化积分与对应血管节段狭窄程度相关分析结果提示：RA（1#）、LM（5#）、LCX（11#）节段钙化积分与对应节段狭窄程度呈正相关。结论总冠状动脉钙化积分与年龄呈正相关,提示随年龄增长冠状动脉钙化发生率增加,但冠状动脉钙化积分仅在部分冠状动脉节段与狭窄程度呈正相关,且限于三支冠状动脉近段。     

Coronary artery calcification detected by a mobile helical computed tomography unit and future cardiovascular death: 4-year follow-up of 6120 asymptomatic Japanese

In the present study, we performed a prospective follow-up study in a population which underwent chest computed tomography (CT) screening. A total of 6120 participants underwent a chest CT medical examination for lung cancer and tuberculosis in Nagano Prefecture, Japan, between 1996 and 1997. Computed tomography scanning was performed from the apex of the lung to the diaphragm at a tube voltage of 120kV and a tube current of 50mA. We measured the CT density of the coronary arteries in 5–7 slices where coronary arteries were detected. The CT density threshold for determining coronary artery calcification (CAC) was above +110 HU. In 2000, we investigated the number of deaths due to cardiac and noncardiac disease among the participants. Of the 6120 participants, 14 died of cardiac disease (9, myocardial infarction; 4, heart failure; and 1, angina pectoris) and 64 died of other diseases. Coronary artery calcification was detected in 10 of the patients who died of cardiac disease, and in 31 of those who died of other diseases. The prevalence of CAC was higher in the former than in the latter (71.4% vs 48.4%, P = 0.084). The relative risk of CAC for cardiac death was 2.66 (95% confidence interval: 0.76, 9.37). The findings of this study suggested that CAC detected in a mass chest CT screening by a mobile helical CT unit was predictive of future cardiovascular death.     

多层螺旋CT对冠状动脉支架通畅性的评价

目的：使用多层螺旋CT（MSCT）评价冠状动脉支架的通畅性和内腔的可视性.方法：使用16层螺旋CT对18例患者的29个支架进行评价,并与常规冠状动脉造影进行对照.结果：29个支架中MSCT可显示26例的支架内腔;其余3个支架不能用于狭窄评价.可用于狭窄评价的支架只有20%～80%的腔径能被显示.MSCT显示22个支架通畅,与常规冠状动脉造影相符合的有20个;MSCT显示4个支架闭塞,均经常规冠状动脉造影证实.结论：MSCT直接观察支架再狭窄存在局限性,但能较可靠地区分支架的开放和闭塞.     

Relationship between age,osteoporosis and coronary artery calcification detected by high-definition computerized tomography in Chinese elderly men

BackgroundFew studies have analyzed the relationship between bone mineral density (BMD) and coronary artery calcification (CAC) in older men, and it remains subject to debate. The present study was designed to evaluate the age-related acceleration of osteoporosis and CAC, as well as the relationship between BMD and CAC in Chinese elderly men.MethodsParticipants included 120 men older than 60 years. CAC was measured with high-definition computerized tomography. It is a highly sensitive technique for detecting the CAC and provides the most accurate CAC scores up to date.ResultsMean (standard deviation) age was 73 (8.5) years. For osteoporosis, there was a strongly inverse correlation between age and BMD of all scanned body parts (p < 0.05 for all) except the lumbar spine 1–4 (p > 0.05 for all). For CAC, there was a moderately positive correlation of agatston, volume and mass scores with age. CAC was present in 67% of participants. There was no significant correlation between all kinds of CAC scores including agatston, volume and mass scores, and BMD of all scanned body parts including lumbar spine 1–4, femoral neck, femoral trochanter and total femur (p > 0.05 for all). BMD of all these body parts had no ability to identify the CAC (p > 0.05 for all). Furthermore, on multiple linear regression analysis, the relationship between CAC scores and BMD remained statistically non-significant.ConclusionsAge constituted an important factor common for loss of BMD and development of CAC detected by HDCT, and no direct relationship was observed between osteoporosis and CAC in Chinese elderly men.     

Prognostic value of coronary CT angiography

Coronary computed tomography angiography (CTA) is a highly accurate noninvasive test that is increasingly used in symptomatic patients primarily for the diagnosis of coronary artery disease (CAD). Beyond its proven accuracy, data have now clearly demonstrated the incremental prognostic information available from coronary CTA related to the presence, extent, and severity of obstructive and nonobstructive CAD across a variety of clinical settings and patient populations. Current evidence supports the use of coronary CTA not only for the diagnosis of CAD in appropriately selected symptomatic patients but also to further refine their cardiovascular risk assessment following testing.