冠状动脉钙化斑块对CTA诊断冠状动脉狭窄准确性的影响

目的通过与经皮冠状动脉造影(CAG)对照,评价不同钙化积分负荷下,冠状动脉CT血管造影(CTA)对病变血管狭窄程度判断的准确性。方法收集2008年6月—2012年5月100例拟行CAG检查的患者进行钙化积分与冠状动脉CTA检查。Agatston积分及钙化容积以血管段为单位统计,并以四分位法分成不同钙化积分负荷组,分析不同钙化积分组每段血管管腔狭窄程度,并与CAG结果对照,统计不同钙化积分对冠状动脉CTA诊断管腔狭窄程度准确性的影响。结果当钙化容积≤79 mm~3时诊断敏感性、特异性分别为96.9%和96.7%;钙化容积≥80 mm~3时,分别为100%和90.9%。在钙化积分≤65分的冠状动脉段中,与冠脉造影比较,诊断准确性较高,而钙化积分>180分的冠状动脉段中,诊断准确性较差。结论不同钙化斑块负荷对冠状动脉CTA诊断准确性的影响不同,钙化病变的体积大小及斑块内钙化成分含量的多少是影响冠状动脉CTA诊断准确性的主要因素之一。

Accuracy of calcified coronary artery assessment by CTA in different calcification burden groups

Objective To evaluate diagnostic accuracy of calcified coronary artery in different calcification score groups,find out cut-off point in calcification score as predictors for diagnostic accuracy of CTA.Methods 100 patients have been included so far.They underwent both 64 MSCT and coronary angiography.Agatston and volume scores were calculated based on segment;those scores were divided by quartiles into different groups.MSCT datasets were analyzed by software with quantitative coronary artery analysis tool based on segment.In different groups,sensitivity and specificity were calculated, ROC curve were performed to find out cutoff point that could predict diagnostic accuracy.Results MSCT showed sensitivity and specificity of 96.9%and 96.7%when volume score≤79 mm~3（cut-off point）,100%and 90.9%when volume scored 80 mm,In coronary segment which Agatston score≤65（cut-off point）,the diagnostic accuracy was higher than CA,while in coronary segment which Agaston score 180,the diagnostic accuracy was lower.Conclusion In this study,initial results showed cut-off point of calcification score could predict diagnostic accuracy of calcified arteries.