冠状动脉钙化积分评价的新方法及临床应用的初步探讨  

Preliminary study on new method for evaluation of coronary artery calcification score and its clinical application

作　　者：王启蒙[1] 翟继良[2] 张海静 李江[2] 李理[2] 李敏[2] 杨林峰[2] 孙钢[2] 

机构地区：[1]泰山医学院,山东泰安271000 [2]济南军区总医院 [3]济南军区26集团军防化团

出　　处：《实用放射学杂志》2013年第5期748-751,共4页Journal of Practical Radiology

摘　　要：目的探讨在冠状动脉CT造影（CT coronary angiography,CTCA）中评估钙化积分的准确性以及对冠状动脉显著狭窄的预测能力，减少病人的辐射剂量。方法前瞻性研究包括73例患者（女25例，男48例，平均年龄60．27岁±9．78岁，年龄范围34482岁），使用320排容积CT进行扫描，并对传统钙化积分图像及CTCA图像中分别评估钙化积分。利用Spearman相关分析评价两者的相关性。利用ROC工作曲线，以冠状动脉造影（ICA）结果为参考标准，对比传统钙化积分与造影后钙化积分预测冠状动脉管腔显著狭窄的诊断能力。结果传统钙化积分的平均值为365±514，造影后钙化积分平均值为404±572，两者呈高度相关（r=0．977，P〈0．01）。传统的钙化积分曲线下面积（area under the curve,AUC）为0．859，95％C10．774-0．945，CTCA中评估的钙化积分AUC为0．863，95％C10．779-0．947。结论CTCA中评估的钙化积分与传统平扫钙化积分有良好的相关性和准确性，从而可以略过单纯的钙化积分扫描，进一步降低病人的辐射剂量。Objective To investigate the accuracy of calcium score （CS） in CT coronary angiography （CTCA} and its predictive value for significant coronary stenosis in order to reduce the radiation dose. Methods 73 patients were enrolled in the prospective study and underwent CTCA with 320-row volume CT scanner. CS was assessed using traditional method and CTCA respectively. The correlation between two methods were evaluated using Spearman analysis. Regarding ICA as a reference standard,the capability to predict obvious coronary stenosis with two methods was compared using ROC curve. Results The average value of traditional CS and CSin CTCA were 365±514 and 404±572 respectively,exhibiting a close correlation （ r=0.977 , P（0.01 ） .The area under the curve（ AUC ） for traditional CS was 0. 859,95% CI 0. 774-0. 945,while the value for CS in CTCA was 0. 863,95% CI 0. 779-0. 947. Conclusion CS in CTCA is correlated with traditional CS. Thus traddifional CS scanning may be skipped in order to reduce the radiation dose.

关 键 词：冠状动脉 Agatston积分 冠状动脉钙化 血管成像 计算机体层成像 

分 类 号：R543.3[医药卫生—心血管疾病] R814.42[医药卫生—内科学]