血管特异性冠状动脉钙化评分在检测冠状动脉狭窄方面的诊断效果。

IF 0.4 4区 医学
Iranian Red Crescent Medical Journal Pub Date : 2014-12-30 eCollection Date: 2014-12-01 DOI:10.5812/ircmj.26010
Marzieh Motevalli, Hossein Ghanaati, Kavous Firouznia, Jalal Kargar, Mounes Aliyari Ghasabeh, Mona Shahriari, Amir Hosein Jalali, Madjid Shakiba
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引用次数: 0

摘要

背景:通过冠状动脉钙化评分定量确定的冠状动脉钙化被认为是冠状动脉狭窄的标志,因此也是未来心脏事件的征兆;近年来,冠状动脉钙化一直是研究人员关注的焦点。由于冠状动脉疾病(CAD)是导致人口死亡的首要原因,因此开发不同的方法来早期、最佳地检测冠状动脉疾病(CAD)确实非常重要:评估血管特异性冠状动脉钙化(CAC)评分在预测阻塞性冠状动脉疾病方面的预测价值:在这项诊断测试研究中,我们对伊朗德黑兰两家放射学转诊中心转诊的冠状动脉计算机断层扫描(CCTA)和CAC评分患者进行了评估,最后以单次和连续的模式选择了2525名患者进行诊断研究。我们按两个不同的组别分别计算了 A 组(既往有 CABG 病史的患者)和 B 组(无 CABG 病史的患者)4 条主要心外冠状动脉的全心 CAC 评分和血管特异性 CAC 评分。评估阻塞树的截断点如下0>;至少有1段有任何形式的狭窄,≥50;至少有1段狭窄≥50,≥70;至少有1段狭窄≥70:正常患者 LAD、RCA、LCX 的平均 CAC 得分分别为 6.06、6.21 和 5.04,而完全狭窄患者的平均 CAC 得分分别为 221.6、226.7 和 106.6。此外,通过增加四条血管的钙化评分临界值,敏感性降低,特异性增加,但窃取 LAD 的敏感性高于其他血管,而 LM 的特异性更高。因此,使用钙评分法有助于排除 LAD 血管狭窄,而 LM 的钙评分可以预测 LM 是否存在狭窄。然而,没有一种血管特异性 CAC 的敏感性和特异性能达到 CCTA 方法的 100%:结论:CCTA 比血管特异性 CAC 评分更有优势,因此,为了最大限度地减少对患者的辐射,我们或许可以在 CCTA 开始时取消常规进行的 CAC 扫描。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Diagnostic efficacy of vessel specific coronary calcium score in detection of coronary artery stenosis.

Diagnostic efficacy of vessel specific coronary calcium score in detection of coronary artery stenosis.

Diagnostic efficacy of vessel specific coronary calcium score in detection of coronary artery stenosis.

Diagnostic efficacy of vessel specific coronary calcium score in detection of coronary artery stenosis.

Background: Coronary artery calcification which is determined quantitatively by coronary calcium scoring has been known as a sign of coronary stenosis and thus future cardiac events; hence it has been noticed on spotlight of researchers in recent years. Developing different method for early and optimal detection of coronary artery disease (CAD) is really essential as CAD are the first cause of death in population.

Objectives: To evaluate predictive value of vessel specific coronary artery calcium (CAC) score in predicting obstructive coronary artery disease.

Patients and methods: In this diagnostic test study we evaluated patients with coronary computed tomography angiography (CCTA) and CAC score which had been referred to two referral radiology center in Tehran, Iran and finally we selected 2525 patients in a single and sequential pattern to create a diagnostic study. The whole-heart CAC scores and vessel specific CAC scores were calculated individually for the 4 major epicardial coronary arteries in 2 distinct group; group A ( patients with previous history of CABG) and group B (patients without history of CABG). For evaluation of obstruction tree cut off points were described: 0 > ; at least 1 segment with any kind of stenosis, ≥ 50; at least 1 segment with stenosis ≥ 50, ≥ 70; at least 1 segment with stenosis ≥ 70.

Results: Mean of coronary calcium scores in terms of each coronary artery vessel increase by increasing coronary stenosis grade in group B; LAD, RCA, LCX respectively have mean CAC score 6.06, 6.21 and 5.04 in normal patients and 221.6, 226.7 and 106.6 in patients with complete stenosis. As expected these findings don't work for group A. Also By increasing calcium score cutoff in all four vessels sensitivity decreased and specificity increased but steal LAD had higher sensitivity than other vessels and LM had higher specificity. Thus using calcium score method is useful for ruling out stenosis in LAD while calcium score of LM can predict existence of stenosis in LM. However none of the vessel specific CAC can reach to 100% sensitivity and specificity of CCTA method.

Conclusions: CCTA is highly superior than vessel specific CAC score thus to minimize patients radiation does maybe we can eliminate CAC scan as a routinely perform procedure at the beginning of the CCTA.

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来源期刊
Iranian Red Crescent Medical Journal
Iranian Red Crescent Medical Journal 医学-医学:内科
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期刊介绍: The IRANIAN RED CRESCENT MEDICAL JOURNAL is an international, English language, peer-reviewed journal dealing with general Medicine and Surgery, Disaster Medicine and Health Policy. It is an official Journal of the Iranian Hospital Dubai and is published monthly. The Iranian Red Crescent Medical Journal aims at publishing the high quality materials, both clinical and scientific, on all aspects of Medicine and Surgery
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