无创冠状动脉粥样硬化ct可视化:最新标准和自己的临床经验研究。

V V Lazoryshynets, S V Fedkiv, S V Potashev
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引用次数: 0

摘要

近年来,无创冠状动脉(CA)可视化技术发展迅速。现有的循证数据和试验表明,迫切需要能够可靠、准确地识别ca高危动脉粥样硬化斑块(AP)的无创技术,为个体动脉粥样硬化病理生理提供更多的见解,成为冠状动脉(CAD)患者的初步诊断和治疗干预指标的准确定性和定量方法。到目前为止,乌克兰还没有研究评估上一代640层ct冠状动脉造影(CTCA)诊断不同CAD形式的准确性。本研究的目的是比较CTCA与有创冠状动脉造影(iCAG)在不同形式的慢性冠心病术前诊断的准确性。材料和方法。从2019年1月到2021年5月,我们前瞻性研究了201例年龄(61.8±9.2)岁的不同慢性冠心病患者(76.6%为男性,23.4%为女性),在我们的中心进行诊断工作,并决定是否进行原发性或继发性血运重建术(冠状动脉搭桥(CABG)或经皮(PCI)介入)。所有患者均计划行CTCA和iCAG。结果和结论。手术过程中无明显并发症。共对2412个冠状链段进行了可视化研究。冠状动脉钙指数(CI)与动脉粥样硬化过程的总体负担和严重程度高度显著相关(r = 0,73, r < 0.0001)。与iCAG相比,CTCA没有假阴性结果,在无关病变的病例中只有6例(2.99%)假阳性结果。显著狭窄的诊断准确性无显著差异,总体血管病变数量和负担的准确度非常高(r = 0.95, r < 0.0001),预后方法的准确度非常高(AUC 0.99;OR >>1000, r < 0.0001),使得高多片CTCA作为一种安全且极其准确的动脉粥样硬化性CA病变定性和定量诊断方法,包括血流动力学意义评估,绝对可与iCAG相比较。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
NON-INVASIVE CORONARY ARTERIES ATHEROSCLEROSIS CT-VISUALIZATION: UP-TO-DATE STANDARDS AND OWN CLINICAL EXPERIENCE STUDY.

Non-invasive coronary arteries (CA) visualization experiences fast progress recently. Existing evidence-based dataand trials show that there is a great need in non-invasive technologies able to trustworthy and accurately identifyCA high risk atherosclerotic plaques (AP) and provide more insights into atherosclerosis pathophysiology in individ-ual patents, being accurate qualitative and quantitative methods of primary diagnosis and answer to therapeuticintervention indicators in patients with coronary artery (CAD). Until now in Ukraine there were no studies evaluat-ing accuracy of last generation 640-sliced computed tomography coronary angiography (CTCA) in diagnosing of dif-ferent CAD forms.Objective of the study was to study diagnostic accuracy of CTCA compared to invasive coronary angiography (iCAG)in the patients with different forms of chronic CAD before surgeon revascularization.Materials and methods. From I.2019 to V.2021 we prospectively studied 201 patients with different chronic CADforms (76.6 % men and 23.4 % women) aged (61.8 ± 9.2) years hospitalized to our center for diagnostic work-upand decision about primary or secondary revascularization (coronary aortic bypass (CABG) or percutaneous (PCI)intervention). All patients underwent planned CTCA and iCAG.Results and conclusions. There were no significant complication duing procedures performed. Totally 2412 coro-nary segments were visualized and studied. Coronary calcium index (CI) highly significantly correlated with overallburden and severity of atherosclerotic process (r = 0,73, р < 0.0001). CTCA compared to iCAG showed no false-nega-tive results and only 6 (2.99 %) false positive results in cases of insignificant lesions. There was no significant dif-ference in diagnostic accuracy for significant stenoses with very high accuracy for overall vessels lesions quantityand burden (r = 0.95, р < 0.0001) with very high prognostic method accuracy (AUC 0.99; OR >>1000, р < 0.0001),making high multi-sliced CTCA safe and extremely accurate method for qualitative and quantitative diagnosis of ath-erosclerotic CA lesions absolutely comparable to iCAG, including hemodynamic significance evaluation.

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Problemy radiatsiinoi medytsyny ta radiobiolohii
Problemy radiatsiinoi medytsyny ta radiobiolohii Medicine-Radiology, Nuclear Medicine and Imaging
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