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首页> 外文期刊>Academic radiology >Triage of patients with suspected coronary artery disease using multislice computed tomography.
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Triage of patients with suspected coronary artery disease using multislice computed tomography.

机译：使用多层计算机断层扫描对疑似冠状动脉疾病的患者进行分类。

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RATIONALE AND OBJECTIVES: Several studies have shown that multislice computed tomography (MSCT) has a high sensitivity and specificity for detecting coronary artery stenoses. The aim of the present study was to investigate whether MSCT can reliably triage patients with suspected coronary artery disease (CAD) to coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), or no revascularization. MATERIALS AND METHODS: A total of 123 patients with suspected CAD who were referred for conventional coronary angiography (CATH) additionally underwent MSCT (16*0.5 mm detector collimation). Therapeutic decisions made on the basis of CATH and MSCT strictly following current guidelines for treatment of CAD were compared with decisions made by a cardiac surgeon and an interventional cardiologist. Only MSCTs with at least adequate image quality in all coronary segments were included in the analysis (94/123). RESULTS: Decisions made on the basis of MSCT and CATH according to guidelines did not differ significantly (agreement of 88%, 82 of 94, P = .319). The therapeutic decisions made by the interventional cardiologist and the cardiac surgeon based on CATH differed significantly (overall agreement of 79%, 74 of 94 cases, P < .001; cardiologist: 78% PCI and 22% CABG versus surgeon: 38% PCI and 62% CABG), whereas there was 100% agreement regarding decisions for or against invasive treatment. CONCLUSIONS: MSCT shows good agreement with CATH in triaging patients with suspected CAD to CABG, PCI, or no revascularization. The choice of revascularization procedure is significantly more strongly influenced by whether an interventional cardiologist or a cardiac surgeon makes the decision than by the diagnostic test on which the decision is based.
机译：理由和目的：多项研究表明，多层计算机断层扫描（MSCT）对检测冠状动脉狭窄具有很高的灵敏度和特异性。本研究的目的是调查MSCT是否能够可靠地将疑似冠心病（CAD）的患者分流至冠状动脉搭桥术（CABG），经皮冠状动脉介入治疗（PCI）或无血运重建。材料与方法：总共123例疑似CAD的患者接受了常规冠状动脉造影（CATH）的转诊，另外接受了MSCT（16 * 0.5 mm探测器准直）。将严格遵循当前CAD指南的CATH和MSCT做出的治疗决策与心脏外科医生和介入心脏病专家做出的决策进行了比较。分析中仅包括在所有冠状动脉节段中具有至少足够图像质量的MSCT（94/123）。结果：根据指南根据MSCT和CATH做出的决定没有显着差异（同意率为88％，94的82，P = 0.319）。介入性心脏病专家和心脏外科医生基于CATH做出的治疗决定存在显着差异（总体同意率为79％，94例中的74例，P <.001;心脏病专家：PCI的78％和CABG的22％，而外科医生的PCI：38％， 62％的CABG），而对于支持或反对侵入性治疗的决定达成100％的共识。结论：MSCT与CATH在将可疑CAD分为CABG，PCI或无血运重建的患者中进行了分类。介入性心脏病专家或心脏外科医生是否做出决定，比决定所依据的诊断测试对血运重建程序的选择影响更大。

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