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首页> 外文期刊>Acta Radiologica >Does slice thickness affect diagnostic performance of 64-slice CT coronary angiography in stable and unstable angina patients with a positive calcium score?
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Does slice thickness affect diagnostic performance of 64-slice CT coronary angiography in stable and unstable angina patients with a positive calcium score?

机译：钙片阳性的稳定和不稳定型心绞痛患者，切片厚度是否会影响64层CT冠状动脉造影的诊断性能？

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BACKGROUND: Coronary calcification can lead to over-estimation of the degree of coronary stenosis. Purpose: To evaluate whether thinner reconstruction thickness improves the diagnostic performance of 64-slice CT coronary angiography (CTCA) in angina patients with a positive calcium score. MATERIAL AND METHODS: We selected 20 scans from a clinical study comparing CTCA to conventional coronary angiography (CCA) in stable and unstable angina patients based on a low number of motion artifacts and a positive calcium score. All images were acquired at 64 x 0.625 mm and each CTCA scan was reconstructed at slice thickness/increment 0.67 mm/0.33 mm, 0.9 mm/0.45 mm, and 1.4 mm/0.7 mm. Two reviewers blinded for CCA results independently evaluated the scans for the presence of significant coronary artery disease (CAD) in three randomly composed series, with > or =2 weeks in between series. The diagnostic performance of CTCA was compared for the different slice thicknesses using a pooled analysis of both reviewers. Significant CAD was defined as >50% diameter narrowing on quantitative CCA. Image noise (standard deviation of CT numbers) was measured in all scans. Inter-observer variability was assessed with kappa. RESULTS: Significant CAD was present in 8% of 304 available segments. Median total Agatston calcium score was 181.8 (interquartile range 34.9-815.6). Sensitivity at 0.67 mm, 0.9 mm, and 1.4 mm slice thickness was 70% (95% confidence interval 57-83%), 74% (62-86%), and 70% (57-83%), respectively. Specificity was 85% (82-88%), 84% (81-87%), and 84% (81-87%), respectively. The positive predictive value was 30 (21-38%), 29 (21-37%), and 28 (20-36%), respectively. The negative predictive value was 97% (95-98%), 97% (96-99%), and 97% (96-99%), respectively. Kappa for inter-observer agreement was 0.56, 0.58, and 0.59. Noise decreased from 32.9 HU at 0.67 mm, to 23.2 HU at 1.4 mm (P<0.001). CONCLUSION: Diagnostic performance of CTCA in angina patients with a positive calcium score was not markedly affected by modest variations in reconstruction slice thickness.
机译：背景：冠状动脉钙化可导致对冠状动脉狭窄程度的高估。目的：评估更薄的重建厚度是否可改善钙评分为阳性的心绞痛患者的64层CT冠状动脉造影（CTCA）的诊断性能。材料和方法：我们从临床研究中选择了20个扫描结果，根据运动伪影数量少和钙阳性结果，将CTCA与稳定型和不稳定型心绞痛患者的常规冠状动脉造影（CCA）进行了比较。在64 x 0.625 mm处获取所有图像，并以0.67 mm / 0.33 mm，0.9 mm / 0.45 mm和1.4 mm / 0.7 mm的切片厚度/增量重建每个CTCA扫描。两名对CCA结果不知情的审稿人独立评估了三个随机组成的系列中是否存在重大冠状动脉疾病（CAD）的扫描结果，系列之间间隔≥2周。使用两个审阅者的汇总分析比较了CTCA对不同切片厚度的诊断性能。显着的CAD被定义为在定量CCA上直径> 50％变窄。在所有扫描中测量图像噪声（CT数的标准偏差）。观察者间的变异性用kappa评估。结果：在304个可用细分中，有8％存在明显的CAD。 Agatston总钙中位数为181.8（四分位间距34.9-815.6）。切片厚度为0.67 mm，0.9 mm和1.4 mm时的灵敏度分别为70％（95％置信区间57-83％），74％（62-86％）和70％（57-83％）。特异性分别为85％（82-88％），84％（81-87％）和84％（81-87％）。阳性预测值分别为30（21-38％），29（21-37％）和28（20-36％）。阴性预测值分别为97％（95-98％），97％（96-99％）和97％（96-99％）。观察者之间达成一致的Kappa为0.56、0.58和0.59。噪声从0.67毫米处的32.9 HU降低到1.4毫米处的23.2 HU（P <0.001）。结论：钙化评分为阳性的心绞痛患者的CTCA诊断性能不受重建切片厚度的适度变化的显着影响。

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