在CTCA之前研究非门胸部CT的影响,以减少分层测试
D Murphy1, J Stephenson2, Y Bouhbib3
1Department of Cardiology, Royal United Hospitals Bath, Bath, UK; Department for Health, University of Bath, Bath, UK.
Clinical radiology
|September 17, 2023
概括
在之前的CT扫描中冠状动脉化 (CAC) 显著影响冠状动脉疾病 (CAD) 诊断. 在非心脏CT上识别严重的CAC可以简化测试并降低患者的成本.
科学领域:
- 心血管成像 - 心血管成像
- 放射学 放射学是一门学科.
- 卫生经济学 卫生经济学
背景情况:
- 冠状动脉化 (CAC) 是动脉样硬化的标志物.
- 非心脏CT扫描可以偶然检测到CAC.
- 偶然的CAC对随后的心脏成像的影响尚未完全理解.
研究的目的:
- 评估CAC在非心脏CT上的患病率,这些患者被转诊进行冠状动脉CT血管造影 (CTCA).
- 评估检测到的CAC如何影响CTCA诊断产量以及进一步测试的需要.
- 分析管理偶然CAC.患者的成本效益.
主要方法:
- 对2140次CTCA考试 (2018-2020年) 的回顾性审查.
- 与之前的非通道胸部CT扫描进行交叉引用.
- 对CAC进行半定量评估,并分析诊断产量,进一步测试和成本.
主要成果:
- 在13%的CTCA转诊中,有13%的CTCA转诊中,有13%的CTCA转诊中,有13%的CTCA转诊中,有13%的CTCA转诊中,有13%的CTCA转诊中,有13%的CTCA转诊中,有13%的CTCA转诊中,有13%的CTCA转诊中,有13%的CTCA转诊中,有13%的CTCA转诊中,有13%的CTCA转诊中.
- 不完整的CTCA诊断产量随着CAC严重程度的增加 (轻度32%,中度64%,重度75%).
- 对严重CAC病例的直接功能测试具有成本效益,节省了171英/患者 (DSE) 和61英/患者 (MPS).
结论:
- 在非心脏CT上偶然的CAC在CTCA转诊中很常见.
- 严重的CAC需要改变诊断策略.
- 对严重CAC的直接功能测试途径具有成本效益,并改变了管理.
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