与专用冠状动脉评分相比,偶然的视觉冠状动脉评估的准确性
Viraj Raygor1, Natalie Hoeting2, Colby Ayers2
1University of Texas Southwestern, Division of Cardiology, Dallas, TX, USA; Parkland Health & Hospital System, Department of Internal Medicine, Dallas, TX, USA.
在常规CT扫描中视觉冠状动脉 (CAC) 评分与心脏CT结果相关. 然而,缺乏视觉CAC可能并不排除风险,特别是对比度或非专业阅读器.
科学领域:
- 放射学 放射学是一门学科.
- 心脏病学 心脏病学
- 预防医学 预防医学
背景情况:
- 在常规胸部计算机断层扫描 (CT) 上检测到的冠状动脉 (CAC) 有助于估计心血管疾病 (CVD) 风险.
- 视觉CAC评分的准确性可能会受到放射科医生的专业知识和对比度使用的影响.
研究的目的:
- 为了评估视觉CAC估计在非门CT扫描的准确性.
- 为了将视觉CAC估计与心脏CT的Agatston得分进行比较,按读者专业和对比度使用分层.
主要方法:
- 追溯分析934名成年患者,在6个月内进行了CAC和非通道CT扫描.
- 视觉CAC类别的比较 (没有,小,中等,大) 与Agatston分数 (0,1-99,100-399,≥400).
- 根据阅读器类型的分层 (CT放射科医生与其他) 和对比度的使用 (对比度增强与非对比度).
主要成果:
- 视觉CAC估计与Agatston得分有很强的相关性 (肯德尔的tau-b = 0.76,p < 0.0001).
- 在没有视觉CAC的患者中,76%的Agatston得分为0 (非对比扫描和CT放射科医生的更高准确度).
- 中等至大视觉CAC (≥100) 的预测能力很高 (99%的CAC>0,88%的CAC≥100),不论对比度或读者类型如何.
结论:
- 在非通道CT上视觉CAC估计通常与心脏CT的Agatston得分一致.
- 在非通道CT上缺少视觉CAC,特别是在对比度或非专业读取器上,可能无法充分降低患者的风险.
- 中等至大视觉CAC是显著化的可靠指标,有助于识别高风险个体进行预防性干预.
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