電腦斷層冠狀動脈血管攝影診斷冠狀動脈疾病之臨床經驗

Clinical Experiences of Coronary Computed Tomography Angiography in Diagnosis of Coronary Artery Disease

胡卉婕(Hui-Chieh Hu) ； 方鶯珍(Ying-Chen Fang) ； 陳鴻毅(Hung-Yi Chen)

《北市醫學雜誌》 15卷3期 (2018/09) Pp. 19-29

https://doi.org/10.6200/TCMJ.201809_15(3).0003

摘要

目的：本研究為經由電腦斷層冠狀動脈攝影（CCTA），以靜脈注射顯影劑及電腦後處理得到之冠狀動脈影像，和心導管檢查做比較，評估本院CCTA之診斷正確性，以做為偵測冠狀動脈疾病之非侵入性檢查。方法：本研究收集一個月內同時做過CCTA及心導管檢查的患者，由放射科醫師使用電腦重組Tree VR影像，分析冠狀動脈橫斷面之管徑，再請心臟科醫師判讀心導管攝影影像。分別統計在兩種檢查中的狹窄程度，並比較兩者的差異。結果：總共七名患者共得到105區段，有97區段與心導管檢查一致，有8區段與心導管檢查結果不同，正確率為92%；以每人是否有大於50%狹窄程度區分，則CCTA得到100%之有效心導管攝影建議。結論：CCTA會因其高正確性，對於有家族史、高危險群或者不明確冠狀動脈疾病症狀的病人，可以當做評估是否需要接受心導管治療的前線檢查。

關鍵字

六十四切電腦斷層攝影 ； 冠狀動脈攝影 ； 心導管攝影

並列摘要

Objective: This study evaluated the accuracy and reliability of noninvasive coronary CT angiography (CCTA) with invasive cardiac catheterization as reference. Methods: Patients who received CCTA and cardiac catheterization within one month were recruited in this study. Tree VR images were reconstructed by using the computer and reviewed by radiologists to determine the diameter of coronary artery cross section while the cardiac catheterization images were judged by a cardiologist. All coronary artery were divided into fifteen segments. The diameter narrowing percentage of each segment was compared between the two examinations. Results: Six males and one female were recruited and a total of 105 sections were available for analysis. Consistency was found in 97 segments, while discrepancy in 8 segments. The accuracy rate was 92%. The sensitivity of CCTA for cardiac catheterization suggestion was 100% when any vessel of 50% stenosis for each individual was the criteria. Conclusion: CCTA can be used as a preliminary examination before cardiac catheterization for patients with a family history or a high risk of cardiovascular disease, or uncertain cardiovascular disease symptoms.

並列關鍵字

64-detector-roll Computed Tomography (MDCT) ； coronary CT angiography (CCTA) ； Coronary artery