Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
권호 표지

Diagnostic Accuracy of 64-slice Dual-source Computed Tomography in the Detection of Coronary Artery Stenosis based on Patient Heart Rate and Calcium Scores

관상동맥 질환의 진단에서 심박수와 석회화 정도에 따른 Dual-source CT의 진단적 정확성

  • Kim, Eun-Young (Department of Radiology, Chonbuk National University Medical School, Research Institute of Clinical Medicine) ;
  • Jin, Gong-Yong (Department of Radiology, Chonbuk National University Medical School, Research Institute of Clinical Medicine) ;
  • Han, Young-Min (Department of Radiology, Chonbuk National University Medical School, Research Institute of Clinical Medicine) ;
  • Kwak, Hyo-Sung (Department of Radiology, Chonbuk National University Medical School, Research Institute of Clinical Medicine) ;
  • Chae, Jei-Keon (Department of Internal Medicine, Chonbuk National University Medical School, Research Institute of Clinical Medicine) ;
  • Lee, Sang-Rok (Department of Internal Medicine, Chonbuk National University Medical School, Research Institute of Clinical Medicine) ;
  • Kwon, Keun-Sang (Department of Preventive Medicine, Chonbuk National University Medical School, Research Institute of Clinical Medicine)
  • 김은영 (전북대학교 의학전문대학원 영상의학교실) ;
  • 진공용 (전북대학교 의학전문대학원 영상의학교실) ;
  • 한영민 (전북대학교 의학전문대학원 영상의학교실) ;
  • 곽효성 (전북대학교 의학전문대학원 영상의학교실) ;
  • 채제건 (전북대학교 의학전문대학원 내과학교실) ;
  • 이상록 (전북대학교 의학전문대학원 내과학교실) ;
  • 권근상 (전북대학교 의학전문대학원 예방의학교실)
  • Received : 2010.03.05
  • Accepted : 2010.06.28
  • Published : 2010.09.01
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Abstract

Purpose: To assess the diagnostic accuracy of dual-source computed tomography (DSCT) in the detection of coronary artery stenosis (CAS) based on patient heart rate and calcium scores. Materials and Methods: This study included 102 patients (46 male, 56 female; mean age $64.1{\pm}10.6$ years; age range 37-92 years) with chest pain and who underwent DSCT as well as invasive coronary angiography. Patients were classified into three groups according to mean heart rate (<70 bpm, 70-90 bpm, and >90 bpm) and also classified in three groups according to Agatston calcium scores (<100, 100-400, and >400). Results: For patients with a mean heart rate < 70 bpm, the sensitivity, specificity, PPV, NPV, and diagnostic accuracy of DSCT on a per-vessel basis were 98.5%, 98.2%, 93.6%, 99.1%, and 97.9%, respectively, 99.2%, 99.2%, 97.4%, 99.5%, and 99%, respectively, for 70-90 bpm; and 91.7%, 97.9%, 88.5%, 96.7%, and 95.7%, respectively, for >90 bpm. For calcium scores <100, the sensitivity, specificity, PPV, NPV, and diagnostic accuracy of DSCT on a per-vessel basis were 97.2%, 99.0%, 97.0%, 99.3%, and 98.6%, respectively, 98.5%, 99.5%, 96.2%, 99.4%, and 99.0%, respectively, for calcium scores 100-400, and 95.8%, 97.0%, 87.4%, 97.2%, and 95.6%, respectively, for calcium scores >400. Conclusion: DSCT showed a high diagnostic accuracy and negative predictive value, regardless of heart rate and calcium score.

목적: 관상동맥 질환의 진단에서 심박수와 석회화 정도에 따른 64 절편 이중선원CT(dual-source CT, 이하 DSCT)의 진단 정확도를 알아보고자 하였다. 대상과 방법: 관상동맥 질환이 의심되는 환자 중에서 DSCT와 침습적 관상동맥조영술을 모두 시행한 102명(남자 46명, 여자 56명; 평균 연령, $64.1{\pm}10.6$; 연령 범위, 37-92)의 환자를 대상으로 하였다. 환자들은 평균 심박수에 따라 70 미만, 70-90, 90 이상의 세 그룹으로 구분되었고 Agatston 점수에 따라 100 미만, 100-400, 400 이상으로 구분되었다. 그리고 각 그룹에서 민감도, 특이도, 양성 예측도, 음성 예측도 그리고 정확도를 계산하였다. 결과: 혈관별 분석에서 DSCT의 민감도, 특이도, 양성 예측치, 음성 예측치, 정확도는 심박수가 70 미만인 환자들에서 98.5%, 98.2%, 93.6%, 99.1%, 97.9%, 심박수 70 이상 90 미만인 환자들에서 99.2%, 99.2%, 97.4%, 99.5%, 99%, 심박수 90 이상인 환자들에서 91.7%, 97.9%, 88.5%, 96.7%, 95.7%를 보였다. 또한, 석회화 점수가 100 미만인 환자들에서 97.2%, 99.0%, 97.0%, 99.3%, 98.6%, 100 이상 400 미만인 환자들에서 98.5%, 99.5%, 96.2%, 99.4%, 99.0%, 400 이상인 환자들에서 95.8%, 97.0%, 87.4%, 97.2%, 95.6%를 보였다. 결론: DSCT는 심박수와 석회화 정도와 상관없이 관상동맥 질환의 진단에 있어서 높은 진단적 정확도와 음성 예측도를 보였다.

Keywords

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