DOI QR코드

DOI QR Code

관상동맥 석회화점수 감소 요인 분석

Factor Analysis of Decreased Score on Coronary Artery Calcium Score

  • 심재구 (대구보건대학교 방사선과) ;
  • 김연민 (원광보건대학교 방사선과) ;
  • 김진우 (삼성서울병원 건강의학센터)
  • Shim, Jae-Goo (Department of Radiologic Technology, Daegu Health College) ;
  • Kim, Yon-Min (Department of Radiotechnology, Wonkwang Health Science University) ;
  • Kim, Jin-Woo (Department of Health Promotion, Samsung Medical Center)
  • 투고 : 2016.06.10
  • 심사 : 2016.06.30
  • 발행 : 2016.06.30

초록

이 연구는 관상동맥 CT 석회화점수 검사를 2회 이상 받은 자 중에서, 이전에 비하여 점수가 낮아진 원인을 후향적으로 분석하였다. 건강검자 환자 100명(남자 85명 $60.6{\pm}6.9$세, 여자 15명 $67.2{\pm}7.3$세)을 대상으로 하였다. 석회화점수 감소가 발생한 경우를 Agatston의 분류 방법에 따라 minimal (1-10), mild(11-100), moderate(101-400), severe (400< ) 4개 그룹으로 분류하였다. Mild 그룹에서 49명으로 가장 많았으며, minimal 그룹에서 감소율 변동이 가장 크게 나타났다. 석회화점수 감소 요인은 Scan location 불일치 51%, Motion artifact 26%, 장비변동 14%, 작업자의 실수 5%, 입력 miss 2%, Image loss 1%, 부정맥 1% 로 나타났다. Scan location의 불일치는 scan된 석회화의 slice 위치에 따른 부분체적 효과로 생각되며, 관상동맥 석회화 점수가 작은 100 이하 그룹에서는 높은 변화폭(19.7%)이 나타났고 100 이상의 그룹에서는 낮은 변화폭(2.2%)을 보여 석회화 점수에 따라 허용될 수 있는 변화폭이 달라진다는 것을 알 수 있었다. Motion artifact 요인은 26%로 나타났으며, 이는 높은 심박동에 의한 것으로 심박동이 높거나 검사 전 폐기능, 운동부하 등 심박동에 영향을 미치는 선행검사와 밀접한 관련이 있었다.

The purpose of our study was to retrospectively evaluate the cause of a decreased calcium score of follow-up studies on coronary artery calcium scores (CACs) computed tomography (CT). The subjects were healthy 100 people(85 males $60.6{\pm}6.9$ years, 15 females $67.2{\pm}7.3$ years). The subjects decreased CACs were divided into 4 subgroups depending on Agatston classification, minimal (1-10), mild (11-100), moderate (101-400), severe (400<). As a result of decreased CACs were scan location disagreement 51%, motion artifact 26%, equipment changes 14%, operator mistakes 5%, input miss 2%, image loss 1%, arrhythmia 1%. In the mild group, the most common decreased CACs were 49 people. In the minimal group, the most significant variation reduction has occurred to 6 people. Scan location disagreement was considered a partial volume effects due to the scan starting position. It showed less than 100 CACs a high variation (19.7%) in more than 100 CACs, a lower variation (2.2%), these could be seen that the variation range is different that can be tolerated according to the calcification score. Motion artifact factor was found in 26%, which is so closely related to the preceding tests that affect the higher heart rate like this pulmonary function test, exercise stress test.

키워드

참고문헌

  1. Oudkerk M, Stillman AE, Halliburton SS, et al., "Coronary artery calcium screening: current status and recommendations from the European Society of Cardiac Radiology and North American Society for Cardiovascular Imaging". Int J Cardiovasc Imaging Vol. 24, No. 6, pp. 645-671, 2008. https://doi.org/10.1007/s10554-008-9319-z
  2. Greenland P, Bonow RO, Brundage BH, et al., " ACCF/AHA 2007 clinical expert consensus document on coronary artery calcium scoring by computed tomography in global cardiovascular risk assessment and in evaluation of patients with chest pain: a report of the American College of Cardiology Foundation Clinical Expert Consensus Task Force (ACCF/AHA Writing Committee to Update the 2000 Expert Consensus Document on Electron Beam Computed Tomography)", Circulation, Vol. 115, pp. 402-426, 2007. https://doi.org/10.1161/CIRCULATIONAHA..107.181425
  3. Agatston AS, Janowitz WR, Hildner FJet. al., "Quantification of coronary artery calcium using ultrafast computed tomography", J Am Coll Cardiology, Vol. 15, pp. 827-832, 1990. https://doi.org/10.1016/0735-1097(90)90282-T
  4. Taylor AJ, Bindeman J, Feuerstein I, et. al., "Coronary calcium independently predicts incident premature coronary heart disease over measured cardiovascular risk factors: mean three-year outcomes on the Prospective Army Coronary Calcium(PACC)project", J Am Coll Cardiology, Vol. 46, No. 5, pp. 807-814, 2005. https://doi.org/10.1016/j.jacc.2005.05.049
  5. Shaw LJ, Raggi P, Schisterman E, et. al., "Prognostic value of cardiac risk factors and coronary artery calcium screening for all-cause mortality", Radiology, Vol. 228, No. 3, pp. 826-833, 2003. https://doi.org/10.1148/radiol.2283021006
  6. Kondos GT, Hoff JA, Sevrukov A, et. al., "Electron-beam tomography coronary artery calcium and cardiac events: a 37-month follw-up of 5635 initially asymp-tomatic low-to intermediate-risk adults", Circulation, Vol. 107, No. 20, pp. 2571-2576, 2003. https://doi.org/10.1161/01.CIR.0000068341.61180.55
  7. Heangsoo Yoo, Jikoon Park, Bongjae Jung, et. al., "Potential Risk Assessment of Cardiovascular Disease in Low Calcium-Score", J. Korean. Soc. Radiology, Vol. 7, No. 6, pp. 369-376, 2013. https://doi.org/10.7742/jksr.2013.7.6.369
  8. Mao S, Bakhsheshi H, Lu B, Liu SC, et.al., "Effect of electrocardiogram triggering on reproducibility of coronary artery calcium scoring", Radiology, Vol. 22, No. 3, pp 707-711, 2001.
  9. Mao S, Budoff MJ, Bakhsheshi H, et. al., "Improved reproducibility of coronary artery calcium scoring by electron beam tomography with a new electrocardiographic trigger method", Invest Radiology, Vol. 36, No. 7, pp 363-367, 2001. https://doi.org/10.1097/00004424-200107000-00002
  10. Achenbach S, Ropers D, Mohlenkamp S, et al., "Variability of repeated coronary artery calcium measurements by electron beam tomography", Am J Cardiology, Vol. 87, No. 2, pp 201-213, 2001.
  11. Wang S, Detrano RC, Secci A, et al., "Detection of coronary calcification with electron-beam computed to mography: evaluation of interexamination reproducibility and comparison of three image-acquisition protocols", Am Heart J, vol. 132, No. 3, pp 550-558, 1996. https://doi.org/10.1016/S0002-8703(96)90237-9
  12. Devries S, Wolfkiel C, Shah V, et. al., "Reproducibility of the measurement of coronary calcium with ultrafast computed tomography", Am J Cardiology, Vol. 75, No. 14, pp 973-975, 1995. https://doi.org/10.1016/S0002-9149(99)80706-1
  13. Callister TQ, Cooil B, Raya SP, et. al., "Coronary artery disease: improved reproducibility of calcium scoring with an electron-beam CT volumetric method", Radiology, Vol. 208, No. 3, pp 807-814, 1998. https://doi.org/10.1148/radiology.208.3.9722864
  14. Annemarieke Rutten, Ivana Isgum, Mathias Prokop, "Coronary Calcification: Effect of Small Variation of Scan Starting Position on Agatston, Volume, and Mass Scores" Radiology, Vol. 246, No. 1, pp. 90-98, 2008. https://doi.org/10.1148/radiol.2461070006