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【medical-news】在冠心病的检出方面，CT要优于MR
在冠心病的检出方面，CT要优于MRI
While CT, unlike MRI, involves the use of radiation and intravenous contrast agents, it is more accurate in detecting coronary artery disease (CAD), according to a report in the Annals of Internal Medicine for September 19.
根据国际内科学杂志报道，虽然具有辐射，需要静脉注射对比剂，不如MRI好，但是在冠心病的检出方面，比磁共振更加准确。
"The high negative predictive value of multislice CT for the presence of coronary artery stenoses (95%) makes it potentially useful as a diagnostic tool for ruling out coronary artery disease in a population with a low to intermediate pretest likelihood," lead author Dr. Marc Dewey, from Humboldt-Universitat zu Berlin, and colleagues note.
“多层螺旋CT具有很高的阴性诊断价值，其阴性诊断率可以达到95%，对于具有低到中度冠心病发病危险的病人来说，作为冠心病的排除性检查非常有价值，”，Marc Mewey博士领导下的小组宣称。
Cardiac catheterization with angiography is the reference standard for diagnosing CAD. While useful if an interventional procedure is required, recent reports suggest that the majority of angiographies are performed solely for diagnostic purposes. Multislice CT and MRI have been proposed as noninvasive, cost-effective alternatives to catheterization for diagnosing CAD.
心血管导管造影是诊断冠心病的金标准。如果需要进行介入操作时，就必须进行心脏导管造影，但是最近的研究指出，大多数的心脏导管造影的目的都是诊断性的。多层螺旋CT和磁共振都是无创性的，性价比较高的心脏导管诊断冠心病的替代技术。
Previous reports have suggest that multislice CT is superior to MRI in diagnosing coronary artery disease, the authors note. However, it is important to confirm this finding given the radiation and contrast risks associated with CT, they add.
以前的研究报告提示多层螺旋CT在诊断冠心病方面要优于磁共振。但是本文作者认为，肯定之一发现的时候，因该将辐射和对比剂的风险考虑进去。
The present study involved 129 consecutive patients who were evaluated at a tertiary referral center in Berlin for suspected coronary artery disease. The analysis focused on 108 patients who had 430 vessels examined with both multislice CT and MRI before undergoing conventional angiography.
本研究包括129名连续的病人，在柏林的心血管病第三防治中心进行。本研究分析了108例病人的430条血管，在接受常规血管造影之前，均接受了CT和磁共振冠脉成像。
In the per-patient analysis, multislice CT was 92% sensitive in diagnosing CAD compared with a value of 74% for MRI (p = 0.013). The difference in sensitivities was even more pronounced regarding clinically significant stenoses: 82% versus 54%, respectively (p < 0.001).
在对每一个病人进行的分析中，多层螺旋CT诊断冠心病的敏感性为93%，而磁共振诊断冠心病的敏感性为74%（P=0.013）。对于临床上有意义的狭窄，这种差异更加明显，82%比54%（P<0.001）。
In the per-vessel analysis, multislice CT had a specificity of 90% and a negative predictive value of 95% in diagnosing CAD. The corresponding values for MRI were lower: 87% and 90%.
在每个血管的分析中，多层螺旋CT的特异性为93%,阴性诊断价值为95%，相关的MRI成像要低一些：87%与90%.
Analysis of the radiation dose used during CT indicated that it was on par with that used during diagnostic cardiac catheterization.
辐射剂量分析发现CT扫描过程产生的辐射剂量与导管造影的辐射剂量相近。
When surveyed, 74% of patients indicated a preference for CT over MRI for future diagnostic imaging, the report indicates.
对病人进行调查发现，74%的病人在以后的检查中，愿意接受CT检查。
"Clinicians should not use multislice CT routinely in the evaluation of patients with suspected myocardial ischemia," Dr. Philip Greenland, from Northwestern University in Chicago, states in a related editorial. "Multislice CT is not useful in patients with a high pretest probability of CAD and may be harmful."
“如果怀疑病人心肌缺血时，临床医师不要把多层螺旋CT作为常规检查手段，”来自东北大学的Philip Greenland博士在一篇文章中指出，如果高度怀疑冠心病是的多层螺旋CT检查不但没有帮助，反而有可能有害。“
However, he adds that the test "is useful when the diagnosis is uncertain after a careful chest pain history and equivocal results on functional testing for CAD."
但是他同时指出，“当胸痛病史后，CAD的功能实验诊断不明确的时候是非常有帮助的” [标签:content1][标签:content2]
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作者:admin@医学,生命科学 2010-12-29 05:14
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