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【文摘发布】冠心病诊断：多层CT优于运动心电图
Marc Dewey1,*, Hans-Peter Dübel2, Tania Schink3, Gert Baumann2 and Bernd Hamm1
1 Department of Radiology, Medical School, Humboldt-Universität zu Berlin, Germany
2 Department of Cardiology, Medical School, Humboldt-Universität zu Berlin, Germany
3 Medical Biometry Charité, Medical School, Humboldt-Universität zu Berlin, Germany
Aims: To prospectively compare multislice computed tomography (MSCT) and exercise electrocardiography (ex-ECG) for diagnosis of coronary artery disease (CAD) with conventional coronary angiography as the reference standard.
Methods and results: A consecutive cohort of 80 patients with suspected CAD was examined with MSCT using 16 x 0.5 mm detector collimation, ex-ECG, and conventional coronary angiography according to standard protocols. Results were compared using the paired McNemar's test, the 2 test, and 95%CIs. Both the sensitivity and specificity of MSCT [91% (40 of 44 patients, 95%CI 78–97%) and 83% (30 of 36 patients, 95%CI 67–94%)] were significantly higher (P = 0.039 and P < 0.001) than those for ex-ECG [73% (32 of 44 patients, 95%CI 57–85%) and 31% (11 of 36 patients, 95%CI 16–48%)]. The pairwise McNemar's test showed significant differences between MSCT and ex-ECG in the overall diagnosis in patients with suspected CAD (P = 0.036). The rate of non-diagnostic examinations was not significantly (P = 0.078) different between MSCT and ex-ECG [8% (6 of 80 patients, 95%CI 3–16%) vs. 19% (15 of 80 patients, 95%CI 11–29%)].
Conclusion: In this consecutive cohort of patients scheduled to undergo conventional coronary angiography, the performance of MSCT for diagnosis of CAD was superior to that of ex-ECG.
Key Words: Coronary artery • Coronary angiography • Cardiac • Computed tomography • Electrocardiography • Exercise test • Diagnosis • Sensitivity
European Heart Journal 2007 28(20):2485-2490; doi:10.1093/eurheartj/ehl148 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 Head-to-head comparison of multislice computed tomography and exercise electrocardiography for diagnosis of coronary artery disease
多层CT扫描与运动心电图对冠心病诊断价值的直接比较
Aims: To prospectively compare multislice computed tomography (MSCT) and exercise electrocardiography (ex-ECG) for diagnosis of coronary artery disease (CAD) with conventional coronary angiography as the reference standard.
目的：以传统的冠脉造影结果作为参考标准，前瞻性地比较多层CT扫描与运动心电图在冠心病诊断方面的价值。
Methods and results: A consecutive cohort of 80 patients with suspected CAD was examined with MSCT using 16 x 0.5 mm detector collimation, ex-ECG, and conventional coronary angiography according to standard protocols. Results were compared using the paired McNemar's test, the 2 test, and 95%CIs. Both the sensitivity and specificity of MSCT [91% (40 of 44 patients, 95%CI 78–97%) and 83% (30 of 36 patients, 95%CI 67–94%)] were significantly higher (P = 0.039 and P < 0.001) than those for ex-ECG [73% (32 of 44 patients, 95%CI 57–85%) and 31% (11 of 36 patients, 95%CI 16–48%)]. The pairwise McNemar's test showed significant differences between MSCT and ex-ECG in the overall diagnosis in patients with suspected CAD (P = 0.036). The rate of non-diagnostic examinations was not significantly (P = 0.078) different between MSCT and ex-ECG [8% (6 of 80 patients, 95%CI 3–16%) vs. 19% (15 of 80 patients, 95%CI 11–29%)].
方法与结果：根据标准检查方案，对80位可疑冠心病患者连续采用多层CT扫描（16 x 0.5 mm 平行探测器）、运动心电图以及传统的冠脉造影进行诊断。采用配对的McNemar检验分析结果，多层CT扫描的敏感性为91%（40/44患者，95%可信区间为78-97%）与特异性为83%（30/36患者，95%可信区间为67-94%）；而运动心电图的敏感性为73%（32/44患者，95%可信区间为57-85%）与特异性为31%（11/36患者，95%可信区间为16-48%）。多层CT扫描的结果明显优于运动心电图，敏感性以及特异性差异的P值分别为0.0039与小于0.001。该检验显示出两者对可疑冠心病患者的总体诊断率也具有显著性差别，P值为0.036。而两者的漏诊率无明显差异，前者为8%（6/80患者，95%可信区间为3-16%）与特异性为19%（15/80患者，95%可信区间为11-29%）。
Conclusion: In this consecutive cohort of patients scheduled to undergo conventional coronary angiography, the performance of MSCT for diagnosis of CAD was superior to that of ex-ECG.
结论：对计划采用传统的冠脉造影的该组患者而言，与运动心电图相比较，多层CT扫描在冠心病诊断方面更有优势。
而立2007 wrote:
Methods and results: A consecutive cohort of 80 patients with suspected CAD was examined with MSCT using 16 x 0.5 mm detector collimation, ex-ECG, and conventional coronary angiography according to standard protocols.阅读本文的人还阅读：
作者:admin@医学,生命科学 2011-03-10 05:11
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