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1、小组人员：报告人：岳征题目：DiagnosticPerformanceofCoronaryAngiographyby64-RowCT(出处：NEWENGLANDJOURNALOFMEDICINE卷:359期:22页:2324-2336出版年:NOV272008)所属学科：医学影像学设计类型：诊断试验评价论文性质：诊断评价论文题目（及出处）BackgroundTheaccuracyofmultidetectorcomputedtomographic(CT)angiographyinvolving64dete
2、ctorshasnotbeenwellestablished.MethodsWeconductedamulticenterstudytoexaminetheaccuracyof64-row,0.5-mmmultidetectorCTangiographyascomparedwithconventionalcoronaryangiographyinpatientswithsuspectedcoronaryarterydisease.Ninecentersenrolledpatientswhounderwen
3、tcalciumscoringandmultidetectorCTangiographybeforeconventionalcoronaryangiography.In291patientswithcalciumscoresof600orless,segments1.5mmormoreindiameterwereanalyzedbymeansofCTandconventionalangiographyatindependentcorelaboratories.Stenosesof50%ormorewere
4、consideredobstructive.Theareaunderthereceiver-operating-characteristiccurve(AUC)wasusedtoevaluatediagnosticaccuracyrelativetothatofconventionalangiographyandsubsequentrevascularizationstatus,whereasdiseaseseveritywasassessedwiththeuseofthemodifiedDukeCoro
5、naryArteryDiseaseIndex.ResultsAtotalof56%ofpatientshadobstructivecoronaryarterydisease.Thepatient-baseddiagnosticaccuracyofquantitativeCTangiographyfordetectingorrulingoutstenosesof50%ormoreaccordingtoconventionalangiographyrevealedanAUCof0.93(95%confiden
6、ceinterval[CI],0.90to0.96),withasensitivityof85%(95%CI,79to90),aspecificityof90%(95%CI,83to94),apositivepredictivevalueof91%(95%CI,86to95),andanegativepredictivevalueof83%(95%CI,75to89).CTangiographywassimilartoconventionalangiographyinitsabilitytoidentif
7、ypatientswhosubsequentlyunderwentrevascularization:theAUCwas0.84(95%CI,0.79to0.88)formultidetectorCTangiographyand0.82(95%CI,0.77to0.86)forconventionalangiography.Aper-vesselanalysisof866vesselsyieldedanAUCof0.91(95%CI,0.88to0.93).Diseaseseverityascertain
8、edbyCTandconventionalangiographywaswellcorrelated(r=0.81;95%CI,0.76to0.84).TwopatientshadimportantreactionstocontrastmediumafterCTangiography.ConclusionsMultidetectorCTangiographyaccuratelyidentifiesthepresenceandse
