查詢結果分析
相關文獻
- Relevance Assessment of Clinical Symptoms and Classification of Coronary Artery Anomalies in Sixty-four Multidetector Computed Tomography
- 合歡山臺灣冷杉土壤之發育與分類
- 全民健康保險下疾病分類編碼品質與相關影響因素研究
- Fractal Image Coding Using Projection-Based Classification and Variable Shape Matching
- The Family Sapotaceae in Taiwan
- Genus Tisis Walker from Malaysia and Indonesia (Lepidoptera: Lecithoceridae), with Description of Three New Species
- Synopsis of the Genus Hygroplasta Meyrick in the World with Description of a New Species (Lepidoptera: Lecithoceridae)
- 談稅則分類的理論與實務
- 談稅則分類的理論與實務
- Ground Contact Pattern and Overuse Injury of the Lower Leg in Long Distance Runners
頁籤選單縮合
題名 | Relevance Assessment of Clinical Symptoms and Classification of Coronary Artery Anomalies in Sixty-four Multidetector Computed Tomography=利用64切電腦斷層攝影探討冠狀動脈異常的分類與臨床表現的相關性 |
---|---|
作者姓名(中文) | 侯貴圓; 秦志輝; 莫元亨; 范君凱; 王永成; | 書刊名 | 中華放射線技術學雜誌 |
卷期 | 41:1 2017.03[民106.03] |
頁次 | 頁41-48 |
分類號 | 414.93 |
關鍵詞 | 多切片電腦斷層; 冠狀動脈異常; 臨床相關性; 分類; Multidetector computed tomography; MDCT; Coronary artery anomaly; Clinical relevance; , Classification; |
語文 | 英文(English) |
中文摘要 | 冠狀動脈異常(coronary artery anomaly, CAA)可能屬良性或惡性,惡性的 CAA會引起冠狀動脈疾病、心肌缺氧甚至猝死。自 1990年起已有許多利用心導管檢查分類的方式。本研究的主要目的為利用 64列電腦斷層攝影(multidetector computed tomography, MDCT)來探討 CAA的分類與臨床表現的相關性。本研究收集 2006年 6月到 2009年 6月進行 64列電腦斷層冠狀動脈攝影的 1,974位受檢者(1,351男性, 623位女性,平均年齡 50.5±10.9歲)冠狀動脈電腦斷層攝影,受檢者來源包括有冠狀動脈症狀患者及自費做健康檢查的成人。所有影像由一位放射科醫師及一位心臟內科醫師判讀。篩選出有 CAA的受檢者,利用 Rigatelli等於 2003年提出的 CAA臨床相關性之四類分級:「良性、有意義的、嚴重的及危急的」,進行異常的分類。 CAA病人(心肌橋除外 )的臨床症狀例如:胸痛、胸悶等皆列入評估。追蹤時間從 8個月到 46個月(平均為 31.3±12個月)。檢查過程中利用三種掃描方式:回溯性心電圖門控配合心電圖控制之管電流調控(ECG tube current modulation, ETCM)70%-80% R-R間期及 40%-80% R-R與回溯性心電圖門控三種掃描方式,比較其有效劑量及節省輻射劑量的比例。本研究中共發現 63位 CAA病人,其發生率為 3.19%。臨床相關性分類為良性的有 37位,有意義的有 13位,嚴重的有 10位,危急的有 3位,另有 10位無法追蹤其臨床症狀。有追蹤紀錄的 53人皆無心因性死亡;分類嚴重等級的病人多會進行核醫檢查,另有 13位有進行心導管檢查,檢出之冠狀動脈異常與 MDCT結果相符。分析追蹤病人的臨床症狀及 CAA嚴重度的關係,發現所有追蹤的臨床症狀與嚴重度沒有顯著差異( P > 0.05)。可能的原因是冠狀動脈異常的數量較少,且大多數來自於健康檢查。但本研究 CAA發生率較心導管高,所以 MDCT是診斷冠狀動脈疾病的首選工具。輻射劑量以 ETCM 70%-80% R-R間期的有效劑量最低且節省輻射劑量的比例最高,與另兩種掃描方式相比皆有統計意義(P < 0.001)。 |
英文摘要 | Coronary artery anomalies (CAAs) can be benign or malignant and may result in coronary artery disease, myocardial ischemia, and sudden death. Several classifications of CAA by cardiac catheterization have been reported since 1990. The purpose of this study was to assess clinical symptoms relevant to classification of CAAs by using sixty-four multidetector computed tomography (MDCT). A total of 1,974 subjects (1,351 male, 623 female, mean age of 50.5 ± 10.9 years) who had undergone 64-MDCT from June 2006 to June 2009 were identified retrospectively. CT images were reviewed for coronary artery variants and anomalies. Data were interpreted by a radiologist and a cardiologist. The CAAs were classified into four groups: benign, relevant, severe, and critical that Rigatelli proposed in 2003. The clinical symptoms such as chest pain, chest tightness of the subjects with CAAs (except myocardial bridging) were evaluated. The follow-up time was from eight to forty-six months (mean time: 31.3 ± 12 months). Three scan protocols were used for these patterns: ECG tube current modulation (ETCM) with 70-80% exposure window, 40-80% exposure window and retrospective ECG-gating. Among them, the radiation dose and exposure saving were compared. The incidence rate of CAA was 3.19% (n = 63). The clinical relevance classifications are benign (n = 37), relevant (n = 13), severe (n = 10), and critical (n = 3). Ten subjects were excluded because of lack of follow-up information, and no cardiac death occurred among the fifty-three follow-up patients. Most subjects classified as severe were arranged for nuclear medical examination. Thirteen of CAAs have done cardiac catheterization, and the results were compatible with MDCT. There is no significant difference between the classification of CAAs and the clinical symptoms (P > 0.05). The possible reason is the small amount of our CAAs, and most subjects are for physical examination. Otherwise, the incidence rate of CAA in MDCT is higher than cardiac catheterization. It can be used as the first imaging modality in diagnosing CAAs. Subjects using ETCM with 70-80% exposure window can lower radiation dose and make more dose saving statistically significantly (P < 0.001). |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。