Mehmet Metin BAYRAM, Feyza GELEBEK YILMAZ

Koroner arter patolojilerinin değerlendirilmesinde çok kesitli bilgisayarlı tomografi anjiografi ile invaziv koroner anjiografinin karşılaştırılması

Amaç: Çalışmamızda koroner arter darlıklarının değerlendirmesinde, çok kesitli bilgisayarlı tomografi anjiografi (ÇKBT) bulguları ile konvansiyonel koroner anjiografi (KKA) bulgularını karşılaştırmak ve koroner ÇKBT’ nin tanıdaki yerini araştırmak amaçlanmıştır. Yöntemler: Çalışmaya dahil edilen 50 hastaya (42 erkek ve 8 kadın; ortalama yaşları 56±4) ÇKBT ve bunu takip eden 4 hafta içerisinde KKA incelemeleri yapıldı. ÇKBT incelemesine alınan tüm hastalar sinüs ritminde ve kreatinin seviyesi 1,5 mg/dL’nin altında idi. ÇKBT’ da koroner arter proksimal, orta ve distal segmentlerde tespit edilen darlık ve oranları, KKA’ da tespit edilen darlık ve oranları ile karşılaştırıldı. Duyarlılık, özgüllük, pozitif ve negatif kestrim değerleri hesaplandı. Bulgular: ÇKBT incelemesinde proksimal segment darlıklarında duyarlılık %95, özgüllük %92, pozitif kestrim değeri %92 ve negatif kestrim değeri %95; orta segment darlıklarında duyarlılık %95, özgüllük %96, pozitif kestrim değeri %94 ve negatif kestrim değeri %97; distal segment darlıklarında ise duyarlılık %92, özgüllük %96, pozitif kestrim değeri %80 ve negatif kestrim değeri %98 bulundu. Sonuç: Çalışmamız ÇKBT’nın koroner arterlerin değerlendirilmesinde, özellikle proksimal ve orta segment darlıklarında, güvenilir bir tanısal inceleme olduğunu göstermektedir. ÇKBT, koroner arter hastalığı için düşük-orta riskli semptomatik veya asemptomatik hastalarda tarama ve tanı amacıyla non-invaziv olarak kullanılabilecek bir görüntüleme yöntemi olup teknolojisindeki hızlı gelişmeler ve devamlı artan başarı oranları sayesinde, çok daha etkin ve yaygın olarak kullanılması gereken bir tetkiktir.

The comparison of multislice computed tomography coronary angiography and invasive coronary angiography for the detection of coronary artery pathologies

Objective: We aimed to compare the findings of multi-slice computed tomography (MSCT) coronary angiography and conventionalcoronary angiography (CCA) in the assessment of coronary artery obstructions and to identify the role of MSCT in the diagnosisof coronary artery pathologies.Methods: 50 patients (42 males and 8 females, mean age 56±4 years) underwent MSCT followed by CCA within 4 weeks. Thepatients were on sinus rhythm, could hold their breaths for at least 15 second and had creatinine levels below 1.5 mg/dL. Thenumbers and rates of obstructions identified in the proximal, middle and distal segments of the coronary arteries with MSCT werecompared to those identified with CCA. Sensitivity, specificity, positive, and negative predictive values were calculated.Results: MSCT had sensitivity, specificity, positive, and negative predictive values for proximal segment obstructions of 95%, 92%,92%, and 95%, respectively; for middle segment obstructions: 95%, 96%, 94%, and 97%, respectively; and for distal segment obstructions:92%, 96%, 80%, and 98%, respectively.Conclusion: This study shows us that MSCT is a reliable diagnostic tool in the assessment of coronary arteries, especially in thepresence of proximal and middle segment obstructions. Being a non-invasive imaging modality that can be used for screeningand diagnosis purposes in symptomatic or non-symptomatic coronary artery disease patients with low-to-moderate risks, MSCTis a candidate technique for more effective and widespread use thanks to the rapid developments in its technology and its continuouslyincreasing success rates.

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