전자선단층촬영 관상동맥석회화 정량분석과 관상동맥질환의 비교 = Correlation between Electron Beam Tomographic Coronary Calcium Quantitation and atherosclerotic Coronary Arterial Disease

국문 초록 (Abstract)

목적 : 전자선단층촬영(EBT)으로 관찰이 가능한 관상동맥의 석회화병변을 정량화 하여 동맥경화성 관상동맥질환과 비교 분석하고 그 연관성을 알아보고자 하였다.
대상 및 방법 : 총 53명의 입원 및 외래환자들을 대상으로 EBT를 시행한 후 201Th 심근스캔, 운동부하 심전도검사, 또는 관상동맥조영술을 실시하여 관상동맥질환을 검사하였다. Kendos와 Rumberger에 의해 제안된 석회화수치환산표를 이용하여 EBT 검사결과를 Negative, Low risk, Moderate risk, high riks, very high risk group으로 구분하고 기존의 검사방법을 이용한 검사결과를 정상군, 무증상질환군, 유증상질환군으로 나누어 서로 비교하였다.
결과 : 정상군에서 관상동맥석회수치검사상 negative group이 26명(76%), low risk group이 4명(12%), moderate risk group과 high risk group이 각각 2명(6%)이었고 무증상질환군에서는 High risk group이 1명(33%), very high risk group이 2명(66%)이었다. 또한 유증상질환군에서는 very high risk group이 7명(44%), high risk group이 4명(25%), moderate risk group이 1명(6%), low risk group이 3명(19%), negative group이 1명(6%)으로 비교적 다양한 분포를 보였다. moderate risk group이하와 그 초과 group들을 묶어 크게 두 집단으로 나누고 정상군과 무증상질환군을 비교한 결과 민감도는 100%였고 특이도는 94%였다. 또한 정상군과 질환군을 비교할 경우 민감도는 74%이고 특이도는 94%였다.
결론 : EBT를 이용한 관상동맥석회화검사는 정상군과 무증상질환군을 구분함으로써 동맥경화성관상동맥질환의 조기발견에 도움이 될 것으로 생각된다. 그러나 더 많은 환자를 대상으로 한 연구가 지속되어야 하겠다.

다국어 초록 (Multilingual Abstract)

To analyze the relationship between the presence of obstructive coronary arterial disease and the Electron-beam tomographic coronary calcium quantitation, we have examined 53 patients with EBT scan and conventional studies such as 201Th-MIBI scan, exercise-stress EKG and coronary angiography. We divided the coronary calcium values into 5 groups according to Kondos-Rumberger recommendation (unpublished data) and compared them with the results of conventional studies for coronary arterial disease.
As results, we could find that normal patients (94%) distributed in groups below moderate risk group, and all asymptomatic positive patients were included in high and very high risk groups. Although larger portion of symptomatic positive patients (69%) were in very high and high risk groups, the distribution was quite broad. Due to the limitation in patient number, statistical data analysis was not performed. However, by combining five coronary calcium score groups into two groups, we carried out two-by-two table analysis. The result was then compared with (1) normal and asymptomatic positive group, and (2) normal and disease-positive group. In these analyses the sensitivity for asymptomatic positive group was 100% and the specificity was 94%. The sensitivity for disease-positive group was 74% and the specificity was 94%.
In conclusion, EBT coronary calcium quantitation was useful to differentiate asymptomatic positive patients from normal one and subsequently was valuable in early diagnosis of atherosclerotic coronary areterial disease. However, more-extensive study will be indispensible to acquire more definite result.