双能量胸部DR对筛查冠状动脉钙化的意义:与多排螺旋CT的比较性研究  

Screening of Coronary Artery Calcification Using Digital Radiograhpy with Dual-energy Subtraction Chest:Compared with Multi-detector Row CT

作　　者：秦乃姗[1] 宋鲁新[1] 崔爱国[1] 胡晓煜[1] 蒋学祥[1] 

机构地区：[1]北京大学第一医院影像科,北京100034

出　　处：《实用放射学杂志》2006年第11期1333-1336,共4页Journal of Practical Radiology

摘　　要：目的探讨胸部双能量DR骨骼像在筛查冠脉钙化中的意义。方法35例患者分别行右前斜位胸部双能量DR检查及多排螺旋CT(MDCT)冠状动脉扫描并记录照射后射线的体表入射剂量ESD(mGy)。2位高年资放射科医师及2位低年资医师分析双能量胸片骨骼像,对LAD、LCX、RCA共105条血管的钙化情况进行评估。CT扫描图像进行钙化积分分析。以钙化积分>300为金标准,对双能量DR的结果进行ROC分析。结果DR胸片平均阳性率27.6%(29/105),其中LAD阳性率48.5%(17/35);LCX22.8%(8/35);RCA 11.4%(4/35)。4位医师的ROC结果显示曲线下面积分别为0.866、0.854、0.725、0.642。胸部DR照射平均体表入射剂量为(0.469±0.22)mGy;多排CT入射剂量为(12.29±1.40)mGy。两者经配对t检验有显著差异。结论DR骨骼片可以检出较明显的冠状动脉钙化,对冠心病的筛查和病情的检测有一定的临床意义。Objective To evaluate the diagnostic accuracy of dual - energy subtraction chest digital radiography C DR） for detecting coronary artery calcification as compared with multi - detector row CT （MDCT ）. Methods 35 patients underwent dual - energy subtraction chest DR and ECG - gated MDCT for detection of coronary artery calcifications. The radiation dose of both DR and CT were noted respectively. Two senior and two junior radiologists reviewed the radiogram and assessed the calcifications in LAD,LCX and RCA totaling 105 vessels. ROC curve plotting were used for evaluation with CAC calculated from MDCT as the gold standard. Paired t test was calculated to compare the different radiation dose between DR and CT. Results 27.6% vessels （29/105） showed calcification on DR. The positive incidence in LAD was 48.5% 117/35）, LCX 22.8% 18/35）, and RCA 11.4% 14/35）. The ROC area was0.866j0.854j0.725j0.642 respectively, with a CAC score of more than 300. The average radiation dose was 0. 469 ±0.22 mGy for DR, and 12.29 ±1.40 mGy for MDCT, showing significant differences. Conclusion Chest DR with dual energy subtraction can be used for screening of coronary artery calcification with relatively higher sensitivity for LAD.

关 键 词：冠状动脉钙化 双能量数字X线摄影 体层摄影术 X线计算机 

分 类 号：R543.3[医药卫生—心血管疾病] R814.42[医药卫生—内科学]