颈动脉粥样硬化斑块MDCT定量分析  

Quantitative analysis of carotid atherosclerotic plaque by MDCT

作　　者：黄山[1] 郑穗生[1] 管松[1] 邹立巍[1] 王超[1] 

机构地区：[1]安徽医科大学第二附属医院放射科,安徽合肥230601

出　　处：《中国医学影像技术》2015年第11期1671-1674,共4页Chinese Journal of Medical Imaging Technology

基　　金：安徽省质量工程项目-医学影像教学团队(2014jxtd119)

摘　　要：目的探讨采用颈动脉粥样硬化斑块平扫CT值和强化幅度预测脑血管症状的价值。方法纳入87例拟诊为颈动脉粥样硬化接受MDCT平扫及CTA的患者,根据有无脑血管症状分为有症状组(n=38)及无症状组(n=49),通过手动勾画ROI的方法测量CT平扫及CTA图像上斑块非钙化部分的CT值,采用独立样本t检验比较组间差异。应用ROC曲线分析采用平扫CT值及强化幅度判定是否引起脑血管症状的效能,并采用Z检验对曲线下面积进行比较。结果有症状组和无症状组颈动脉斑块平扫CT值分别为(45.58±8.94)HU和(31.09±6.83)HU,二者差异有统计学意义(t=-8.569,P<0.001);有症状组颈动脉斑块强化增幅大于无症状组(t=-3.421,P=0.001)。ROC曲线阈值分析显示,平扫CT值最佳临界值为37.20HU,判定是否引起脑血管症状的敏感度为92.10%(35/38),特异度为81.63%(40/49),准确率86.21%(75/87),ROC曲线下面积为0.937。强化幅度最佳临界值为10.1 HU,其敏感度为76.32%(29/38),特异度为63.27%(31/49),准确率为68.97%(60/87),曲线下面积为0.735;二者曲线下面积的差异有统计学意义(Z=3.613,P<0.01)。结论颈动脉斑块非钙化部分平扫CT值和强化幅度与脑血管症状有关;斑块平扫CT值对判断是否引起脑血管症状的效能优于斑块强化幅度。Objective To explore the predictive value of pre-contrast CT value and enhancement amplitude of carotid atherosclerotic plaque for cerebrovascular symptoms.Methods Totally 87 patients diagnosed as carotid atherosclerosis were included and accepted non-enhanced and enhanced MDCT scan.According to the presence or absence of cerebrovascular symptom,the patients were divided into symptomatic group（n=38）and asymptomatic group（n=49）.The CT values were measured on non-enhanced and enhanced CT scan by manually outlining the ROI on non-calcified plaque section,and then the differences between two groups were evaluated using the independent t-test.The ROC curve was used to evaluate the optimal threshold and diagnostic efficacy of pre-contrast CT value and enhancement amplitude in predicting cerebrovascular symptom and the difference of area under ROC curve（AUC）were analyzed using Ztest.Results The pre-contrast CT value of symptomatic group and asymptomatic group were（45.58±8.94）HU and（31.09±6.83）HU,respectively,and the difference was statistically significant（t=-8.569,P〈0.001）.Enhancement amplitude of the symptomatic group was higher than that in asymptomatic group（t=-3.421,P=0.001）.ROC analysis showed that 37.20 HU of pre-contrast CT value was the optimal threshold to predict cerebrovascular symptom,the specificity,sensitivity and accuracy was92.11%（35/38）,81.63%（40/49）,86.21%（75/87）,respectively,the AUC was 0.937,while the optimal threshold of enhancement amplitude was 10.1HU,the specificity,sensitivity and accuracy was 76.32%（29/38）,68.97%（60/87）,63.27%（31/49）,respectively,the AUC was 0.735.The difference of AUC between two groups was statistically significant（Z=3.613,P〈0.01）.Conclusion The pre-contrast CT value and enhancement amplitude on part of non-calcified carotid artery plaque have relationship with cerebrovascular symptom.The pre-contrast CT value of plaque is superior to enhancement amplitude in evaluating whether caused cerebrovascular symptom.

关 键 词：体层摄影术 X线计算机 颈动脉粥样硬化 斑块 

分 类 号：R814.42[医药卫生—影像医学与核医学] R543.5[医药卫生—放射医学]