基于冠状动脉CT钙化积分图像与血管成像测量冠状动脉周围脂肪衰减指数的对比研究  

The fat attenuation index around coronary artery measurement on coronary calcium score images and coronary CT angiography images:a comparison study

作　　者：陈灿[1] 陶青 陈蒙[1] 查昕仪 胡粟[1] 胡春洪[1] Chen Can;Tao Qing;Chen Meng;Zha Xinyi;Hu Su;Hu Chunhong(Department of Radiology,the First Affiliated Hospital of Soochow University,Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医院放射科,苏州大学影像医学研究所,苏州215006

出　　处：《中华放射学杂志》2022年第3期254-258,共5页Chinese Journal of Radiology

基　　金：苏州市姑苏卫生人才计划项目(GSWS2020003);苏州市医疗健康信息技术重点实验室(SZS201818);江苏省医学会伦琴影像科研专项[SYH-3201150-0016(2021011)]。

摘　　要：目的探索不同阈值下基于冠状动脉钙化积分(CCS)图像测得的冠状动脉周围脂肪衰减指数(FAI)与基于冠状动脉CT血管成像(CCTA)图像测量结果的差异,并探讨基于CCS方法测量FAI的可行性并探索合适阈值。方法回顾性分析2019年8月至2020年8月于苏州大学附属第一医院行CCTA检查患者的临床及影像学资料,按纳排标准筛选后,非钙化斑块组纳入122例冠状动脉仅有非钙化斑块的患者,包含144支病变血管;无斑块组纳入97例冠状动脉未见明显异常的患者,包含186支正常血管。使用Perivascular Fat Analysis Tool软件勾画CCS和CCTA图像的冠状动脉并设置相应的脂肪组织阈值,软件自动生成冠状动脉周围脂肪的感兴趣区,并计算出FAI。CCS图像设置4种脂肪组织阈值(-190~-30、-185~-25、-180~-20和-175~-15 HU);CCTA图像设置1种脂肪组织阈值(-190~-30 HU)。用组内相关系数(ICC)评估2名医师基于CCS和CCTA图像测量FAI的组内及组间一致性。采用配对t检验比较CCS与CCTA图像测量的血管周围FAI间的差异,并采用Pearson相关系数探讨其相关性。结果(1)2名医师基于CCS及CCTA图像测得的FAI具有较好的组内及组间一致性;(2)阈值取-185~-25 HU时,非钙化斑块组基于CCS和CCTA图像测得的FAI分别为(-84.15±5.99)和(-83.83±5.98)HU,差异无统计学意义(t=0.79,P=0.429);且无斑块组基于CCS和CCTA图像测得的FAI分别为(-83.41±5.75)和(-83.84±6.25)HU,差异也无统计学意义(t=-1.08,P=0.280);(3)阈值取-190~-30、-180~-20和-175~-15 HU时,非钙化斑块组和无斑块组分别基于CCS与CCTA图像测得的FAI间差异有统计学意义(P均<0.05);(4)非钙化斑块组和无斑块组不同阈值下基于CCS图像测得的FAI与CCTA图像所测得的FAI均呈中度相关。结论基于CCS图像测量FAI具有可行性,合适阈值为-185~-25 HU。Objective To investigate the difference in the peri-coronary fat attenuation index(FAI)between using coronary calcium score(CCS)images and coronary CT angiography(CCTA)images,and to explore the feasibility and befitting threshold of FAI measured on CCS images.Methods The clinical and imaging data of patients who underwent CCTA examination from August 2019 to August 2020 were retrospectively analyzed in the First Affiliated Hospital of Soochow University.According to the inclusion and exclusion criteria,there were 122 cases in non-calcified plaque group(144 coronary arteries)and 97 cases in none-plaque group(186 coronary arteries).The coronary arteries were delineated both on CCS and CCTA images with Perivascular Fat Analysis Tool;the regions of interest of peri-coronary adipose tissue were generated automatically after setting the threshold of fat tissue.Then the FAI value was calculated.The thresholds were set in four levels(-190--30,-185--25,-180--20 and-175--15 HU)for CCS images and one level(-190--30 HU)for CCTA images.The intra-class correlation coefficient(ICC)was used to evaluate the consistency of the measurements of FAI values on CCS and CCTA images between the two physicians.Paired t test was used to compare the differences of FAI values between CCS and CCTA images,and Pearson correlation coefficient was used to evaluate the correlation between CCS-FAI and CCTA-FAI.Results(1)FAI values measured on CCS and CCTA images by 2 physicians showed good consistency;(2)At the threshold of-185--25 HU,there was no significant difference in FAI values between the CCS and CCTA images for non-calcified plaque group[(-84.15±5.99)HU vs.(-83.83±5.98)HU,t=0.79,P=0.429],as well as for the none-plaque group[(-83.41±5.75)HU vs.(-83.84±6.25)HU,t=-1.08,P=0.280];(3)There were significant differences on FAI values between the CCS images and CCTA images at the threshold of-190--30、-180--20 and-175--15 HU(all P<0.05);(4)There were moderate correlations on FAI values between the CCS images and CCTA images under different thre

关 键 词：体层摄影术 X线计算机 脂肪衰减指数 冠状动脉 

分 类 号：R541.4[医药卫生—心血管疾病] R816.2[医药卫生—内科学]