无门控大螺距胸部CT扫描心脏冠状动脉钙化积分的可行性研究  

Coronary artery calcification score detection using thorax CT with TurboFlash mode:a feasibility study

作　　者：顾耕 陶欣慰 邓建宏[1] GU Geng;TAO Xinwei;DENG Jianhong(Department of Radiology,Shanghai Sixth People's Hos pital,Shanghai,200233,China)

机构地区：[1]上海市第六人民医院放射科,上海200233

出　　处：《实用放射学杂志》2022年第6期910-914,918,共6页Journal of Practical Radiology

摘　　要：目的 探讨TurboFlash模式下胸部CT平扫用于冠状动脉钙化积分的可行性.方法 回顾性分析既行冠状动脉CT血管成像(CTA)检查又行TurboFlash模式下胸部CT平扫检查的患者.比较2种技术冠状动脉血管钙化体积、等效质量和Agatston评分数据有无差异.结果 定量测定中,2种技术所得钙化体积、等效质量和Agatston评分数据有显著差异(P<0.05),该差异主要由右冠状动脉(RCA)引起,差异系数为0.989.在各亚组中,2种技术的各类评分也有良好的一致性:按照心率分组,各参数的组内相关系数(ICC)均在0.9以上,加权Kappa值均>0.8;按照体质量指数(BMI)分组,各评分的ICC在0.8以上,除B4组外,加权Kappa值均>0.9(B4组为0.722).将患者按照Agatston评分4个等级划分冠心病风险等级,2种技术间一致性极佳[加权Kappa=0.91,95%置信区间(CI):0.84,0.98].在心率分组和不同BMI分组中,钙化积分的定性分级无显著差别(P=0.897,P=0.77).结论 胸部CT检查使用TurboFlash模式是一种可靠的冠状动脉钙化积分筛查影像学模式,具有可直接定量计算钙化积分的潜力.Objective To investigate the feasibility of TurboFlash mode for thorax CT used in coronary artery calcification score.Methods Patients who underwent both coronary computed tomography angiography(CTA)and thorax CT with TurboFlash mode were analyzed retrospectively.Differences in calcification volume,equivalent mass and Agatston score derived from the two acquisition modes were com pared.Results In the quantitative measurements,there was a significant difference between calcification volume,equivalent mass and Agatston score derived from two scan modes(P<0.05),which was mainly caused by the right coronary artery(RCA)with the coefficient in linear regression 0.989.In subgroup analysis,the Agatston score from two techniques also had a good agreement.For different heart rate subgroups,the agreement of the measurements derived from the two techniques was excellent with the interclass correlation coefficient(ICC)above 0.9,and weighted Kappa values greater than 0.8;for different body mass index(BMI)subgroups,the ICC was above 0.8 for all measurements,with weighted Kappa values greater than 0.9 except for group B4(0.722).For risk stratification with Agatston score,excellent agreement between the two techniques[weighted Kappa=0.91,95% confidence interval(CI):0.84,0.98]was found.There was no significant difference in stratification of calcification score in subgroups divided by heart rate or BMI(P=0.897 and 0.77,respectively)Conclusion Thorax CT examination using TurboFlash mode is a reliable method for screening coronary artery calcification score.It has the potential to directly quantify coronary calcification.

关 键 词：冠状动脉钙化积分 等效质量 Agarston评分 计算机体层成像 

分 类 号：R816.2[医药卫生—放射医学] R816.4[医药卫生—临床医学] R814.42