双能CT定量参数鉴别颈动脉自发性壁内血肿及动脉粥样硬化的价值  

The value of dual-energy CT quantitative parameters in differentiating carotid artery spontaneous intramural hematoma and atherosclerosis

作　　者：牛剑飞 王灵杰 石彩云 张倩[2] 张华[2] NIU Jianfei;WANG Lingjie;SHI Caiyun;ZHANG Qian;ZHANG Hua(School of Medical Imaging,Shanxi Medical University,Taiyuan 030001,China;Department of Imaging,the First Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学医学影像学院,山西太原030001 [2]山西医科大学第一医院影像科,山西太原030001

出　　处：《实用放射学杂志》2023年第2期195-198,共4页Journal of Practical Radiology

基　　金：山西省重点研发项目(201803D31109)。

摘　　要：目的探讨双能CT定量参数鉴别颈动脉自发性壁内血肿及动脉粥样硬化的价值。方法回顾性分析经高分辨率磁共振血管壁成像(HRMR-VWI)检查或随访证实的14例颈动脉自发性壁内血肿患者和56例动脉粥样硬化患者的双能CT数据。比较2组常规CT值、标准化碘浓度(NIC)、标准化有效原子序数(Zeff-c)、脂肪分数、能谱曲线斜率(λHU)、虚拟平扫(VNC)CT值及病灶与管腔的VNC CT值差值(VNCΔCT)的差异,将差异有统计学意义的参数进行多因素分析得出独立预测因子,并绘制受试者工作特征(ROC)曲线,评估鉴别诊断效能。结果NIC、VNCΔCT是鉴别颈动脉自发性壁内血肿和动脉粥样硬化的独立预测因子(P<0.05)。NIC、VNCΔCT及2个参数联合鉴别2种疾病的曲线下面积(AUC)分别为0.83、0.76和0.88,敏感度分别为78.6%、71.4%和85.7%,特异度分别为83.9%、78.6%和83.9%。结论双能CT定量参数中的NIC、VNCΔCT及2个参数联合能够对颈动脉自发性壁内血肿及动脉粥样硬化进行鉴别,为2种疾病的鉴别提供了一种新的影像学证据。Objective To evaluate the value of dual-energy CT quantitative parameters in distingushing carotid artery spontaneous intramural hematoma and atherosclerosis.Methods Dual-energy CT data of 14 patients of carotid artery spontaneous intramural hematoma and 56 patients of atherosclerosis confirmed by high-resolution magnetic resonance vessel wall imaging(HRMR-VWI)or follow-up were retrospectively analyzed.The conventional CT attenuation value,normalized iodine concentration(NIC),normalized effective atomic number(Zeff-c),fat fraction,λHU,the CT attenuation value of virtual non-contrast(VNC)and the difference of CT attenuation value of VNC between lesion and tube lumen(VNCΔCT)were compared between different groups,from which the statistically significant variables tested were substituted into multivariate Logistic regression to determine independent prediction predictors,and receiver operating characteristic(ROC)curves were used to evaluate diagnostic efficacy.Results NIC and VNCΔCT were independent predictors in distingushing carotid artery spontaneous intramural hematoma and atherosclerosis(P<0.05).The area under the curves(AUC)of NIC,VNCΔCT and combined NIC and VNCΔCT were 0.83,0.76 and 0.88,the sensitivity was 78.6%,71.4%and 85.7%and the specificity was 83.9%,78.6%and 83.9%,respectively.Conclusion The NIC,VNCΔCT and combined two parameters can differentiate carotid artery spontaneous intramural hematoma and atherosclerosis,which provide a new imaging evidence in distingushing two diseases.

关 键 词：壁内血肿 动脉粥样硬化 血管造影术 颈动脉 计算机体层成像 

分 类 号：R543.4[医药卫生—心血管疾病] R814.42[医药卫生—内科学] R814.43[医药卫生—临床医学]