冠状动脉前降支不同造影体位和图像区域测量准确性分析  

The measurement accuracy of left anterior descending coronary artery in different angiographic position and image area

作　　者：张祥海 闫红野 周林 刘倩 廖春 张乐天 ZHANG Xianghai;YAN Hongye;ZHOU Lin;LIU Qian;LIAO Chun;ZHANG Letian(Department of Radiology,Daping Hospital,Army Medical University,Chongqing 400042,China)

机构地区：[1]中国人民解放军陆军军医大学大坪医院放射科,重庆400042

出　　处：《医学影像学杂志》2023年第3期417-421,共5页Journal of Medical Imaging

基　　金：重庆市科技计划项目(编号:CSTC2015YFPT-gcjsyjzx0175)。

摘　　要：目的探讨冠状动脉前降支在不同造影体位和图像区域测量的准确性。方法选取201例前降支支架植入术的造影图像共240幅,根据造影体位分为:右肩位(RAO 30°+CRA 30°)、头位(RAO 0°+CRA 30°)和左肩位(LAO 30°+CRA 30°)三组。将图像平均分为九个区域,比较血管内支架在不同造影体位和图像区域测量值与实际值的差异。结果三组样本间的血管特征和支架类型差异无统计学意义。右肩位造影图像上测量值和实际值差异无统计学意义(P>0.05),头位、左肩位图像中上区和中间区的测量值和实际值差异有统计学意义(P<0.05)。造影体位结合图像区域的模式下,右肩位+中上区、右肩位+中间区和头位+中上区的测量值与实际值比较差异无统计学意义(P>0.05)。头位+中上区、左肩位+中间区和左肩位+中上区的测量值和实际值呈正相关(r=0.864,0.835,0.823,P<0.05)。以测量值为自变量(X),实际值为因变量(Y)建立回归方程。头位+中上区:Y=4.664+0.91X(F=138.17,P<0.01);左肩位+中间区:Y=3.988+1.012X(F=50.56,P<0.01);左肩位+中上区:Y=6.955+0.828X(F=113.27,P<0.01)。结论不同造影体位和成像区域影响着图像的测量精确度。造影体位+图像区域的模式下测量值和实际值有很好的相关性,在前降支血管的测量中可以依据成像条件应用测量值或回归方程的计算结果,为介入治疗提供了更精准的手术方案。Objective To explore the measurement accuracy of left anterior descending(LAD)coronary artery during coronary angiography(CAG)in different angiographic positions and image areas.Methods A total of 240 patients’images of LAD angiography were collected retrospectively.The images were divided into three groups(n=80)according to angiographic position:the right shoulder position(RAO30°+CRA 30°),the cranial position(RAO 0°+CRA 30°)and the left shoulder position(LAO30°+CRA 30°).The images were equally divided into nine areas,the measured value and actual length of stent in different angiographic positions and image areas were compared.Results The vessel characteristics and stent types among the three groups showed no statistical differences(P>0.05).No significant difference was found between measured values of right shoulder position and actual lengths(P>0.05).There were significant differences between measured values and actual lengths in cranial position,left shoulder position,central areas and upper central areas of images(P<0.05).In the measuing mode of angiographic position combining with the imaging area,no significant difference of measured values was found in right shoulder positon plus central image area,right shoulder positon plus upper central image area and cranial position plus central image area versus actual lengths(P>0.05).The measuring values of cranial position plus upper central image area,left shoulder position plus central image area and left shoulder position plus upper central image area were assessed with correlation analysis and proved significant positive correlation(r=0.864,0.835,0.823,P<0.05).Establishing the linear regression equation between the measuring values(X)and actual value(Y),the cranial position plus upper central image area was Y=4.664+0.91X(F=138.17,P<0.01),left shoulder position plus central image area was Y=3.988+1.012X(F=50.56,P<0.01),left shoulder position plus upper central image area was Y=6.955+0.828X(F=113.27,P<0.01).Conclusion Angiographic position and image area

关 键 词：冠状动脉病变 介入性 放射学 造影体位 冠状动脉造影定量分析 

分 类 号：R541.4[医药卫生—心血管疾病] R815[医药卫生—内科学]