双层探测器光谱CT定量收缩期与舒张期心肌细胞外容积一致性研究  

A study on the consistency of myocardial extracellular volume quantification in the systole and diastole phases using dual-layer detector spectral CT

作　　者：刘紫渲 张钰 李燕君 程勇 帅桃[1] 王紫薇[1] 李真林[1] Liu Zixuan;Zhang Yu;Li Yanjun;Cheng Yong;Shuai Tao;Wang Ziwei;Li Zhenlin(Department of Radiology,West China Hospital of Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院放射科,成都610041

出　　处：《中华放射学杂志》2024年第2期165-171,共7页Chinese Journal of Radiology

摘　　要：目的探究双层探测器光谱CT定量心肌细胞外容积(ECV)在心脏收缩期与舒张期的一致性。方法该研究为横断面研究。回顾性纳入2022年4月至12月于四川大学华西医院行心脏光谱CT检查的患者35例, 扫描前3 d内采集红细胞比容, 扫描时采用双层探测器光谱CT获得延迟期的心脏收缩期(45%)及舒张期(75%)全息光谱图像, 并通过光谱后处理工作站分别得到收缩期和舒张期基于碘密度的ECV图像(CT-ECV)。根据美国心脏协会左心室16节段模型, 重建出标准心脏短轴位图像, 在左心室心底部、心中部和心尖部3个切面, 将心肌标准化分为16节段。两名放射科医师采用5分法对收缩期和舒张期的3个切面以及全心整体的CT-ECV图像质量进行主观评分, 并分别测量、计算收缩期和舒张期心肌16个节段和全心的心肌CT-ECV。对于两名医师的主观评价, 采用Kappa检验评价评分的一致性, 采用Wilcoxon符号秩和检验比较收缩期和舒张期之间的评分差异。采用配对样本t检验比较收缩期及舒张期各节段CT-ECV的差异。两名医师在CT-ECV图像上测量结果的观察者内和观察者间的一致性使用ICC检验。结果两名医师对收缩及舒张期CT-ECV图像质量主观评分的一致性较好(Kappa>0.80), 收缩期与舒张期心底层、心中层、心尖层及全心整体之间的图像质量差异均无统计学意义(P>0.05)。35例患者通过延迟期获得的收缩期及舒张期全心CT-ECV分别为(33.29±3.46)%、(33.50±3.39)%, 差异无统计学意义(t=-0.78, P=0.442)。心肌节段8收缩期、舒张期CT-ECV为(34.15±3.94)%、(35.30±3.99)%, 节段9收缩期、舒张期CT-ECV为(34.03±3.76)%、(35.46±3.74)%, 节段14收缩期、舒张期CT-ECV为(33.98±3.32)%、(35.05±3.98)%, 节段8、9、14的平均收缩期CT-ECV低于舒张期, 差异具有统计学意义(t值分别为-2.65、-3.26、-2.42, P值分别为0.012、0.003、0.022)。两名放射科医师测量的收缩期和舒Objective To investigate the consistency of myocardial extracellular volume between systole and diastole using dual-layer detector spectral CT.Methods This was a cross-sectional study.Thirty-five patients who underwent cardiac spectral CT examination in West China Hospital of Sichuan University from April 2022 to December 2022 were retrospectively collected.Hematocrit was collected within 3 days before the CT scan.The delayed phases holographic spectral images in systole(45%)and diastole(75%)were obtained using dual-layer spectral CT.CT data were processed using a spectral post-processing workstation,and the extracellular volume(ECV)based on iodine density images,referred as CT-ECV,in systolic and diastolic phases were calculated,respectively.According to the American Heart Association′s 16-segment model of left ventricular,the standard short-axis images were constructed,and the myocardium was standardized into 16 segments at the basal,mid-cavity,and apical levels of the left ventricle.Two radiologists performed a subjective evaluation in the image quality of the CT-ECV images of the whole heart and the three sections in systole and diastole using a"five-point"scale.The ECV of the 16 segments and the whole heart in systole and diastole was calculated.The consistency of subjective evaluations between systole and diastole was assessed using Kappa statistics.Wilcoxon signed-rank tests were used to compare the differences in scores between systole and diastole.Paired sample t-test was used to compare the differences in CT-ECV scores between systole and diastole.The intraclass correlation coefficient was used to test the intra-and inter-observer consistency of CT-ECV measurements between two radiologists.P<0.05 was statistically significant.Results There was good agreement between the two radiologists on subjective scores of CT-ECV image quality between systole and diastole(Kappa>0.80),and there was no statistical difference in image quality among the basal,mid-cavity,and apical levels of the left ventricle and whol

关 键 词：体层摄影术 X线计算机 细胞外容积 光谱CT 

分 类 号：R816.2[医药卫生—放射医学]