IQon光谱CT冠状动脉CTA多参数成像对冠心病的诊断价值  

Diagnostic value of IQon Spectral CT-coronary CTA multi-parameter imaging for coronary heart disease

作　　者：陈钦[1] 李华灿[1] 郑春红[1] 金佳熙 苏煜敏 许杨[1] CHEN Qin;LI Huacan;ZHENG Chunhong;JIN Jiaxi;SU Yumin;XU Yang(Imaging Department,the Second People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fujian,Fuzhou 350003,China)

机构地区：[1]福建中医药大学附属第二人民医院影像科,福建福州350003

出　　处：《中国医药科学》2024年第9期164-168,共5页China Medicine And Pharmacy

基　　金：福建省中青年教师教育科研项目(JAT210196)。

摘　　要：目的探讨IQon光谱计算机断层扫描(CT)冠状动脉CT血管造影(CTA)多参数成像对冠心病的诊断价值,包括斑块性质、心肌缺血、心肌纤维化等方面。方法于2021年1—12月采用IQon光谱CT多参数成像对福建中医药大学附属第二人民医院的100例患者进行检查,其中50例健康体验者为正常组,50例为疑似冠心病组。对所有受试者行光谱冠状动脉平扫检查,并进行钙化评分。对疑似冠心病组受试者注入对比剂,行冠状动脉CTA检查,并通过后处理软件获得虚拟平扫图像、有效原子序数图、碘密度图、多期相心肌碘密度图和延迟扫描心肌图像。对各种图像进行分析,评价其对冠心病诊断的价值,并计算最佳碘密度阈值。结果普通平扫和虚拟平扫所得钙化评分具有良好的一致性(Kappa=0.871)。有效原子序数图能够区分钙化和非钙化斑块,碘密度图能够反映斑块内碘分布。多期相心肌碘密度图能够显示心肌灌注情况,受试者工作特征曲线分析显示,碘密度阈值为30 HU时,对心肌缺血的诊断敏感度为90%,特异度为94%。结论IQon光谱CT冠状动脉CTA多参数成像对冠心病具有较高的诊断价值,能够提供综合的解剖和功能信息,为临床诊断和治疗提供依据。Objective To explore the diagnostic value of IQon Spectral computed tomography(CT)-coronary computed tomography angiography(CTA)multi-parameter imaging for coronary heart disease,including plaque properties,myocardial ischemia,myocardial fibrosis,and other aspects.Methods From January to December 2021,IQon Spectral CT multi-parameter imaging was used to examine 100 patients at the Second People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine.Among them,50 healthy individuals were in the normal group and 50 were in the suspected coronary heart disease group.Performed spectral coronary artery routine scans and calcification scoring on all subjects.Injected contrast agent to the suspected coronary heart disease group,performed coronary CTA examination,and obtained virtual routine scan images,effective atomic number maps,iodine density maps,multi-temporal myocardial iodine density maps,and delayed scan myocardial images through post-processing software.Analyzed various images,evaluated their values in the diagnosis of coronary heart disease,and calculated the optimal iodine density threshold.Results There have good consistency(Kappa=0.87)between the calcification scores obtained from routine and virtual routine scans.The effective atomic number maps could distinguish between calcified and non-calcified plaques,and the iodine density maps could reflect the distribution of iodine within plaques.Multi-temporal myocardial iodine density maps could display myocardial perfusion,and receiver operating characteristic curve analysis showed that when the iodine density threshold was 30 HU,the diagnostic sensitivity for myocardial ischemia was 90%,and the specificity was 94%.Conclusion IQon Spectral CT coronary CTA multi-parameter imaging has high diagnostic value for coronary heart disease,providing comprehensive anatomical and functional information as a basis for clinical diagnosis and treatment.

关 键 词：IQon光谱CT 冠状动脉CTA 多参数成像 冠心病 

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