基于冠脉CTA减影的斑块定量参数对冠状动脉钙化所致狭窄程度的评估  

Evaluation of Plaque Quantitative Parameters Based on Coronary CTA Subtraction for the Degree of Stenosis Caused by Coronary Artery Calcification

作　　者：李前进 田鑫 LI Qianjin;TIAN Xin(Department of Imaging,Jincheng People’s Hospital,Jincheng 048000,Shanxi,P.R.China)

机构地区：[1]晋城市人民医院影像科,山西晋城048000

出　　处：《影像科学与光化学》2024年第4期299-307,共9页Imaging Science and Photochemistry

基　　金：山西省(科技厅)基础研究计划(20210302123015)。

摘　　要：目的:探讨基于冠状动脉CT血管造影(CCTA)减影的斑块定量参数对冠状动脉钙化所致狭窄程度评估的可行性。方法:选择2021年4月至2023年6月于我院行CCTA减影检查的184例患者,经影像学检查后根据管腔狭窄程度分为阳性组(n=84)和阴性组(n=100),比较两组患者的一般资料以及斑块定量参数;采用受试者操作特征(ROC)曲线评估CCTA减影的斑块定量参数对冠状动脉钙化所致明显狭窄的诊断价值;采用分层回归模型分析不同斑块定量参数与冠状动脉钙化所致明显狭窄的关系;采用多因素Logistic回归分析影响冠状动脉钙化所致明显狭窄发生的危险因素;研究对象按1∶1的比例随机分为建模组(n=92)和验证组(n=92),构建人工神经网络(ANN)预测模型并评价。结果:阳性组与阴性组患者钙化积分之间具有显著差异(P<0.05);与阴性组患者相比,阳性组患者斑块长度、斑块总体积、斑块负荷、钙化斑块体积、钙化斑块比例以及钙化成分平均密度更大(P<0.05);CCTA减影斑块定量参数的斑块长度、斑块总体积、斑块负荷、钙化斑块体积、钙化斑块比例、钙化成分平均密度对冠状动脉钙化所致明显狭窄的诊断效能良好。且联合诊断冠状动脉钙化所致明显狭窄,诊断效能更高;分层回归分析结果显示,斑块长度、斑块总体积、斑块负荷、钙化斑块体积、钙化斑块比例、钙化成分平均密度会对冠状动脉钙化所致明显狭窄产生正向影响关系(P<0.05);多因素Logistic回归分析显示,钙化积分、斑块长度、斑块总体积、斑块负荷、钙化斑块体积、钙化斑块比例、钙化成分平均密度升高均为行CCTA减影检查的患者发生冠状动脉钙化所致明显狭窄的危险因素(P<0.05);多因素Logistic回归筛选出的7个变量作为ANN输入变量,其中,斑块长度、斑块总体积、斑块负荷、钙化斑块体积等指标对冠状动脉钙化所致明显狭窄的影响最大Objective:To explore the feasibility of plaque quantitative parameters based on coronary CT angiography(CCTA)subtraction in evaluating the degree of stenosis caused by coronary artery calcification.Methods:A total of 184 patients who underwent CCTA subtraction examination in our hospital from April 2021 to June 2023 were selected.After imaging examination,they were divided into positive group(n=84)and negative group(n=100)according to the degree of lumen stenosis.General data and plaque quantitative parameters of the two groups were compared.Receiver operating characteristic(ROC)was used to evaluate the value of plaque quantitative parameters of CCTA subtraction in the diagnosis of significant coronary artery stenosis caused by calcification.Hierarchical regression model was used to analyze the relationship between different plaque quantitative parameters and coronary artery stenosis caused by calcification.Multivariate Logistic regression was used to analyze the risk factors of coronary artery stenosis induced by calcification.The subjects were randomly divided into a training set(n=92)and a verification set(n=92)at a 1∶1 ratio,and the artificial neural network(ANN)prediction model was constructed and evaluated.Results:There was significant difference in calcification score between positive group and negative group(P<0.05).Compared with the negative group,the plaque length,total plaque volume,plaque load,calcified plaque volume,calcified plaque proportion and average density of calcified components in the positive group were higher(P<0.05).Plaque length,total plaque volume,plaque load,calcified plaque volume,proportion of calcified plaque,and average density of calcified components of CCTA subtractive plaque quantitative parameters were effective in the diagnosis of significant coronary artery stenosis caused by calcification.And combined diagnosis of coronary artery calcification caused by obvious stenosis,diagnosis efficiency is higher.Stratified regression analysis showed that plaque length,total plaque vol

关 键 词：冠状动脉血管造影 减影技术 动脉斑块 冠状动脉狭窄 

分 类 号：R445.3[医药卫生—影像医学与核医学]