利用非门控胸部CT平扫数据行冠状动脉钙化积分评价的可行性分析  

Feasibility study of coronary artery calcification score evaluation using non-gated chest CT

作　　者：顾海峰 王清清 梁泉 蔡军 张龙江 GU Haifeng;WANG Qingqing;LIANG Quan;CAI Jun;ZHANG Longjiang(Department of Diagnostic Radiology,General Hospital of Eastern Theater Command,Jinling Hospital,Nanjing University School of Medicine,Nanjing China)

机构地区：[1]中国人民解放军东部战区总医院,南京大学医学院附属金陵医院放射诊断科,江苏南京210002

出　　处：《医学影像学杂志》2024年第7期22-26,共5页Journal of Medical Imaging

基　　金：江苏省科技项目(编号:BE2020699)。

摘　　要：目的 探讨利用非门控胸部CT平扫数据评定冠状动脉钙化积分(coronary artery calcium scoring, CACS)的准确性、可行性。方法 选取临床需要同时做胸部CT平扫和冠状动脉CT血管造影(CTA)检查的患者(BMI≤25kg/m^(2))且CACS扫描时发现有冠状动脉钙化患者165例,采用标准的计算CACS的图像重建要求分别对两种扫描方法获得原始数据进行重建,然后对主动脉根部管腔CT值、标准差(SD)、图像信噪比(SNR)、冠状动脉钙化斑块(CAC)的最大CT值以及CAC的数量、体积与质量进行测量和对比,再分别计算每种扫描方法对应的Agatston(AS)积分,最后进行统计学处理。结果 两种不同扫描方法对主动脉根部管腔内CT值、SD、SNR、对比度噪声比(contrast-to-noise ratio, CNR)、CAC最大CT值、CAC的数量、体积、质量以及AS评分差异均有统计学意义(P<0.05)。胸部CT平扫相比CACS扫描,无论是对所有患者的危险分组还是对符合条件的部分患者的危险分层,均有低分组患者数量明显增多,高分组患者数量相对减少。其中52.35%的患者经胸部CT平扫时获得的危险分层情况与CACS扫描的分层情况一致,有40.94%的患者向下移动了一个层级,即危险分层被低估了一个层级。结论 利用非门控胸部CT平扫数据评价CACS还是有一定误差的,但考虑到这只是额外提供诊断信息,只要对结果判读时留意到这一差别还是有积极的指导意义。Objective To evaluate the accuracy and feasibility of evaluating coronary artery calcium score(CACS)using non-gated chest CT scan data.Methods 165 patients(BMI≤25kg/m^(2)),who were needed to have both chest CT and coronary CT angiography as well as found to have coronary artery calcified plaque(CAC)during CACS scan,were collected in this work.All the raw data were reconstructed separately using the image reconstruction requirements of CACS.Then,we measured and computed the CT value of aortic root,standard deviation(SD),signal-to-noise ratio(SNR),the max CT value of CAC and the number,volume and mass of the CAC,and calculated the AS scores,separately.Finally statistical processing was performed.Results The two different scanning methods showed statistically significant difference in the CT value of aortic root,SD,SNR,the max CT value of CAC and the number,volume and mass of the CAC(P<0.05).Compared with CACS scan,the number of patients in the chest CT scan were significantly increased in the low risk stratification group and relatively decreased in the high risk stratification group.In the risk stratification situation,52.35%of the patients obtained by the chest CT scan were consistent with the CACS scan,and 40.94%of the patients moved down one level.Conclusions There is a little different in evaluating CACS with non-gated chest CT scan data,but considering that it only provides additional diagnostic information,as long as we pay attention to the existence of this difference when interpreting the results,it still has positive guiding significance.

关 键 词：冠心病 体层摄影术 X线计算机 冠状动脉钙化积分扫描 冠状动脉钙化积分 

分 类 号：R541.4[医药卫生—心血管疾病] R814.42[医药卫生—内科学]