64层螺旋CT冠状动脉钙化积分计算的研究

The assessment of coronary calcium scoring of 64 multi-slice CT

目的:评价不同层厚重建、不同医师对64层螺旋CT冠状动脉钙化积分计算结果的影响。方法:40例行冠状动脉钙化积分扫描且冠状动脉有钙化的患者,对每一位患者的数据分别进行1.5 mm、2.0 mm、3.0 mm的重建,由两名医师分别获得不同层厚冠状动脉各段斑块钙化的Agatston积分、体积积分、钙质量积分,比较不同医师、不同层厚钙化积分值及图像质量的差异。结果:相同患者不同层厚重建各段冠状动脉得到不同的Agatston积分、体积积分、钙质量积分,两组皆以1.5 mm层厚重建获得的钙化积分最高,2.0 mm次之,3.0 mm最低,但差异无统计学意义(P>0.05)。两位医师对相同患者进行相同的层厚重建,冠状动脉各段得到不完全一致的Agatston积分、体积积分、钙质量积分,两位医师获得的积分值一致性较好(r≈1)。不同层厚重建的图像噪声差异具有统计学意义(P<0.05),相同层厚重建不同感兴趣区测得的图像噪声之间差异无统计学意义(P>0.05)。结论:64层螺旋CT钙化积分计算时,重建层厚3 mm即可获得较满意的结果。64层螺旋CT冠状动脉钙化积分软件较为稳定,不受操作者熟练程度的影响。

Objective： To evaluate the effects of different reconstruction thickness and different observers on coronary artery calcium score of 64 multi-slice CT.Methods： Forty consecutive cases who underwent coronary artery calcium and demonstrated with coronary calcification were enrolled in this study.The data of coronary artery calcium was reconstructed with slice thickness of 1.5 mm,2.0 mm and 3.0 mm by two observers separately to obtain the Agatston score（AS）,volume score（VS）and mineral mass score（MS）.The inter-and intraobserver agreement were analyzed.The image noise of different reconstruction thickness and different region of interest（ROI） was appreciated.Results： Different reconstruction thickness result in different AS、VS and MS.The slice thickness of 1.5 mm produced the highest score,whereas thickness of 3 mm resulted in the lowest score,but the score showed no significant statistical difference（P0.05）.The observers didn＇t acquired completely same score but the consistency was perfect（r≈1）.The difference of image noise between reconstruction slice was significant（P0.05）.There was no significant difference according to different ROI with the same reconstruction thickness（P0.05）.Conclusion： It is available to evaluated coronary calcium score with 3 mm reconstruction thickness of 64 multi-slice CT.The score isn＇t affected by different observers due to the stable Cascoring software.