双源CT双能量去骨技术在颈动脉狭窄病变中的应用价值

Application of dual-energy bone-removal technique in carotid artery stenosis with dual-source computed tomography

目的:探讨双源CT双能量去骨技术在颈动脉钙化性狭窄病变中的应用价值。方法:回顾性分析18例颈动脉钙化性狭窄患者的病例资料,根据北美症状性颈动脉内膜切除试验(NASCET)标准评价血管的狭窄程度,分析颈动脉双能量去骨技术去除钙化斑块后的图像与DSA图像在量化分析颈动脉狭窄程度上的相关性。以DSA图像为对照,评价双能量去骨技术诊断钙化性颈动脉狭窄的敏感性、特异性、准确性、阳性和阴性预测值。结果:64段有明显致密钙化斑块的颈动脉血管,双能量去骨技术检出54个血管节段狭窄,DSA检出50个血管节段狭窄,两者对于颈动脉钙化性狭窄病变的检出差异无统计学意义(P>0.05),两者对于狭窄程度的分级相关性好(R2=0.913)。以DSA为对照,双能量去骨技术检出颈动脉狭窄的敏感度为98.0%,特异度为100.0%,符合率为90.6%,阳性预测值为90.7%,阴性预测值为90.0%。结论:采用双能量去骨技术去除钙化斑块可以很好地评价颈动脉钙化性狭窄病变。

Objective：To evaluate the application of dual energy （DE） bonmremoval technique in the diagnosis of cal cified carotid artery stenosis with dual-source computed tomography. Methods： 18 cases of calcified carotid artery stenosis were analyzed retrospectively. According to the North American Symptomatic Carotid Endarterectomy Trial （NASCET） criteria, the degree of carotid stenosis was assessed, and the correlation of carotid artery images after the calcified plaque was removed with DE bone removal technique and the DSA images were analyzed in respect of the quantified analysis of the de gree of carotid stenosis. The sensitivity,specificity,accuracy, positive predictive value （PPV） and negative predictive value （NPV） of CT images with DE bone-removal technique were compared with DSA images in the diagnosis of carotid artery stenosis. Results：It was demonstrated that 54 segments of vessel were narrow on the CT images with DE bone removal technique in the total 64 segments of vessels with obvious calcification, while 50 segments on the DSA images. The detection rate of calcified carotid artery stenosis was not significantly different in the two groups （P〉0.5）, while the degrees of ste nosis were in good correlation with each other （R2 = 0.913）. Compared with the DSA images, the sensitivity, specificity, ac curacy,PPV and NPV of CT images with DE bone-removal technique were 98.0% ,100.0% ,90.6% ,90.7% and 90.0% in the detection of calcified carotid artery stenosis respectively. Conelusion：CT images with removal of the plaque by DE bone- removal technique are beneficial to the assessment of calcified carotid artery stenosis.