BMI结合基于高级迭代重建算法的CTCA对老年高危冠心病的诊断价值

Clinical Study on BMI Combined with CTCA Based on Advanced Iterative Reconstruction Algorithm in the Diagnosis of Elderly High-risk Coronary Heart Disease

目的:探讨体质量指数(BMI)结合基于高级迭代重建算法(ADMIRE)的冠状动脉计算机扫描成像血管造影(CTCA)对老年高危冠心病的诊断价值。方法:198例实施基于ADMIRE(强度1~5)的CTCA的老年高危冠心病患者,根据患者BMI分为低BMI组(n=46,BMI≤18 kg/m^2)、中BMI组(n=89,18 kg/m^2<BMI≤25 kg/m^2)及高BMI组(n=63,BMI>25 kg/m^2);对比不同ADMIRE强度下3组患者CTCA图像噪声、信噪比(SNR)、载波-噪音比(CNR)、主观评分、容积CT剂量指数(CTDIvol)、辐射剂量长度乘积(DLP)及有效剂量(ED),以单独基于ADMIRE的CTCA作为对照,绘制受试者工作曲线(ROC),得出曲线下面积(AUC),评价BMI结合基于ADMIRE的CTCA对老年高危冠心病的诊断价值。结果:低BMI组、中BMI组和高BMI组在不同ADMIRE强度下的图像噪声、SNR、CNR、主观评分、CTDIvol、DLP及ED比较,差异均有统计学意义(P<0.05),且每组图像噪声均随着ADMIRE强度的升高而降低(P<0.05),SNR、CNR、主观评分、CTDIvol、DLP和ED均随着强度的升高而升高(P<0.05);BMI结合基于ADMIRE的CTCA诊断老年冠心病AUC为0.942,而单独基于ADMIRE的CTCA诊断老年冠心病的AUC为0.814。结论:BMI结合基于ADMIRE的CTCA对老年冠心病的诊断价值明显优于单独基于ADMIRE的CTCA。

Objective： To investigate the diagnostic value of body mass index（ BMI） combined with coronary computed tomography angiography（ CTCA） based on advanced iterative reconstruction algorithm（ ADMIRE） in elderly high-risk coronary heart disease. Methods： The data of 198 elderly patients with high risk of coronary heart disease,based on ADMIRE（ 1 - 5）,were reviewed. The patients were divided into group A（ BMI≤18 kg/m^2）,group B（ BMI 〉18 kg/m^2 and ≤25 kg/m^2）,and group C（ BMI 〉25 kg/m^2）. The image noise,signal-to-noise ratio（ SNR）,carrier to noise ratio（ CNR）,subjective score,volume CT dose index（ CTDIvol）,dose length product（ DLP） and effective dose（ ED） under different ADMIRE intensity were compared. Then the receiver operating characteristic curve（ ROC） was plotted,and the area under the curve（ AUC） was obtained. Results： The image noise,signal-to-noise ratio（ SNR）,carrier to noise ratio（ CNR）,subjective scores,volume CT dose index（ CTDIvol）,dose length product（ DLP） and effective dose（ ED） showed significant differences among different ADMIRE intensities in group A,B and C（ P〈0. 05）,among which the noise decreased with the increase of the intensities,while the SNR,CNR,subjective scores,CTDIvol,DLP and ED increased with the increase of the intensities. The AUC of BMI combined with CTCA based on ADMIR in the diagnosis of elderly coronary heart disease was 0. 942,which was 0. 814 by only CTCA based on ADMIR. Conclusions： BMI combined with ADMIRE based on CTCA has a higher diagnostic value in elderly patients with coronary heart disease,which is significantly better than CTCA based on ADMIRE alone.