减影冠状动脉CT血管成像对轻中度钙化积分患者的诊断价值

Diagnostic value of subtraction coronary computed tomography angiography in patients with mild-moderate calcification score

目的:探讨减影冠状动脉CT血管成像(coronary computed tomography angiography,CCTA)在轻中度钙化积分(Agatston score<400分)患者中的临床应用价值。方法:对接受减影CCTA扫描的69例冠状动脉轻中度钙化患者的临床资料进行回顾性分析。采用4分法评估冠状动脉节段图像质量。定量评估每个钙化节段的狭窄程度,将狭窄分为Ⅰ、Ⅱ、Ⅲ、Ⅳ共4个等级。定量测量每个病变节段所需时间。结果:69例患者共113个钙化节段。常规CCTA与减影CCTA评估钙化节段的平均成像质量分别为(3.4±0.6)分、(3.8±0.4)分,差异有统计学意义(P<0.01);常规CCTA与减影CCTA定量测量钙化节段狭窄程度所需平均时间分别为(105±44)s、(72±44)s,差异有统计学意义(P<0.01)。描述这两种成像方法评估狭窄分级一致性的Kappa值为0.77。结论:上述两种成像方法对评估轻中度钙化冠状动脉狭窄程度具有良好的一致性;与常规CCTA相比,减影CCTA可提高成像质量,减少定量评估冠状动脉病变节段狭窄所需时间。

Objective:To investigate the clinical diagnostic value of subtraction coronary computed tomography angiography(CCTA)in patients with mild-moderate calcification of coronary artery(Agatston score<400).Methods:A retrospective analysis of 69 cases with mild-moderate coronary calcification undergoing subtraction CCTA was performed.The image quality of calcified segments was evaluated using 4-point scale method.The stenosis of calcified segment was quantitatively assessed and divided into four different classifications(Ⅰ-Ⅳ).The time for quantitative assessment of calcified segments was recorded.Results:There were 113 calcified segments in 69 cases.The average image quality of calcified segments for conventional CCTA and subtraction CCTA was(3.4±0.6)and(3.8±0.4),respectively,with significant difference(P<0.01).The Kappa coefficient used to describe the consistency of the stenosis grading in these two imaging methods was 0.77.The average time needed for quantitative assessment was(105±44)s and(72±44)s,respectively,with significant difference(P<0.01).Conclusions:The two imaging methods have good consistency in evaluating stenosis grading in patients with mild-moderate calcification of coronary artery.Compared with conventional CCTA,subtraction CCTA can improve the image quality and reduce the time required for quantitative assessment of stenosis,thus improve the clinical efficiency.