双源CT评估冠状动脉钙化与病理诊断符合度

The coincidence of coronary artery calcification with pathological diagnosis evaluated by DSCT

目的以病理诊断为标准评价双源CT增强扫描定性和定量冠状动脉钙化斑块的准确性。方法采用双源CT对离体冠状动脉进行0.6 mm层厚横断面增强扫描,将CT值>130 HU的斑块定性为钙化斑块,依据钙化斑块在管壁横断面上的弧度将其分为3型:轻度钙化、中度钙化和重度钙化。计算钙化斑块导致的冠状动脉狭窄,并与病理分型和所测冠状动脉狭窄进行对比。结果病理切片发现钙化斑块69个,DSCT发现57个,双源CT检测轻度、中度和重度钙化斑块的敏感性分别为88.3%、100%和100%。与病理诊断结果相比,双源CT高估了轻度、中度和重度钙化斑块导致的冠状动脉狭窄程度,分别相差(3.2±2.0)%、(4.9±4.7)%和(14.7±8.2)%,P<0.05。结论双源CT增强扫描能够检测定性不同类型的冠状动脉钙化;与病理对比,双源CT高估了钙化斑块导致的冠状动脉狭窄程度较严重。

Objective To evaluate the accuracy of dual-source CT and quantitative coronary artery calcification based on the pathological diagnosis.Methods Coronary arteries were scanned by contrastedenhanced DSCT with an axial slice thickness of 0.6 mm in vitro.The plaque with computed tomographic value more than 130 Hounsfield units was identified as calcified plaque.According to the arc of calcification in the cross section of coronary artery wall,calcified plaques can be divided as follows:mild calcification,moderate calcification,severe calcification.The coronary artery stenosis caused by calcified plaque was calculated.Pathological classification and coronary artery stenosis measured by pathology were used as comparison criteria.Results Histopathology detected 69 calcified plaques.57 calcified plaques were found at DSCT.The sensitivity of DSCT for detecting mild、moderate and severe calcified plaques were 88.3%、100%and 100%,respectively.Compared with pathological diagnosis,DSCT overestimated coronary artery stenosis caused by mild,moderate and severe calcified plaques(3.2%±2.0%,4.9%±4.7%and 14.7%±8.2%,respectively;P<0.05).Conclusions Compared with histopathology,dual-source CT contrast enhancement scanning can detect and characterize different types of coronary artery calcification.Compared with histopathology dual source CT overestimates coronary artery stenosis caused by calcified plaque.