窗技術對冠狀動脈CTA狹窄程度影響研究

Application of CT window technique in the diagnosis of coronary artery stenosis

目的探討窗技術對冠狀動脈CT血管成像(CCTA)檢查中冠狀動脈狹窄程度判斷的價值。方法選取2016年11月~2017年05月期間同時進行冠狀動脈CT血管成像(CCTA)及選擇性冠狀動脈導管造影檢查(CAG)的20例病例共39處病變血管進行對比分析,以CAG為標準,分別用高窗位/寬窗寬(H,窗位360HU/窗寬1600HU)及較低窗位/較窄窗寬(L,窗位60HU/窗寬300HU)的不同窗技術,對比觀察各病例共32支39處不同程度狹窄的病變段血管測量結果,進行統計學分析處理。結果20例共32支39處非鈣化斑塊所致冠狀動脈狹窄或完全閉塞,CAG與H、L的測量結果相互之間均為顯著之高度相關,P值均<0.01,均為正向相關且相關程度相似,R分別為0.768及0.754,即CAG越高,H及L便會越高,其關連性達顯著。結論窗技術對CCTA檢查中冠狀動脈狹窄程度判斷有較大影響,且不能證明哪一種窗技術更有優勢,因此應結合高及低兩種窗技術綜合判斷。

Objective To investigate the value of CT window technique in the diagnosis of coronary artery stenosis.Methods 39 lesions of twenty patients with coronary artery stenosis admitted in our hospital from November 2016 to May 2017 were selected as the study objects.Patients received both selective coronary artery angiography(CAG)and coronary artery CT(CCTA)scan.Luminal stenosis rates measured at high Window Length/Window Width(WW/WL,WL 360HU/WW 3600HU)and lowWL/WW(WL 60HU/WW 300HU)of CCTA were compared to CAG.Results Luminal stenosis rates measured at high-and low-WL/WW ofCCTA were significantly different from CAG results(P<0.01).Additionally,stenosis rates at both high-and low-WL/WW of CCTA were positively correlated with CAG results(R 0.768 and 0.754 respectively).Conclusion Our study suggest that the measurement of luminal stenosis is affected by different CT window settings on CCTA.It is possible that either high-or low-WW/WL is superior in diagnosing luminal stenosis rate,and we are convinced that combining both techniques is essential for accurate diagnosis.