能谱CT物质分离技术对冠状动脉钙化斑块狭窄程度的诊断价值

Diagnostic value of material differentiation technology of energy spectral CT on stenosis of calcified plaques in coronary arteries

目的探讨利用能谱CT物质分离技术评价冠状动脉钙化斑块狭窄率的准确性。方法收集行冠状动脉CT能谱成像的86例钙化斑块患者的图像,使用物质分离软件评价钙化斑块的狭窄程度,以冠状动脉造影为金标准进行对比;根据对比结果符合与否分成2组,比较2组之间在图像质量上的差异;根据钙化斑块所在冠状动脉节段管腔直径分为2~mm、3~mm及≥4 mm 3组,比较3组在符合程度上的差异。结果能谱CT扫描共检出256处钙化斑块。利用物质分离技术诊断0、<50%、≥50%和≥70%狭窄的灵敏度分别为88.89%、88.04%、83.08%、75.93%;特异度分别为97.16%、90.24%、92.15%、98.51%。2组在CT值、信躁比(SNR)上的差异有统计学意义,在SD上的差异无统计学意义。钙化斑块所在冠状动脉节段管腔大小影响狭窄率的判断,管腔越大,符合率越高。结论能谱CT物质分离技术评价冠状动脉钙化斑块狭窄率具有较高的准确性,图像质量和钙化斑块所在冠脉节段管腔大小对准确性的影响较大。

Objective To investigate the accuracy of using material differentiation technology of energy spectral CT to evaluate the stenosis rate of calcified plaques in coronary arteries. Methods The images of 86 patients with calcified plaques, who underwent energy spectral CT imaging of coronary artery, were included in the study. The stenosis degree of calcified plaques was evaluated using material differentiation software, and the coronary angiogra-phy was used as the gold standard for comparison. According to the consistency of the comparison findings, the im-ages were divided into two groups, and the difference in the image quality between the two groups was compared. Ac-cording to the lumen diameter of the coronary segment with calcified plaque, the images were divided into 2-mm, 3-mm and ≥4 mm groups. The difference in the degree of consistency was compared among the three groups. Results A total of 256 calcified plaques were determined by energy spectral CT scanning. The sensitivity of 0, <50%, ≥50%and ≥70% stenosis was 88.89%, 88.04%, 83.08% and 75.93%, and the specificity was 97.16%, 90.24%, 92.15%,98.51%, respectively, determined by material differentiation technology. There were statistically significant differences in CT and SNR between the two groups, and there was no statistically significant difference in SD. The lumen size of the coronary segment with calcified plaque affect the stenosis rate, the greater the lumen, the higher the consistency.Conclusion The accuracy of using material differentiation technology of energy spectral CT to evaluate the stenosis rate of calcified plaques in coronary arteries is high. The image quality and the lumen size of the coronary segment with calcified plaque affect the accuracy.