腔内CT密度值用于评估冠状动脉钙化及狭窄程度
Chinese Journal of Medical Imaging Technology(2020)
Abstract
目的 观察冠状动脉CT成像(CCTA)中,根据冠状动脉钙化(CAC)近端与远端冠状动脉管腔CT值及校正后冠状动脉强化值(CCO)差值评估钙化部位管腔狭窄的准确度.方法 对CCTA显示钙化的233支主要冠状动脉(左前降支、左回旋支和右冠状动脉),根据狭窄程度分为轻度狭窄组、中度狭窄组、重度狭窄组和完全闭塞组,比较各组CCO差值,分析以钙化近远端CCO差值评估冠状动脉狭窄的准确度.结果 完全闭塞组CCO差值高于轻度狭窄组、中度狭窄组和重度狭窄组(P<0.001);重度狭窄组与中度狭窄组CCO差值差异无统计学意义(P>0.05);中度狭窄组和重度狭窄组CCO差值高于轻度狭窄组(P<0.001).以钙化近远侧CCO差值0.086 9作为诊断界点,其诊断冠状动脉≥50%狭窄的敏感度、特异度、阳性预测值和阴性预测值分别为76.67%、75.47%、91.39%和48.78%;以0.2070作为诊断界点时,其诊断冠状动脉闭塞的敏感度、特异度、阳性预测值和阴性预测值分别为91.84%、79.89%、54.88%和97.35%.结论 冠状动脉钙化近远端管腔CCO差值随狭窄程度加重而升高,以之作为评价指标,可明显提高评估冠状动脉钙化及狭窄程度的准确性.
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