HDCT对冠状动脉钙化节段和支架图像质量的评价

发布时间：2018-05-17 23:39

本文选题：高清CT冠状动脉 + 钙化　；参考：《安徽医科大学》2012年硕士论文

【摘要】：目的比较GE Light Speed HDCT（High Definition CT,HDCT）与Light Speed64层VCT分别以高清标准算法重建模式及标准重建模式对冠状动脉钙化和支架的图像质量的影响，探讨HDCT高清成像技术对减轻冠状动脉钙化和支架的射线束硬化伪影及部分容积效应等方面的临床应用价值。方法将2009年8月至2012年2月行冠状动脉CT血管成像伴冠状动脉钙化及冠状动脉支架植入术后随访的患者分为钙化组和支架组。（1）钙化组：128例患者，其中，64例患者行HDCT扫描并采用高清标准重组算法重建图像，64例患者行64-VCT扫描并采用标准重建算法对冠状动脉钙化图像进行重建。按Agatston方法,测量每段血管的钙化积分，将段血管的钙化积分值10～100定为轻度钙化,100～400为中度钙化,＞400为重度钙化。（2）支架组：81例患者，其中，34例患者行HDCT扫描并采用高清标准重组算法重建图像，47例患者行64-VCT扫描并采用标准重建算法对冠状动脉支架图像进行重建。运用Osiris419软件分别对重建后图像的支架的内径进行测量。采用5分制等级评分方法评估冠状动脉钙化和支架的曲面重组图像的质量。统计学分析采用独立样本资料的t检验。结果(1)钙化组：HDCT和64-VCT两组患者临床资料的匹配性及一致性良好。HDCT的64例患者有220段血管存在钙化，64-VCT的64例患者有225段血管存在钙化。HDCT和64-VCT两组轻度、中度及重度钙化节段血管的图像质量评分分别为3.83±0.79，3.36±1.45，3.25±1.37及3.17±0.71，2.72±0.90，2.45±1.18，HDCT轻度、中度及重度钙化节段血管的图像质量均优于64-VCT，经检验差异有统计学意义（均P0.05）。(2)支架组：HDCT和64-VCT两组患者临床资料的匹配性及一致性良好。HDCT有41枚支架，64-VCT有69枚支架，支架直径为2.5mm～4mm。对于直径为2.5mm、3.0mm、3.5mm及4mm支架，HDCT支架内径测量值均高于64-VCT，经检验差异有统计学意义(t＝9.33,8.54,7.04及3.78，均P0.05)。对于直径为2.5mm及3.0mm支架，HDCT支架图像质量评分分别为4.36±0.67及4.08±0.76，均优于64-VCT标准重建图像的质量（2.65±0.83及3.20±0.52），经检验差异有统计学意义(t＝5.94及3.94，均P＝0.000)；对于直径为3.5mm及4mm支架，HDCT和64-VCT两组支架图像质量评分分别为3.75±0.46，4.13±0.35及3.69±0.75，3.75±0.45，经检验差异无统计学意义（t＝0.20及1.97，P＝0.850及0.060）。结论HDCT高清成像技术获得的冠状动脉钙化节段和支架的图像质量可更清楚地显示钙化节段局部管腔和支架腔内的结构，降低了钙化和支架段的射线束硬化伪影及部分容积效应的影响，冠状动脉钙化节段的图像质量和支架的图像质量较64层螺旋CT有了明显的改善。
[Abstract]:Objective to compare the image quality of coronary artery calcification and stent between GE Light Speed HDCT(High Definition CTT and Light Speed64 layer VCT with high definition standard algorithm and standard reconstruction mode. To explore the clinical application value of HDCT high-definition imaging in reducing coronary artery calcification, beam sclerosis artifact and partial volume effect of stent. Methods from August 2009 to February 2012, patients undergoing coronary artery CT angiography with coronary artery calcification and coronary stent implantation were divided into calcification group and stenting group (n = 128). Among them, 64 patients underwent HDCT scan and 64 patients underwent 64-VCT scan with high definition standard reconstruction algorithm. Coronary artery calcification images were reconstructed by standard reconstruction algorithm. According to the Agatston method, the calcification integral of each segment of blood vessel was measured. The calcification integral value of the segmental blood vessel was 10 ~ 100%. The calcification integral value of the segmental blood vessel was determined to be moderate calcification in mild calcification group, moderate calcification in light calcification group, and severe calcification in > 400) stent group (81 patients). Among them, 34 patients underwent HDCT scan and 47 patients underwent 64-VCT scan with high definition standard reconstruction algorithm. The coronary stent images were reconstructed by standard reconstruction algorithm. The inner diameter of the reconstructed image was measured by Osiris419 software. The quality of coronary artery calcification and curved surface reconstruction images of stent was evaluated by 5-score method. T test of independent sample data was used for statistical analysis. Results in the calcification group, the matching and consistency of the clinical data of the two groups were good. There were 220 segments of vascular calcification and 64 cases of 64 cases of 64-VCT. There were 225 segments of vascular calcification. HDCT and 64-VCT were mild in 64 patients. The image quality scores of moderate and severe calcified blood vessels were 3.83 卤0.79 卤3.36 卤1.45V 3.25 卤1.37 and 3.17 卤0.71 卤0.90 卤2.45 卤1.18HDCT, respectively. The image quality of moderate and severe calcified blood vessels was better than that of 64-VCT.The difference was statistically significant (all P 0.05%). The matching and consistency of clinical data between the two groups were good. There were 41 stents with 64-VCT and 69 stents with a diameter of 2.5mm ~ 4mm ~ (-1). For the diameter of 2.5mm to 3.0mm or 3.5mm to 3.5mm, the diameter of 4mm stent was higher than that of 64-VCT, and the difference was statistically significant (P 0.05). The image quality scores of 2.5mm and 3.0mm stents were 4.36 卤0.67 and 4.08 卤0.76, respectively, which were better than those of 64-VCT standard reconstruction images (2.65 卤0.83 and 3.20 卤0.52), respectively. The difference was statistically significant (P < 5.94 and 3.94, respectively); for 3.5mm and 4mm stents, the diameters were 3.5mm and 4mm stents. The image quality scores of the two groups were 3.75 卤0.46v 4.13 卤0.35 and 3.69 卤0.75U 3.75 卤0.45respectively. There was no significant difference between the two groups. Conclusion the image quality of coronary artery calcification segment and stent obtained by HDCT high-definition imaging technique can more clearly show the local lumen and the stenting structure of calcified segment. The effects of calcification, beam hardening artifacts and partial volume effect were reduced. The image quality of coronary artery calcification segment and stent was significantly improved than that of 64-slice spiral CT.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R541.4;R816.2

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