多排螺旋CT对动脉粥样硬化斑块无创探查及其冠状动脉成像研究
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摘要
目的：探索兔动脉粥样硬化模型建立的方法及评价多排螺旋CT探查粥样硬化斑块的能力。方法成年新西兰大白兔9只，随机分成3组，对照组1只，实验A组4只，实验B组4只。实验A组麻醉固定后以相同方法损伤主动脉内膜，并每日每只喂养胆固醇3g加基础饲料。实验B组不行主动脉内膜损伤，每日每只喂养胆固醇3g加基础饲料。对照组只喂基础饲料。喂养16周左右对照组兔及实验A组兔行16排螺旋CT主动脉增强扫描，实验B组兔行64排螺旋CT扫描。检查结束一日后处死实验动物以观察主动脉病理变化。结果对照组兔内膜光滑。全部横断面病理切片共135层，对照组未发现斑块，实验A组60层切片中53层发现斑块(88.3％)，实验B组60层切面中37层发现斑块(37.3％)，三组间有显著性差异(p＜0.001)：实验A组粥样硬化斑块中脂质斑块占68％，实验B组脂质斑块占69％，两组间无显著性差异；逐层测量实验A组及B组切片主动脉内膜厚度，两组平均内膜厚度分别为488±128μm和532±230μm，有显著性差异(p＜0.001)。16排CT对斑块探查敏感性为45％，特异性为86％，64排CT对斑块探查敏感性为65％，特异性为85％。结论两种方法均可成功建立兔动脉粥样硬化模型，主动脉内膜损伤后斑块形成更广泛，多排螺旋CT对实验动脉粥样硬化斑块探查还有一定限度。
目的以冠状动脉节段为基础，对照冠状动脉内超声(Intravascular Ultrasound IVUS)结果，评价16排螺旋CT(Multi-detector Spiral Computed Tomography MDCT)探查无明显管腔狭窄的冠状动脉粥样斑块的能力及准确性。方法2005年10月至2006年1月，共30例患者行冠状动脉内超声检查及冠状动脉MDCT(美国GE公司Lightspeed 16排螺旋CT)成像。共对94支无明显狭窄及支架置入的冠状动脉节段的MDCT及IVUS图像行对照研究，逐一分析每支冠状动脉节段是否出现粥样硬化斑块，IVUS根据斑块回声特点将斑块分为钙化斑块、纤维斑块、脂质斑块，MDCT则测量斑块密度，以CT值表示。结果总共对94个冠状动脉节段行对照研究(左主干19段，前降支49个节段，回旋支6个节段，右冠状动脉20个节段)，对照IVUS结果，MDCT对出现任何粥样硬化斑块节段的诊断敏感性为82％，特异性为89％。对于含钙化斑块的节段，MDCT诊断敏感性为92％，特异性为96％。对于含非钙化斑块的节段，MDCT诊断敏感性为73％，特异性89％。对于仅含非钙化斑块的节段，MDCT诊断敏感性仅为68％。MDCT分析54个斑块平均CT值，按照IVUS的分类，钙化斑块19个，纤维斑块19个，脂质斑块16个，对应CT值为钙化斑块：489±169(196～817 HU)，纤维斑块69±21(25～117 HU)以及软斑块23±18(-12～47)。非参数Kruskal-Wallis检验显示三组斑块MDCT测量密度CT值间有显著差异(p＜0.001)。两种方法对斑块面积的测量具有相关性(r=0.58 p＜0.01)，MDCT测定斑块平均面积为5.3mm~2，而IVUS为5.6 mm~2。结论MDCT具有良好的探查无明显狭窄冠状动脉粥样斑块的能力。根据斑块密度(CT值)差异，MDCT能区分不同类型冠状动脉粥样斑块。对斑块面积测量，MDCT与IVUS结果具有相关性。随着软硬件进步，时间分辨率、空间分辨率提高，MDCT这种无创手段将会作出更加准确的诊断结果。
目的对照冠状动脉内超声(Intravascular Ultrasound IVUS)结果，评价64排螺旋CT(Multi-Detector Spiral Computed Tomography MDCT)探查无明显管腔狭窄的冠状动脉粥样斑块的能力及准确性。方法2006年7月至2006年9月，共18例连续住院患者行冠状动脉内超声检查及冠状动脉64排螺旋CT(美国GE公司Lightspeed VCT)成像。共对25段无明显管腔狭窄的冠状动脉节段的MDCT及IVUS图像行对照研究，其中左主干节段5共2段、前降支近段节段6共9段、前降支中段节段7共10段、回旋支近段节段11共2段、第一钝缘支节段12仅1段。结果对照IVUS结果，MDCT对粥样硬化斑块的诊断敏感性为96％，特异性为94％。两种方法对斑块面积的测量具有很好相关性(r=0.87 p＜0.001)，MDCT测定斑块平均面积为7.8mm~2±4.10 mm~2，而IVUS为9.2 mm~2±4.59mm~2。结论64排CT具有良好的探查无明显管腔狭窄冠状动脉粥样斑块的能力。对斑块面积测量，64排CT与IVUS结果具有好的相关性。64排CT图像对斑块脂质核心的直接显示对患者危险度分层及随访具有重要意义。
第四部分64排螺旋CT对冠状动脉成像质量的相关因素分析
目的探讨影响64排螺旋CT冠状动脉造影(MDCTA)图像质量的因素。方法对100例临床怀疑冠心病的患者行64排MDCT冠状动脉造影检查，对重组图像进行评分，分析心率等因素与冠状动脉评分的相关性。统计学处理采用多元线性回归模型。结果心率、心率变化、钙化积分、冠状动脉腔内对比剂密度、图像噪声对图像质量的影响有统计学意义，上述因素与图像质量间具有多元线性回归关系(标准化回归系数分别为-0.298、-0.310、-0.258、0.265、-0.247)。结论对患者心率良好控制，扫描方案、对比剂用法的恰当选择有利于改善MDCT冠状动脉造影成像质量。
目的探讨64排螺旋CT(MDCT)诊断冠状动脉病变的准确性及影响因素。方法72例连续住院患者行64排MDCT冠状动脉成像，并与同期常规冠状动脉造影(CCA)结果行盲法对照。结果CCA共分析了1085个冠状动脉节段(美国心脏病协会冠状动脉15节段划分法，其中后降支为节段4，左室后支为节段4+)。MDCT除图像质量差的10个节段(占0.9％)及细小远端和分支19个节段(占1.8％)外，共1056个节段(占97.3％)的MDCT图像与CCA结果对照。以节段为基础，IVIDCT诊断≥50％狭窄的敏感性为84.5％，特异性为93.7％，阳性预测值为77.2％，阴性预测值为96.0％；诊断≥75％重度狭窄病变的敏感性为88.3％，特异性为96.7％，阳性预测值为77.9％，阴性预测值为98.5％。仅分析近、中节段则诊断≥50％狭窄的敏感性为89.5％，特异性为91.3％。按钙化积分中位数(30分)分组，则积分低组(＜30分)及积分高组(≥30分)诊断敏感性分别为89.3％、81.9％，特异性分别为96.8％、89.8％。按冠状动脉腔内造影剂密度分组，密度高组(≥407HU)与密度低组(＜407HU)诊断敏感性分别为87.5％、82.4％；特异性94.4％、92.8％。结论在良好的图像质量前提下，64排MDCT诊断冠状动脉狭窄性病变准确性较高，适宜于筛查冠心病，并协助确定治疗方案。
Part1 Establishing atherosclerosis model with rabbit and detection atherosclerotic plaque by multidetector Computer Tomography
Objective To probe and compare two methods of establishing atherosclerosis model with rabbit and detecting atherosclerotic plaque by multi-detector CT. Methods 9 adult NEW Zealand rabbits were randomized into three groups, 4 into treatment group A, 4 into treatment group B and 1 into control group. After fundamental anesthetized, the rabbits of treatment group A underwent hurt to endomembrane of aorta and then each rabbit fed on 3g cholesterol plus fundamental fodder each day. Each rabbit of treatment group B fed on 3g cholesterol plus fundamental fodder each day only without injury of aorta. The rabbit of control group fed on fundamental fodder only. After 16 weeks, the rabbits of treatment group A and the rabbit of control group underwent scan of 16—detector—row spiral CT, the rabbits of treatment group B underwent scan of 64-detector--row spiral CT, and subsequently all the rabbits were sacrificed for pathological examination. Results The rabbit of control group had smooth endomembrane. There were 135 pathological slices totally, 53 slices containing plaque were found in 60 slices of treatment group A, 37 slices containing plaque were found in 60 slices of treatment group B, and no slice containing was found in control rabbit .The difference among three groups was significant(P＜0.001). The mean thickness of each slice of endomembrane of treatment group A is 488±128μm (170μm～730μm), and treatment group B 532±230μm (50μm～950μm)。The difference between two groups was significant(P＜0.001). The sensitivity and speciality of 16—detector—row spiral CT is 45% and 86% respectively, 65% and 85% of 64—detector—row spiral CT accordingly. Conclusion Arteriosclerosis model can be successfully established with rabbit with two above methods. There were some limitation in more precise evaluation of plaque by MDCT. intravascular ultrasound(IVUS),based on segment. Methods The IVUS and MDCT scans (Lightspeed Ultra-16, GE, USA) were performed in 30 patients. A total of 94 coronary segments without significant coronary stenoses and stents were imaged and analyzed. MDCT data sets were evaluated for the presence and areas of plaques in the coronary segments. Plaque composition was analyzed according to IVUS (plaque echogenity: soft, intermediate, calcified) and MDCT criteria (plaque dencity expressed by Hounsfield units[HU]). Results were compared with IVUS in a blinded fashion. Results A total of 94 coronary artery segments were imaged and analyzed(left main, 19; left anterior descending, 49; left circumflex, 6; right coronary, 20). For the detection of segments with any plaque, MDCT had a sensitivity of 82% (46 of 56) and specificity of 89% (34 of 38). For calcified plaque, sensitivity was 92% (35 of 38 ) and specificity 96% (54of 56). Coronary segments containing noncalcified plaque were detected with a sensitivity of 73%(30 of 41) and specificity of 89%(47 of 53), but presence of exclusively noncalcified plaque was detected with 68% sensitivity (12 of 18). The density of 54 plaques were analyzes. With IVUS, the plaque was classified as calcified (n=19), intermediate(n=19) and soft (n=16). Using MDCT, calcified plaques had a density of 489±169(range 196 to 817 HU), intermediate plaques of 69±21(25 to 117 HU) and soft plaques 23±18 (-12 to 47). Nonparametric Kruskal-Wallis test revealed a significant difference of plaque density among the three groups (p＜0.001). The mean plaque areas measured by IVUS and MDCT were 5.3mm~2 versus 5.6 mm~2(p＜0.01, r=0.58) Conclusions The results indicate the potential of MDCT to detect coronary atherosclerotic plaque in patients without significant coronary stenoses. Coronary plaques configuration might be correctly differentiated by MDCT .Measurements of plaques areas derived by MDCT correlated well with IVUS. This noninvasive method might become an important tool for risk stratification. However, further improvements in image quality will necessary to achieve reliable assessment.
Part3 Noninvasive Detection and Evaluation of Coronary Atherosclerotic Plaque with 64-Detector-Row Spiral Computed Tomography- Initial Result of Comparison With Intravascular Ultrasound
Objectives The aim of the present study was to evaluate the ability and accuracy in detect atherosclerotic plaque in nonstenotic coronary arteries by 64-detector-row spiral computed tomography(MDCT). The results were compared with the findings of intravascular ultrasound(IVUS), based on plaque. Methods The IVUS and MDCT scans (Lightspeed VCT , GE) were performed in 18 patients . A total of 25 coronary segments without significant coronary stenoses and stents were imaged and analyzed. MDCT data sets were evaluated for the presence and areas of plaque one by one. Results were compared with IVUS in a blinded fashion. Results For the detection of any plaque, MDCT had a sensitivity of 96%(23 of 24) and specificity of 94%(35 of 37). The mean plaque areas measured by IVUS and MDCT were 7.8mm~2 versus 9.2 mm~2(p＜0.001 , r=0.87) Conclusions The results indicate the excellent ability of 64-detector row CT to detect coronary atherosclerotic plaque in patients without significant coronary stenoses. Measurements of plaques areas derived by MDCT correlated well with IVUS. The direct demonstration of plaque lipid pool of 64-detector row CT image will be very important for risk stratification and patients follow-up.
Part 4 Analysis of main influence factors on coronary artery image quality with 64-detector-row spiral CT
Objective TO explore the main influence factors heart rate(HR),heart rate changing, coronary calcium score(CCS),impact of intravascular enhancement, image noise, diameter of coronary artery et al)on the image quality of coronary artery with 64-slice helical CT. Methods 100 patients with suspected CAD were underwent MDCTA, the image quality score(IQS)was evaluated according to the same evaluation standard of reformatted image. The correlation between some factors for example HR and IQS were analyzed. Results The heart rate, heart rate changing, coronary calcium score, impact of intravascular enhancement and image noise had significant influence on IQS. The equation of multiple regression was IQS=4.21-0.030×(HR)-0.029×(HR changing)-0.001×(CCS)-0.003×(impact of intravascular enhancement)-0.027×(image noise). Conclusion Better HR control,proper select of scan and contrast
Part5 64-Detector-Row Spiral CT of the coronary imaging:assessment of accuracy in detecting stenoses
Objective To evaluate the accuracy in detecting coronary artery lesions of 64-multi detector computed tomography(MDCT).Methods Seventy two patients were studied by MDCT. The results were compared with invasive coronary angiography(ICA). Results In 1056 segments with diagnosis MDCT image quality(American Heart Association 15-segment model).Sensitivity for the detection of stenosis≥50%,≥75% on segments was 84.5% and 88.3% ,respectively, and specificity was 93.7% and 96.7%.
Conclusion Our results indicate high quantitative and qualitative diagnostic accuracy of 64-multi detector CT in comparison to ICA with good image quality.
目的以冠状动脉节段为基础，对照冠状动脉内超声(Intravascular Ultrasound IVUS)结果，评价16排螺旋CT(Multi-detector Spiral Computed Tomography MDCT)探查无明显管腔狭窄的冠状动脉粥样斑块的能力及准确性。方法2005年10月至2006年1月，共30例患者行冠状动脉内超声检查及冠状动脉MDCT(美国GE公司Lightspeed 16排螺旋CT)成像。共对94支无明显狭窄及支架置入的冠状动脉节段的MDCT及IVUS图像行对照研究，逐一分析每支冠状动脉节段是否出现粥样硬化斑块，IVUS根据斑块回声特点将斑块分为钙化斑块、纤维斑块、脂质斑块，MDCT则测量斑块密度，以CT值表示。结果总共对94个冠状动脉节段行对照研究(左主干19段，前降支49个节段，回旋支6个节段，右冠状动脉20个节段)，对照IVUS结果，MDCT对出现任何粥样硬化斑块节段的诊断敏感性为82％，特异性为89％。对于含钙化斑块的节段，MDCT诊断敏感性为92％，特异性为96％。对于含非钙化斑块的节段，MDCT诊断敏感性为73％，特异性89％。对于仅含非钙化斑块的节段，MDCT诊断敏感性仅为68％。MDCT分析54个斑块平均CT值，按照IVUS的分类，钙化斑块19个，纤维斑块19个，脂质斑块16个，对应CT值为钙化斑块：489±169(196～817 HU)，纤维斑块69±21(25～117 HU)以及软斑块23±18(-12～47)。非参数Kruskal-Wallis检验显示三组斑块MDCT测量密度CT值间有显著差异(p＜0.001)。两种方法对斑块面积的测量具有相关性(r=0.58 p＜0.01)，MDCT测定斑块平均面积为5.3mm~2，而IVUS为5.6 mm~2。结论MDCT具有良好的探查无明显狭窄冠状动脉粥样斑块的能力。根据斑块密度(CT值)差异，MDCT能区分不同类型冠状动脉粥样斑块。对斑块面积测量，MDCT与IVUS结果具有相关性。随着软硬件进步，时间分辨率、空间分辨率提高，MDCT这种无创手段将会作出更加准确的诊断结果。
目的对照冠状动脉内超声(Intravascular Ultrasound IVUS)结果，评价64排螺旋CT(Multi-Detector Spiral Computed Tomography MDCT)探查无明显管腔狭窄的冠状动脉粥样斑块的能力及准确性。方法2006年7月至2006年9月，共18例连续住院患者行冠状动脉内超声检查及冠状动脉64排螺旋CT(美国GE公司Lightspeed VCT)成像。共对25段无明显管腔狭窄的冠状动脉节段的MDCT及IVUS图像行对照研究，其中左主干节段5共2段、前降支近段节段6共9段、前降支中段节段7共10段、回旋支近段节段11共2段、第一钝缘支节段12仅1段。结果对照IVUS结果，MDCT对粥样硬化斑块的诊断敏感性为96％，特异性为94％。两种方法对斑块面积的测量具有很好相关性(r=0.87 p＜0.001)，MDCT测定斑块平均面积为7.8mm~2±4.10 mm~2，而IVUS为9.2 mm~2±4.59mm~2。结论64排CT具有良好的探查无明显管腔狭窄冠状动脉粥样斑块的能力。对斑块面积测量，64排CT与IVUS结果具有好的相关性。64排CT图像对斑块脂质核心的直接显示对患者危险度分层及随访具有重要意义。
第四部分64排螺旋CT对冠状动脉成像质量的相关因素分析
目的探讨影响64排螺旋CT冠状动脉造影(MDCTA)图像质量的因素。方法对100例临床怀疑冠心病的患者行64排MDCT冠状动脉造影检查，对重组图像进行评分，分析心率等因素与冠状动脉评分的相关性。统计学处理采用多元线性回归模型。结果心率、心率变化、钙化积分、冠状动脉腔内对比剂密度、图像噪声对图像质量的影响有统计学意义，上述因素与图像质量间具有多元线性回归关系(标准化回归系数分别为-0.298、-0.310、-0.258、0.265、-0.247)。结论对患者心率良好控制，扫描方案、对比剂用法的恰当选择有利于改善MDCT冠状动脉造影成像质量。
目的探讨64排螺旋CT(MDCT)诊断冠状动脉病变的准确性及影响因素。方法72例连续住院患者行64排MDCT冠状动脉成像，并与同期常规冠状动脉造影(CCA)结果行盲法对照。结果CCA共分析了1085个冠状动脉节段(美国心脏病协会冠状动脉15节段划分法，其中后降支为节段4，左室后支为节段4+)。MDCT除图像质量差的10个节段(占0.9％)及细小远端和分支19个节段(占1.8％)外，共1056个节段(占97.3％)的MDCT图像与CCA结果对照。以节段为基础，IVIDCT诊断≥50％狭窄的敏感性为84.5％，特异性为93.7％，阳性预测值为77.2％，阴性预测值为96.0％；诊断≥75％重度狭窄病变的敏感性为88.3％，特异性为96.7％，阳性预测值为77.9％，阴性预测值为98.5％。仅分析近、中节段则诊断≥50％狭窄的敏感性为89.5％，特异性为91.3％。按钙化积分中位数(30分)分组，则积分低组(＜30分)及积分高组(≥30分)诊断敏感性分别为89.3％、81.9％，特异性分别为96.8％、89.8％。按冠状动脉腔内造影剂密度分组，密度高组(≥407HU)与密度低组(＜407HU)诊断敏感性分别为87.5％、82.4％；特异性94.4％、92.8％。结论在良好的图像质量前提下，64排MDCT诊断冠状动脉狭窄性病变准确性较高，适宜于筛查冠心病，并协助确定治疗方案。
Part1 Establishing atherosclerosis model with rabbit and detection atherosclerotic plaque by multidetector Computer Tomography
Objective To probe and compare two methods of establishing atherosclerosis model with rabbit and detecting atherosclerotic plaque by multi-detector CT. Methods 9 adult NEW Zealand rabbits were randomized into three groups, 4 into treatment group A, 4 into treatment group B and 1 into control group. After fundamental anesthetized, the rabbits of treatment group A underwent hurt to endomembrane of aorta and then each rabbit fed on 3g cholesterol plus fundamental fodder each day. Each rabbit of treatment group B fed on 3g cholesterol plus fundamental fodder each day only without injury of aorta. The rabbit of control group fed on fundamental fodder only. After 16 weeks, the rabbits of treatment group A and the rabbit of control group underwent scan of 16—detector—row spiral CT, the rabbits of treatment group B underwent scan of 64-detector--row spiral CT, and subsequently all the rabbits were sacrificed for pathological examination. Results The rabbit of control group had smooth endomembrane. There were 135 pathological slices totally, 53 slices containing plaque were found in 60 slices of treatment group A, 37 slices containing plaque were found in 60 slices of treatment group B, and no slice containing was found in control rabbit .The difference among three groups was significant(P＜0.001). The mean thickness of each slice of endomembrane of treatment group A is 488±128μm (170μm～730μm), and treatment group B 532±230μm (50μm～950μm)。The difference between two groups was significant(P＜0.001). The sensitivity and speciality of 16—detector—row spiral CT is 45% and 86% respectively, 65% and 85% of 64—detector—row spiral CT accordingly. Conclusion Arteriosclerosis model can be successfully established with rabbit with two above methods. There were some limitation in more precise evaluation of plaque by MDCT. intravascular ultrasound(IVUS),based on segment. Methods The IVUS and MDCT scans (Lightspeed Ultra-16, GE, USA) were performed in 30 patients. A total of 94 coronary segments without significant coronary stenoses and stents were imaged and analyzed. MDCT data sets were evaluated for the presence and areas of plaques in the coronary segments. Plaque composition was analyzed according to IVUS (plaque echogenity: soft, intermediate, calcified) and MDCT criteria (plaque dencity expressed by Hounsfield units[HU]). Results were compared with IVUS in a blinded fashion. Results A total of 94 coronary artery segments were imaged and analyzed(left main, 19; left anterior descending, 49; left circumflex, 6; right coronary, 20). For the detection of segments with any plaque, MDCT had a sensitivity of 82% (46 of 56) and specificity of 89% (34 of 38). For calcified plaque, sensitivity was 92% (35 of 38 ) and specificity 96% (54of 56). Coronary segments containing noncalcified plaque were detected with a sensitivity of 73%(30 of 41) and specificity of 89%(47 of 53), but presence of exclusively noncalcified plaque was detected with 68% sensitivity (12 of 18). The density of 54 plaques were analyzes. With IVUS, the plaque was classified as calcified (n=19), intermediate(n=19) and soft (n=16). Using MDCT, calcified plaques had a density of 489±169(range 196 to 817 HU), intermediate plaques of 69±21(25 to 117 HU) and soft plaques 23±18 (-12 to 47). Nonparametric Kruskal-Wallis test revealed a significant difference of plaque density among the three groups (p＜0.001). The mean plaque areas measured by IVUS and MDCT were 5.3mm~2 versus 5.6 mm~2(p＜0.01, r=0.58) Conclusions The results indicate the potential of MDCT to detect coronary atherosclerotic plaque in patients without significant coronary stenoses. Coronary plaques configuration might be correctly differentiated by MDCT .Measurements of plaques areas derived by MDCT correlated well with IVUS. This noninvasive method might become an important tool for risk stratification. However, further improvements in image quality will necessary to achieve reliable assessment.
Part3 Noninvasive Detection and Evaluation of Coronary Atherosclerotic Plaque with 64-Detector-Row Spiral Computed Tomography- Initial Result of Comparison With Intravascular Ultrasound
Objectives The aim of the present study was to evaluate the ability and accuracy in detect atherosclerotic plaque in nonstenotic coronary arteries by 64-detector-row spiral computed tomography(MDCT). The results were compared with the findings of intravascular ultrasound(IVUS), based on plaque. Methods The IVUS and MDCT scans (Lightspeed VCT , GE) were performed in 18 patients . A total of 25 coronary segments without significant coronary stenoses and stents were imaged and analyzed. MDCT data sets were evaluated for the presence and areas of plaque one by one. Results were compared with IVUS in a blinded fashion. Results For the detection of any plaque, MDCT had a sensitivity of 96%(23 of 24) and specificity of 94%(35 of 37). The mean plaque areas measured by IVUS and MDCT were 7.8mm~2 versus 9.2 mm~2(p＜0.001 , r=0.87) Conclusions The results indicate the excellent ability of 64-detector row CT to detect coronary atherosclerotic plaque in patients without significant coronary stenoses. Measurements of plaques areas derived by MDCT correlated well with IVUS. The direct demonstration of plaque lipid pool of 64-detector row CT image will be very important for risk stratification and patients follow-up.
Part 4 Analysis of main influence factors on coronary artery image quality with 64-detector-row spiral CT
Objective TO explore the main influence factors heart rate(HR),heart rate changing, coronary calcium score(CCS),impact of intravascular enhancement, image noise, diameter of coronary artery et al)on the image quality of coronary artery with 64-slice helical CT. Methods 100 patients with suspected CAD were underwent MDCTA, the image quality score(IQS)was evaluated according to the same evaluation standard of reformatted image. The correlation between some factors for example HR and IQS were analyzed. Results The heart rate, heart rate changing, coronary calcium score, impact of intravascular enhancement and image noise had significant influence on IQS. The equation of multiple regression was IQS=4.21-0.030×(HR)-0.029×(HR changing)-0.001×(CCS)-0.003×(impact of intravascular enhancement)-0.027×(image noise). Conclusion Better HR control,proper select of scan and contrast
Part5 64-Detector-Row Spiral CT of the coronary imaging:assessment of accuracy in detecting stenoses
Objective To evaluate the accuracy in detecting coronary artery lesions of 64-multi detector computed tomography(MDCT).Methods Seventy two patients were studied by MDCT. The results were compared with invasive coronary angiography(ICA). Results In 1056 segments with diagnosis MDCT image quality(American Heart Association 15-segment model).Sensitivity for the detection of stenosis≥50%,≥75% on segments was 84.5% and 88.3% ,respectively, and specificity was 93.7% and 96.7%.
Conclusion Our results indicate high quantitative and qualitative diagnostic accuracy of 64-multi detector CT in comparison to ICA with good image quality.
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