摘要
目的探究基于全模型迭代重建(iterative model reconstruction,IMR)技术的低剂量冠状动脉(简称冠脉)CT血管造影(coronary CT angiography,CCTA)检查对冠心病冠脉狭窄的诊断价值。方法选择疑似冠心病冠脉狭窄患者78例,所有患者均行基于IMR技术的低剂量CCTA检查。分析CCTA检查的图像质量评分,并分别比较IMR、iDose^(4)及FBP算法下冠脉各节段的CT、对比噪声比(contrast noise ratio,CNR)、噪声(standard deviation,SD)值。将冠脉造影(coronary angiography,CAG)诊断结果作为金标准,分析基于IMR技术的低剂量CCTA检查在冠心病冠脉狭窄诊断中的价值,并分析其与金标准诊断结果的一致性。结果本次检查共获得冠脉血管主支图像310个,其中300个符合冠脉图像质量标准,评分1分的图像有10个、2分11个、3分44个、4分235个。不同算法下冠脉各节段CT值差异无统计学意义(P>0.05);基于IMR技术的低剂量CCTA检查所得的冠脉各节段CNR值均高于iDose^(4)、FBP,而SD值均低于iDose^(4)、FBP,且差异均有统计学意义(均P<0.05)。以冠脉节段计算,在共获得的780个冠脉节段中有765个符合冠脉异常的诊断标准。基于IMR技术的低剂量CCTA检查对冠脉狭窄的诊断准确率、敏感性、特异性、阳性及阴性预测值分别为89.02%、92.48%、82.31%、91.03%和84.92%。该检查在冠脉狭窄诊断中的一致性良好(Kappa值=0.753,P<0.05)。结论基于IMR技术的低剂量CCTA扫描能够有效检出冠心病冠脉狭窄情况,具有较高的诊断准确率与一致性,可为冠心病冠脉狭窄的临床诊断提供有效参考,值得推广应用。
Objective To explore the diagnostic value of low-dose coronary CT angiography(CCTA)examination based on the technology of iterative model reconstruction(IMR)for coronary artery stenosis in coronary heart disease(CHD).Methods Seventy-eight patients suspected with CHD and coronary artery stenosis were selected.All patients underwent low-dose CCTA examination based on IMR technology.The image quality score of CCTA examination was analyzed,while the CT,contrast noise ratio(CNR)and standard deviation(SD)values of each coronary artery segment separately by using IMR,iDose^(4) and FBP algorithms were compared.Taking coronary angiography(CAG)diagnosis results as the gold standard,the diagnostic value of low-dose CCTA examination using IMR technology for coronary artery stenosis in CHD was analyzed,and its consistency with the diagnosis results of the gold standard was discussed.Results A total of 310 images of the main branches of coronary arteries were obtained in this examination,and 300 of them met the standard for the quality of coronary artery images.There were 10 images with a score of 1,11 images with 2 points,44 images with 3 points,and 235 images with 4 points.There was no statistically significant difference in CT values of each coronary artery segment by using different algorithms(P>0.05).The CNR values of each segment of coronary arteries obtained by low-dose CCTA examination based on IMR technology were all higher than those based on iDose^(4) and FBP,while the SD values of each segment of coronary arteries were all lower than those based on iDose^(4) and FBP,all with statistically significant differences(all P<0.05).Based on the calculation of coronary artery segments,there were 765 out of the obtained 780 segments in all,which met the diagnostic criteria for anomalous coronary artery.The diagnostic accuracy rate,sensitivity,specificity,and positive and negative predictive values of low-dose CCTA examination using IMR technology for coronary artery stenosis were 89.02%,92.48%,82.31%,91.03%and 84.92%,respectively.The consistency of this examination was good in the diagnosis of coronary artery stenosis(Kappa=0.753,P<0.05).Conclusion Low-dose CCTA scanning based on IMR technology could effectively detect coronary artery stenosis in CHD,with relatively high diagnostic accuracy rate and consistency.It provides effective references for clinical diagnosis of coronary artery stenosis in CHD,and is worthy of promotion and application.
作者
刘静静
洪念全
LIU Jingjing;HONG Nianquan(Department of Imaging,Puyang Huimin Hospital,Puyang Henan 457000,China)
出处
《实用心电与临床诊疗》
2025年第1期80-84,共5页
PRACTICAL ELECTROCARDIOLOGY AND CLINICAL TREATMENT
关键词
冠心病
全模型迭代重建
冠状动脉CT血管造影
冠状动脉造影
准确率
coronary heart disease
iterative model reconstruction
coronary CT angiography
coronary angiography
accuracy rate
