能谱CT在鉴别冠状动脉粥样硬化r非钙化斑块成分中的应用价值

摘要

目的:探讨宝石能谱CT碘基图在鉴别冠状动脉粥样硬化非钙化斑块成分中的应用价值.方法:收集行冠状动脉能谱模式扫描的45例冠状动脉粥样硬化,在宝石能谱成像软件上获得各组的能谱曲线图、碘基图像和水基图像,计算斑块标准化碘浓度,即标准化碘浓度=斑块碘含量/主动脉碘含量,并采用方差分析.结果:45例共检出非钙化斑块73处,其中脂质成分21处,纤维成分40处,血栓样组织12处.不同类型非钙化斑块的碘浓度及标准化碘浓度差异均有统计学意义(均P<0.05),3名医师对图像评价结果的一致性较好(K=0.672).结论:CT能谱成像通过对碘含量进行测定,对不同性质的斑块成分鉴别有较大的意义,可早期提示脂质成分等不稳定斑块,为明确斑块性质提供量化依据.%Object:To explore the value of gemstone spectral imaging (GSI) with single source dual-energy spectral CT to as-sess the compositions of non-calcified plaques in patients with coronary atherosclerosis. Methods:Totally 45 patients with coro-nary artery stenosis underwent enhanced CT scan using single source dual-energy CT by GSI mode. The compositions of non-calcified plaques were analyzed,and CT spectral imaging parameters were evaluated statistically by using analysis of vari-ance. Results:Totally 73 non-calcified plaques were found in 45 patients,including 21 lipid plaques,40 fiber plaques and 12 thrombotic tissue. There were statistical differences of iodine density and standard iodine density between any two kinds of non-calcified plaques (all P<0.05). Three doctors had good agreement on the results of image quality evaluation. Conclusions:The spectral CT imaging may be helpful for the assessment of non-calcified plaque compositions in coronary atherosclerosis. The pa-rameters of CT spectral imaging can provide quantification information for differentiation of lipid,fiber and thrombus plaques.