中国临床解剖学杂志 ›› 2021, Vol. 39 ›› Issue (6): 649-653.doi: 10.13418/j.issn.1001-165x.2021.06.006

• 断层影像解剖 • 上一篇    下一篇

双源CT评估冠状动脉钙化与病理诊断符合度

刘云霏1, 马延贺2, 王常月3, 李志营1, 郭长英1, 郭琳1   

  1. 1.郑州市第七人民医院重症医学科,  郑州   450016;   2 .天津市胸科医院影像科,  天津   300051; 
    3.天津医科大学人体解剖与组织胚胎系,  天津   300070
  • 收稿日期:2020-08-21 出版日期:2021-11-25 发布日期:2021-12-01
  • 通讯作者: 郭琳,主任医师,E-mail:1365389203@163.com
  • 作者简介:刘云霏(1988-),男,河南南阳人,硕士,主治医师,主要从事冠状动脉粥样硬化影像学和病理学研究,E-mail:Yunfeiliu2012@163.com
  • 基金资助:
    河南省医学科技攻关计划联合共建项目(LHGJ20191120)

The coincidence of coronary artery calcification with pathological diagnosis evaluated by DSCT

Liu Yunfei1, Ma Yanhe2, Wang Changyue3, Li Zhiying1, Guo Changying1, Guo Lin1   

  1. 1. Department of Intensive Care Unit, The 7th People's Hospital of Zhengzhou, Zhengzhou 450016, China; 2. Department of Radiology, Tianjin Chest Hospital,Tianjin 300051, China; 3. Department of Anatomy and Histoembryology, Tianjin Medical University, Tianjin 300070, China
  • Received:2020-08-21 Online:2021-11-25 Published:2021-12-01

摘要: 目的 以病理诊断为标准评价双源CT增强扫描定性和定量冠状动脉钙化斑块的准确性。  方法 采用双源CT对离体冠状动脉进行0.6 mm层厚横断面增强扫描,将CT值>130 HU的斑块定性为钙化斑块,依据钙化斑块在管壁横断面上的弧度将其分为3型:轻度钙化、中度钙化和重度钙化。计算钙化斑块导致的冠状动脉狭窄,并与病理分型和所测冠状动脉狭窄进行对比。  结果 病理切片发现钙化斑块69个,DSCT发现57个,双源CT检测轻度、中度和重度钙化斑块的敏感性分别为88.3%、100%和100%。与病理诊断结果相比,双源CT高估了轻度、中度和重度钙化斑块导致的冠状动脉狭窄程度,分别相差(3.2±2.0)%、(4.9±4.7)%和(14.7±8.2)%,P<0.05。  结论 双源CT增强扫描能够检测定性不同类型的冠状动脉钙化;与病理对比,双源CT高估了钙化斑块导致的冠状动脉狭窄程度较严重。

关键词:  , 双源CT,  冠状动脉钙化,  病理组织学

Abstract: Objective To evaluate the accuracy of dual-source CT and quantitative coronary artery calcification based on the pathological diagnosis. Methods Coronary arteries were scanned by contrasted-enhanced DSCT with an axial slice thickness of 0.6mm in vitro. The plaque with computed tomographic value more than 130 Hounsfield units was identified as calcified plaque. According to the arc of calcification in the cross section of coronary artery wall, calcified plaques can be divided as follows: mild calcification, moderate calcification, severe calcification. The coronary artery stenosis caused by calcified plaque was calculated. Pathological classification and coronary artery stenosis measured by pathology were used as comparison criteria. Results Histopathology detected 69 calcified plaques. 57 calcified plaques were found at DSCT. The sensitivity of DSCT for detecting mild、moderate and severe calcified plaques were 88.3%、100% and 100%, respectively. Compared with pathological diagnosis, DSCT overestimated coronary artery stenosis caused by mild, moderate and severe calcified plaques (3.2%±2.0%, 4.9%±4.7% and 14.7%±8.2%, respectively; P<0.05). Conclusions Compared with histopathology, dual-source CT contrast enhancement scanning can detect and characterize different types of coronary artery calcification. Compared with histopathology dual source CT overestimates coronary artery stenosis caused by calcified plaque.

Key words: Dual-source computer tomography,  Coronary artery calcification,  Histopathology

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