de Weert Thomas T, de Monyé Cécile, Meijering Erik, Booij Ronald, Niessen Wiro J, Dippel Diederik W J, van der Lugt Aad
Department of Radiology, Erasmus MC, University Medical Center Rotterdam, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
Int J Cardiovasc Imaging. 2008 Oct;24(7):751-9. doi: 10.1007/s10554-008-9309-1. Epub 2008 Mar 29.
The amount of atherosclerotic plaque and its components (calcifications, fibrous tissue, and lipid core) could be better predictors of acute events than the now currently used degree of stenosis. Therefore, we evaluated a dedicated software tool for volume measurements of atherosclerotic carotid plaque and its components in multidetector computed tomography angiography (MDCTA) images.
Data acquisition was approved by the Institutional Review Board and all patients gave written informed consent. MDCTA images of 56 carotid arteries were analyzed by three observers. Plaque volumes were assessed by manual drawing of the outer vessel contour. The luminal boundary was determined based on a Hounsfield-Unit (HU) threshold. The contribution of different components was measured by the number of voxels within defined ranges of HU-values (calcification >130 HU, fibrous tissue 60-130 HU, lipid core <60 HU). Interobserver variability (IOV) was assessed.
Plaque volume was 1,259 +/- 621 mm3. The calcified, fibrous and lipid volumes were 238 +/- 252 mm3, 647 +/- 277 mm3 and 376 +/- 283 mm3, respectively. IOV was moderate with interclass correlation coefficients (ICC) ranging from 0.76 to 0.99 and coefficients of variation (COV) ranging from 3% to 47%.
Atherosclerotic carotid plaque volume and plaque component volumes can be assessed with MDCTA with a reasonable observer variability.
与目前使用的狭窄程度相比，动脉粥样硬化斑块的数量及其成分（钙化、纤维组织和脂质核心）可能是急性事件更好的预测指标。因此，我们评估了一种专用软件工具，用于在多排螺旋计算机断层血管造影（MDCTA）图像中测量动脉粥样硬化颈动脉斑块及其成分的体积。
数据采集经机构审查委员会批准，所有患者均签署了书面知情同意书。三位观察者对56条颈动脉的MDCTA图像进行了分析。通过手动绘制血管外轮廓来评估斑块体积。基于亨氏单位（HU）阈值确定管腔边界。通过在定义的HU值范围内的体素数量来测量不同成分的贡献（钙化>130 HU，纤维组织60 - 130 HU，脂质核心<60 HU）。评估了观察者间的变异性（IOV）。
斑块体积为1259±621 mm³。钙化、纤维和脂质体积分别为238±252 mm³、647±277 mm³和376±283 mm³。IOV为中等，组内相关系数（ICC）范围为0.76至0.99，变异系数（COV）范围为3%至47%。
使用MDCTA可以合理评估观察者间变异性的情况下评估动脉粥样硬化颈动脉斑块体积和斑块成分体积。
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