CT冠状动脉造影斑块成像：血管内衰减对斑块类型分类的影响。
Plaque imaging with CT coronary angiography: Effect of intra-vascular attenuation on plaque type classification.
作者信息
Maffei Erica, Martini Chiara, Arcadi Teresa, Clemente Alberto, Seitun Sara, Zuccarelli Alessandra, Torri Tito, Mollet Nico R, Rossi Alexia, Catalano Onofrio, Messalli Giancarlo, Cademartiri Filippo
机构信息
Erica Maffei, Chiara Martini, Teresa Arcadi, Filippo Cademartiri, Cardiovascular Imaging Unit, Giovanni XXIII Hospital, 31050 Monastier di Treviso, Treviso, Italy.
出版信息
World J Radiol. 2012 Jun 28;4(6):265-72. doi: 10.4329/wjr.v4.i6.265.
AIM
To assess the attenuation of non-calcified atherosclerotic coronary artery plaques with computed tomography coronary angiography (CTCA).
METHODS
Four hundred consecutive patients underwent CTCA (Group 1: 200 patients, Sensation 64 Cardiac, Siemens; Group 2: 200 patients, VCT GE Healthcare, with either Iomeprol 400 or Iodixanol 320, respectively) for suspected coronary artery disease (CAD). CTCA was performed using standard protocols. Image quality (score 0-3), plaque (within the accessible non-calcified component of each non-calcified/mixed plaque) and coronary lumen attenuation were measured. Data were compared on a per-segment/per-plaque basis. Plaques were classified as fibrous vs lipid rich based on different attenuation thresholds. A P < 0.05 was considered significant.
RESULTS
In 468 atherosclerotic plaques in Group 1 and 644 in Group 2, average image quality was 2.96 ± 0.19 in Group 1 and 2.93 ± 0.25 in Group 2 (P ≥ 0.05). Coronary lumen attenuation was 367 ± 85 Hounsfield units (HU) in Group 1 and 327 ± 73 HU in Group 2 (P < 0.05); non-calcified plaque attenuation was 48 ± 23 HU in Group 1 and 39 ± 21 HU in Group 2 (P < 0.05). Overall signal to noise ratio was 15.6 ± 4.7 in Group 1 and 21.2 ± 7.7 in Group 2 (P < 0.01).
CONCLUSION
Higher intra-vascular attenuation modifies significantly the attenuation of non-calcified coronary plaques. This results in a more difficult characterization between lipid rich vs fibrous type.
目的
通过计算机断层扫描冠状动脉造影（CTCA）评估非钙化性动脉粥样硬化冠状动脉斑块的衰减情况。
方法
400例连续患者因疑似冠状动脉疾病（CAD）接受CTCA检查（第1组：200例患者，使用西门子Sensation 64 Cardiac；第2组：200例患者，使用通用电气医疗集团的VCT，分别使用碘普罗胺400或碘克沙醇320）。CTCA采用标准方案进行。测量图像质量（评分0 - 3）、斑块（在每个非钙化/混合斑块可及的非钙化成分内）和冠状动脉管腔衰减。数据按节段/斑块进行比较。根据不同的衰减阈值将斑块分为纤维型和富含脂质型。P < 0.05被认为具有统计学意义。
结果
第1组有468个动脉粥样硬化斑块，第2组有644个。第1组平均图像质量为2.96 ± 0.19，第2组为2.93 ± 0.25（P ≥ 0.05）。第1组冠状动脉管腔衰减为367 ± 85亨氏单位（HU），第2组为327 ± 73 HU（P < 0.05）；第1组非钙化斑块衰减为48 ± 23 HU，第2组为39 ± 21 HU（P < 0.05）。第1组总体信噪比为15.6 ± 4.7，第2组为21.2 ± 7.7（P < 0.01）。
结论
较高的血管内衰减显著改变非钙化冠状动脉斑块的衰减。这导致富含脂质型与纤维型之间的特征区分更加困难。
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