Willemink Martin J, Abramiuc Bronislaw, den Harder Annemarie M, van der Werf Niels R, de Jong Pim A, Budde Ricardo P J, Wildberger Joachim E, Vliegenthart Rozemarijn, Willems Tineke P, Greuter Marcel J W, Leiner Tim
Department of Radiology, University Medical Center Utrecht, P.O. Box 85500, E01.132, Utrecht 3508 GA, The Netherlands.
Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
J Cardiovasc Comput Tomogr. 2015 Sep-Oct;9(5):415-21. doi: 10.1016/j.jcct.2015.03.010. Epub 2015 Apr 2.
To evaluate the effect of chest size on coronary calcium score (CCS) as assessed with new-generation CT systems from 4 major vendors.
An anthropomorphic, small-sized (300 × 200 mm) chest phantom containing 100 small calcifications (diameters, 0.5-2.0 mm) was evaluated with and without an extension ring on state-of-the-art CT systems from 4 vendors. The extension ring was used to mimic a patient with a large chest size (400 × 300 mm). Image acquisition was repeated 5 times with small translations and/or rotations. Routine clinical acquisition and reconstruction protocols for small and large patients were used. CCS was quantified as Agatston and mass scores with vendor software.
The small-sized phantom resulted in median (interquartiles) Agatston scores of 10 (9-35), 136 (123-146), 34 (30-37), and 87 (85-89) for Philips, GE, Siemens, and Toshiba, respectively. Mass scores were 4 mg (3-9 mg), 23 mg (21-27 mg), 8 mg (8-9 mg), and 20 mg (20-20 mg), respectively. Adding the extension ring resulted in reduced Agatston scores for all vendors (17%-48%) and mass scores for 2 vendors (11%-49%). Median Agatston scores decreased to 9 (5-10), 79 (60-80), 27 (24-32), and 45 (29-53) units, and median mass scores remained similar for Philips at 4 mg (4-6 mg) and Siemens at 8 mg (7-8 mg) and decreased for the other vendors to 13 mg (11-14 mg) and 10 mg (8-13 mg), respectively.
This multivendor phantom study showed that CCS can be underestimated up to 50% (49%-66%) for Agatston scores and 49% (36%-59%) for mass scores at a larger chest size, which may be relevant for women and large patients. However, CCS underestimation by chest size differs considerably by vendor.
评估胸廓大小对使用4家主要供应商的新一代CT系统所评估的冠状动脉钙化积分（CCS）的影响。
使用一个含100个小钙化灶（直径0.5 - 2.0毫米）的拟人化小型（300×200毫米）胸部模体，在4家供应商的先进CT系统上分别在使用和不使用扩展环的情况下进行评估。扩展环用于模拟胸廓较大（400×300毫米）的患者。图像采集在进行小幅度平移和/或旋转的情况下重复5次。使用针对小体型和大体型患者的常规临床采集和重建方案。使用供应商软件将CCS量化为阿加斯顿积分和质量积分。
对于飞利浦、通用电气、西门子和东芝的系统，小型模体的阿加斯顿积分中位数（四分位间距）分别为10（9 - 35）、136（123 - 146）、34（30 - 37）和87（85 - 89）。质量积分分别为4毫克（3 - 9毫克）、23毫克（21 - 27毫克）、8毫克（8 - 9毫克）和20毫克（20 - 20毫克）。添加扩展环后，所有供应商的阿加斯顿积分均降低（17% - 48%），2家供应商的质量积分降低（11% - 49%）。阿加斯顿积分中位数降至9（5 - 10）、79（60 - 80）、27（24 - 32）和45（29 - 53）单位，飞利浦的质量积分中位数保持在4毫克（4 - 6毫克），西门子的保持在8毫克（7 - 8毫克），其他供应商的质量积分中位数分别降至13毫克（11 - 14毫克）和10毫克（8 - 13毫克）。
这项多供应商模体研究表明，在胸廓较大时，阿加斯顿积分的CCS可能被低估高达50%（49% - 66%），质量积分的CCS可能被低估49%（36% - 59%），这可能与女性和大体型患者相关。然而，不同供应商因胸廓大小导致的CCS低估情况差异很大。
