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基于双层探测器光谱CT定量参数的急性缺血性卒中颈动脉斑块评估的诊断价值

Diagnostic Value of Carotid Plaque Assessment with AIS Based on Quantitative Parameters of Dual-Layer Detector Spectral CT.

作者信息

Meng Xiaoying, Li Fei, Wu Wenpei, Wu Juncang

机构信息

Department of Neurology, Hefei Hospital Affiliated to Anhui Medical University (Hefei Second People's Hospital), Hefei, Anhui, 230011, People's Republic of China.

The Fifth Clinical School of Medicine, Anhui Medical University, Hefei, Anhui, 230032, People's Republic of China.

出版信息

Int J Gen Med. 2024 Mar 30;17:1263-1272. doi: 10.2147/IJGM.S448852. eCollection 2024.

Abstract

PURPOSE

To investigate the quantitative assessment of carotid plaque by each parameter of dual-layer detector spectral CT and its diagnostic value in patients with acute cerebral infarction.

PATIENTS AND METHODS

Eighty-three patients with carotid atherosclerotic plaques who underwent spectral CT scanning were retrospectively included. Forty-two patients with acute ischaemic stroke (AIS) were included in the study group, and 41 patients without AIS were included in the control group. We compared the detection of carotid plaques in the two groups and the differences in the spectral quantitative parameters of the plaques in the two groups, and their diagnostic efficacy was obtained.

RESULTS

The detection rate of carotid plaques in the AIS group was higher than that in the non-AIS group (<0.05); the carotid plaques in the AIS group mainly consisted of non-calcified plaques, while those in the non-AIS group mainly consisted of calcified plaques. The effective atomic number (Zeff), slope of the energy spectrum curve (λH), electron density (ED), and iodine-no-water value of the carotid plaques in the AIS group were lower than those in the non-AIS (<0.05). For the differentiation of the carotid plaques in the AIS group from those in the non-AIS group, the area under the curve (AUC) of Zeff amounted to 0.637 (cut-off value: 11.865; sensitivity: 72.5%; specificity: 56.2%), the AUC of λH amounted to 0.628 (cut-off value: 19.56; sensitivity: 76.3%; specificity: 51.6%), and that for ED amounted to 0.624 (cut-off value: 110.45; sensitivity: 60.0%; specificity: 64.1%), AUC of iodine-no-water value amounted to 0.645 (cut-off value: 9.125; sensitivity: 61.3%; specificity: 65.6%).

CONCLUSION

In summary, the quantitative parameters of dual-layer detector spectral CT can be used to assess plaque stability and have certain value in the diagnosis of AIS. The quantitative parameters can effectively differentiate carotid plaques in AIS and non-AIS patients.

摘要

目的

探讨双层探测器光谱CT各参数对颈动脉斑块的定量评估及其在急性脑梗死患者中的诊断价值。

患者与方法

回顾性纳入83例接受光谱CT扫描的颈动脉粥样硬化斑块患者。研究组纳入42例急性缺血性卒中(AIS)患者,对照组纳入41例无AIS患者。比较两组颈动脉斑块的检出情况及斑块光谱定量参数的差异,并得出其诊断效能。

结果

AIS组颈动脉斑块检出率高于非AIS组(<0.05);AIS组颈动脉斑块以非钙化斑块为主,而非AIS组以钙化斑块为主。AIS组颈动脉斑块的有效原子序数(Zeff)、能谱曲线斜率(λH)、电子密度(ED)及碘水比低于非AIS组(<0.05)。对于区分AIS组与非AIS组的颈动脉斑块,Zeff的曲线下面积(AUC)为0.637(截断值:11.865;敏感度:72.5%;特异度:56.2%),λH的AUC为0.628(截断值:19.56;敏感度:76.3%;特异度:51.6%),ED的AUC为0.624(截断值:110.45;敏感度:�0.0%;特异度:64.1%),碘水比的AUC为0.645(截断值:9.125;敏感度:61.3%;特异度:65.6%)。

结论

综上所述,双层探测器光谱CT定量参数可用于评估斑块稳定性,对AIS诊断有一定价值。该定量参数能有效区分AIS和非AIS患者的颈动脉斑块。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8882/10993903/3d424304a95e/IJGM-17-1263-g0001.jpg

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