Laohachewin Danai, Ruile Philipp, Breitbart Philipp, Minners Jan, Jander Nikolaus, Soschynski Martin, Schlett Christopher L, Neumann Franz-Josef, Westermann Dirk, Hein Manuel
Department of Cardiology and Angiology, Medical Center-University of Freiburg, Faculty of Medicine, Suedring 15, 79189 Bad Krozingen, Germany.
Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany.
J Clin Med. 2024 Apr 19;13(8):2386. doi: 10.3390/jcm13082386.
: The goal of our study is to evaluate a method to quantify aortic valve calcification (AVC) in contrast-enhanced computed tomography for patients with suspected severe aortic stenosis pre-interventionally. : A total of sixty-five patients with aortic stenosis underwent both a native and a contrast-enhanced computed tomography (CECT) scan of the aortic valve (45 in the training cohort and 20 in the validation cohort) using a standardized protocol. Aortic valve calcification was semi-automatically quantified via the Agatston score method for the native scans and was used as a reference. For contrast-enhanced computed tomography, a calcium threshold of the Hounsfield units of the aorta plus four times the standard deviation was used. : For the quantification of aortic valve calcification in contrast-enhanced computed tomography, a conversion formula (691 + 1.83 x AVCCECT) was derived via a linear regression model in the training cohort. The validation in the second cohort showed high agreement for this conversion formula with no significant proportional bias (Bland-Altman, = 0.055) and with an intraclass correlation coefficient in the validation cohort of 0.915 (confidence interval 95% 0.786-0.966) < 0.001. : Calcium scoring in patients with aortic valve stenosis can be performed using contrast-enhanced computed tomography with high validity. Using a conversion factor led to an excellent agreement, thereby obviating an additional native computed tomography scan. This might contribute to a decrease in radiation exposure.
我们研究的目的是评估一种在对比增强计算机断层扫描中对疑似重度主动脉瓣狭窄患者进行干预前主动脉瓣钙化(AVC)定量的方法。共有65例主动脉瓣狭窄患者按照标准化方案接受了主动脉瓣的平扫和对比增强计算机断层扫描(CECT)(45例在训练队列,20例在验证队列)。通过阿加斯顿评分法对平扫图像进行主动脉瓣钙化的半自动定量,并将其作为参考。对于对比增强计算机断层扫描,使用主动脉的亨氏单位钙阈值加上四倍标准差。对于对比增强计算机断层扫描中主动脉瓣钙化的定量,通过训练队列中的线性回归模型得出一个转换公式(691 + 1.83 x AVCCECT)。在第二个队列中的验证显示,该转换公式具有高度一致性,无显著比例偏差(布兰德 - 奥特曼分析, = 0.055),验证队列中的组内相关系数为0.915(95%置信区间0.786 - 0.966)< 0.001。主动脉瓣狭窄患者的钙化评分可以使用对比增强计算机断层扫描进行,有效性高。使用转换因子可实现极佳的一致性,从而无需额外进行平扫计算机断层扫描。这可能有助于减少辐射暴露。
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