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  本文選題：高清CT冠狀動脈 + 鈣化��； 參考：《安徽醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的比較GE Light Speed HDCT（High Definition CT,HDCT）與Light Speed64層VCT分別以高清標(biāo)準(zhǔn)算法重建模式及標(biāo)準(zhǔn)重建模式對冠狀動脈鈣化和支架的圖像質(zhì)量的影響，探討HDCT高清成像技術(shù)對減輕冠狀動脈鈣化和支架的射線束硬化偽影及部分容積效應(yīng)等方面的臨床應(yīng)用價值。 方法將2009年8月至2012年2月行冠狀動脈CT血管成像伴冠狀動脈鈣化及冠狀動脈支架植入術(shù)后隨訪的患者分為鈣化組和支架組。（1）鈣化組：128例患者，其中，64例患者行HDCT掃描并采用高清標(biāo)準(zhǔn)重組算法重建圖像，64例患者行64-VCT掃描并采用標(biāo)準(zhǔn)重建算法對冠狀動脈鈣化圖像進(jìn)行重建。按Agatston方法,測量每段血管的鈣化積分，將段血管的鈣化積分值10～100定為輕度鈣化,100～400為中度鈣化,＞400為重度鈣化。（2）支架組：81例患者，其中，34例患者行HDCT掃描并采用高清標(biāo)準(zhǔn)重組算法重建圖像，47例患者行64-VCT掃描并采用標(biāo)準(zhǔn)重建算法對冠狀動脈支架圖像進(jìn)行重建。運用Osiris419軟件分別對重建后圖像的支架的內(nèi)徑進(jìn)行測量。采用5分制等級評分方法評估冠狀動脈鈣化和支架的曲面重組圖像的質(zhì)量。統(tǒng)計學(xué)分析采用獨立樣本資料的t檢驗。 結(jié)果(1)鈣化組：HDCT和64-VCT兩組患者臨床資料的匹配性及一致性良好。HDCT的64例患者有220段血管存在鈣化，64-VCT的64例患者有225段血管存在鈣化。HDCT和64-VCT兩組輕度、中度及重度鈣化節(jié)段血管的圖像質(zhì)量評分分別為3.83±0.79，3.36±1.45，3.25±1.37及3.17±0.71，2.72±0.90，2.45±1.18，HDCT輕度、中度及重度鈣化節(jié)段血管的圖像質(zhì)量均優(yōu)于64-VCT，經(jīng)檢驗差異有統(tǒng)計學(xué)意義（均P0.05）。(2)支架組：HDCT和64-VCT兩組患者臨床資料的匹配性及一致性良好。HDCT有41枚支架，64-VCT有69枚支架，支架直徑為2.5mm～4mm。對于直徑為2.5mm、3.0mm、3.5mm及4mm支架，HDCT支架內(nèi)徑測量值均高于64-VCT，經(jīng)檢驗差異有統(tǒng)計學(xué)意義(t＝9.33,8.54,7.04及3.78，均P0.05)。對于直徑為2.5mm及3.0mm支架，HDCT支架圖像質(zhì)量評分分別為4.36±0.67及4.08±0.76，均優(yōu)于64-VCT標(biāo)準(zhǔn)重建圖像的質(zhì)量（2.65±0.83及3.20±0.52），經(jīng)檢驗差異有統(tǒng)計學(xué)意義(t＝5.94及3.94，均P＝0.000)；對于直徑為3.5mm及4mm支架，HDCT和64-VCT兩組支架圖像質(zhì)量評分分別為3.75±0.46，4.13±0.35及3.69±0.75，3.75±0.45，經(jīng)檢驗差異無統(tǒng)計學(xué)意義（t＝0.20及1.97，P＝0.850及0.060）。 結(jié)論HDCT高清成像技術(shù)獲得的冠狀動脈鈣化節(jié)段和支架的圖像質(zhì)量可更清楚地顯示鈣化節(jié)段局部管腔和支架腔內(nèi)的結(jié)構(gòu)，降低了鈣化和支架段的射線束硬化偽影及部分容積效應(yīng)的影響，冠狀動脈鈣化節(jié)段的圖像質(zhì)量和支架的圖像質(zhì)量較64層螺旋CT有了明顯的改善。
[Abstract]:Objective to compare the image quality of coronary artery calcification and stent between GE Light Speed HDCT(High Definition CTT and Light Speed64 layer VCT with high definition standard algorithm and standard reconstruction mode. To explore the clinical application value of HDCT high-definition imaging in reducing coronary artery calcification, beam sclerosis artifact and partial volume effect of stent. Methods from August 2009 to February 2012, patients undergoing coronary artery CT angiography with coronary artery calcification and coronary stent implantation were divided into calcification group and stenting group (n = 128). Among them, 64 patients underwent HDCT scan and 64 patients underwent 64-VCT scan with high definition standard reconstruction algorithm. Coronary artery calcification images were reconstructed by standard reconstruction algorithm. According to the Agatston method, the calcification integral of each segment of blood vessel was measured. The calcification integral value of the segmental blood vessel was 10 ~ 100%. The calcification integral value of the segmental blood vessel was determined to be moderate calcification in mild calcification group, moderate calcification in light calcification group, and severe calcification in > 400) stent group (81 patients). Among them, 34 patients underwent HDCT scan and 47 patients underwent 64-VCT scan with high definition standard reconstruction algorithm. The coronary stent images were reconstructed by standard reconstruction algorithm. The inner diameter of the reconstructed image was measured by Osiris419 software. The quality of coronary artery calcification and curved surface reconstruction images of stent was evaluated by 5-score method. T test of independent sample data was used for statistical analysis. Results in the calcification group, the matching and consistency of the clinical data of the two groups were good. There were 220 segments of vascular calcification and 64 cases of 64 cases of 64-VCT. There were 225 segments of vascular calcification. HDCT and 64-VCT were mild in 64 patients. The image quality scores of moderate and severe calcified blood vessels were 3.83 鹵0.79 鹵3.36 鹵1.45V 3.25 鹵1.37 and 3.17 鹵0.71 鹵0.90 鹵2.45 鹵1.18HDCT, respectively. The image quality of moderate and severe calcified blood vessels was better than that of 64-VCT.The difference was statistically significant (all P 0.05%). The matching and consistency of clinical data between the two groups were good. There were 41 stents with 64-VCT and 69 stents with a diameter of 2.5mm ~ 4mm ~ (-1). For the diameter of 2.5mm to 3.0mm or 3.5mm to 3.5mm, the diameter of 4mm stent was higher than that of 64-VCT, and the difference was statistically significant (P 0.05). The image quality scores of 2.5mm and 3.0mm stents were 4.36 鹵0.67 and 4.08 鹵0.76, respectively, which were better than those of 64-VCT standard reconstruction images (2.65 鹵0.83 and 3.20 鹵0.52), respectively. The difference was statistically significant (P < 5.94 and 3.94, respectively); for 3.5mm and 4mm stents, the diameters were 3.5mm and 4mm stents. The image quality scores of the two groups were 3.75 鹵0.46v 4.13 鹵0.35 and 3.69 鹵0.75U 3.75 鹵0.45respectively. There was no significant difference between the two groups. Conclusion the image quality of coronary artery calcification segment and stent obtained by HDCT high-definition imaging technique can more clearly show the local lumen and the stenting structure of calcified segment. The effects of calcification, beam hardening artifacts and partial volume effect were reduced. The image quality of coronary artery calcification segment and stent was significantly improved than that of 64-slice spiral CT.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R541.4;R816.2

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