ISSN 1004-4140
CN 11-3017/P
黄晓颖, 郭方凯, 王鹏朝, 等. 能量CT联合标准化碘含量在评估下肢动脉支架狭窄程度中的诊断价值[J]. CT理论与应用研究（中英文）, 2024, 33(6): 701-708. DOI: 10.15953/j.ctta.2024.141.
引用本文: 黄晓颖, 郭方凯, 王鹏朝, 等. 能量CT联合标准化碘含量在评估下肢动脉支架狭窄程度中的诊断价值[J]. CT理论与应用研究（中英文）, 2024, 33(6): 701-708. DOI: 10.15953/j.ctta.2024.141.
shu
HUANG X Y, GUO F K, WANG P C, et al. Diagnostic Value of Dual-energy Computed Tomography Combined with Standardized Iodine Content in Assessing Restenosis of Lower Extremity Artery Stents[J]. CT Theory and Applications, 2024, 33(6): 701-708. DOI: 10.15953/j.ctta.2024.141. (in Chinese).
Citation: HUANG X Y, GUO F K, WANG P C, et al. Diagnostic Value of Dual-energy Computed Tomography Combined with Standardized Iodine Content in Assessing Restenosis of Lower Extremity Artery Stents[J]. CT Theory and Applications, 2024, 33(6): 701-708. DOI: 10.15953/j.ctta.2024.141. (in Chinese).
shu

能量CT联合标准化碘含量在评估下肢动脉支架狭窄程度中的诊断价值

Diagnostic Value of Dual-energy Computed Tomography Combined with Standardized Iodine Content in Assessing Restenosis of Lower Extremity Artery Stents

    摘要
  • 摘要: 目的：探讨双能量CT（DECT）联合标准化碘含量（NIC）在评估下肢动脉支架狭窄程度中的诊断价值。方法：回顾性收集2020年1月至2024年6月于我院行双能量下肢CTA检查的支架植入患者32例，共48枚支架。均在CTA检查后1周内行DSA检查。双能数据分别重建50～90 keV间隔10 keV的5组虚拟单能量图像和1组最佳非线性融合（OCM）图像，共6组；测量并比较支架内管腔CT值、SD值 、CNR、SNR及NIC值及进行图像质量主观评价；诊断管腔狭窄率和是否达到支架内再狭窄（ISR），并以DSA为金标准，评价管腔狭窄率和ISR的诊断准确性。结果：①客观评价：50 keV时SNR、CNR值最高，随着单能量能级上升逐渐降低；OCM与60 keV两组图像的SNR、CNR值仅低于50 keV，比较差异无统计学意义。②主观评价：6组主观评价得分比较差异有统计学差异。OCM（4.23±0.89）和60 keV（4.19±0.64）两组图像评分最高且差异无统计学意义。③与 DSA相比，DECT在管腔狭窄率和ISR的诊断中一致性均一般（Kappa=0.563和Kappa=0.654）。DECT联合NIC在ISR诊断中一致性良好（Kappa=0.830），NIC数值分别是支架无明显狭窄病变（1.02±0.14）、ISR（0.73±0.14）。闭塞性病变（0.18±0.09），联合诊断的敏感性、特异性、阳性预测值、阴性预测值和诊断准确率分别为94.11％、85.71％、94.11％、85.71％和91.66％。结论：DECT重组60 keV和OCM图像用于评估下肢动脉支架图像质量最佳，进一步联合应用NIC定量分析可提高支架内管腔狭窄率和ISR诊断准确率，具有较高的诊断价值。

     

    Abstract:
    Objective: To explore the diagnostic value of dual-energy computed tomography (DECT) combined with standardized iodine concentration (NIC) for assessing the degree of lower-extremity artery stent stenosis.
    Methods: A retrospective study was conducted on 32 patients with 48 stents who underwent dual-energy lower-extremity CTA at our hospital between January 2020 and June 2024. All patients underwent DSA within one week of CTA. Dual-energy data were reconstructed into five sets of virtual monochromatic images from 50～90 keV with 10 keV intervals, along with one set of optimum contrast (OCM) images. The CT, SD, CNR, SNR, and NIC values within the stent lumen were measured and compared, and subjective image quality evaluations were performed. The diagnostic accuracy of DECT for lumen stenosis rate and in-stent restenosis (ISR) was evaluated using DSA as the gold standard.
    Results: The SNR and CNR values were highest at 50 keV, gradually decreasing as the monochromatic energy level increased. The SNR and CNR values of the OCM and 60 keV groups were slightly lower than those of the 50 keV group, though were not significantly different. There were significant differences in the subjective evaluation scores among the six groups. The OCM (4.23±0.89) and 60 keV (4.19±0.64) groups had the highest scores but were not significantly different. Compared with DSA, DECT had moderate consistency in diagnosing lumen stenosis rate and ISR (kappa=0.563 and 0.654, respectively). DECT combined with NIC showed good consistency in ISR diagnosis (kappa=0.830). The NIC values were 1.02±0.14 for no significant stenosis, 0.73±0.14 for ISR, and 0.18±0.09 for occlusive lesions. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the combined diagnosis were 94.11%, 85.71%, 94.11%, 85.71%, and 91.66%, respectively.
    Conclusion: DECT reconstructed at 60 keV and OCM images were best for assessing lower-extremity artery stent stenosis. Combining quantitative analysis with NIC can improve the accuracy of grading stent lumen stenosis and judging ISR, which has high diagnostic value.

     

    • HTML全文
    • 参考文献(24)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回