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心脏CT平扫与CT血管造影定量分析对心外膜脂肪体积的测定效果比较

Quantitative analyses of cardiac CT plain scan versus CT angiography in assessing epicardial fat volume

    摘要
  • 摘要:
      目的  比较心脏CT平扫与心脏CT血管造影(CTA)定量分析测定心外膜脂肪体积的临床效果。
      方法  选取170例冠心病患者为研究对象，患者均同期接受心脏CT平扫与CTA检查，将原始图像上传工作站，基于最佳R-R间期相位重建患者心脏影像，自动勾勒心包轮廓，提取心外膜脂肪组织信息，应用容积增强工具测量并计算脂肪容积，操作由放射影像科2名资深医师采用双盲法完成，比较观察指标水平，分析CT平扫与CTA测定心外膜脂肪体积结果的一致性。
      结果  CT平扫测定心外膜脂肪体积为(99.59±43.14) cm2, CTA测定心外膜脂肪体积为(94.05±45.70) cm3, 差异无统计学意义(P>0.05)。线性回归分析显示, 2名医师CT平扫与CTA测定心外膜脂肪体积结果的一致性呈显著正相关(RA2=0.942, RB2=0.947)。Bland-Altman分析显示, CT平扫与CTA测定心外膜脂肪体积的重复系数误差分别为9.45(95%CI 7.83~10.62) cm3和7.68(95%CI 6.71~7.93)cm3。CT平扫的组内相关系数为0.95(95%CI 0.94~0.96), CTA的组内相关系数为0.96(95%CI 0.95~0.97), 两者具有较好一致性。
      结论  心脏CT平扫与CTA均可用于心外膜脂肪体积评估, 两者定量分析结果的一致性较好，临床可根据患者实际情况酌情选用。

     

    Abstract:
      Objective  To compare the clinical effect of quantitative analysis of CT plain scan and CT angiography (CTA) in assessing epicardial fat volume.
      Methods  A total of 170 patients with coronary heart disease were selected as study objects, and underwent cardiac CT plain scan and CTA examination at the same period. After uploading the original images to the workstation, patients' heart images were reconstructed based on optimal R-R interphase, and outline of the pericardium was automatically drawn. Epicardial adipose tissue was extracted; volume enhancement tools were used to measure and calculate fat volume; the operation was performed by two senior radiographic physicians using double blind methods. CT plain scan and CTA were used to determine the consistency of measured results of epicardial fat volume.
      Results  Volume of epicardial fat measured by CT was (99.59±43.14) cm2, and was (94.05±45.70) cm3 by CTA, the difference was not statistically significant (P>0.05). Linear regression analysis showed that there was a significant positive correlation between consistency of CT plain scan and that of epicardial fat volume CTA determined by two physicians (RA2=0.942, RB2=0.947). Bland-Altman analysis showed that the repetition coefficient errors of CT scan and CTA were 9.45(95%CI, 7.83 to 10.62) cm3 and 7.68 (95%CI, 6.71 to 7.93) cm3, respectively. The correlation coefficient in CT plain scan group was 0.95(95%CI, 0.94 to 0.96), and was 0.96(95%CI, 0.95 to 0.97) in the CTA group, and they had good consistency.
      Conclusion  Both cardiac CT flat scan and CTA can be used to evaluate the fat volume of the external cardiac membrane, and they both have good consistency in quantitative analysis results, therefore they can be selected according to the actual situations.

     

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