摘要
目的联合应用冠状动脉钙化积分（Agatston Calcium Score）和CT血管成像（CTA）技术定量定性分析颈动脉钙化,探讨两者联合应用的价值。方法收集颈动脉钙化者68例,所有病例均行Siemens64层CTA检查,参考北美症状性颈动脉内膜切除术（NASCET）标准对血管狭窄分级,平扫原始数据被传入西门子工作站,应用Agaston Calcium Score软件行钙化分析。结果①无论是否考虑狭窄和年龄的协同作用,症状组比无症状组病人具有更高的总钙化体积、钙化质量及钙化积分,但其差异均无统计学意义。②在轻度与重度及中度狭窄组间总钙化体积、钙化质量及钙化积分的差异均有统计学意义（P〈0.001）,但中度与重度狭窄组间的差异无统计学意义。3个年龄组间总钙化体积、钙化质量及钙化积分的差异有统计学意义;其中51～69岁与≥70岁年龄组间的差异有统计学意义（P〈0.001）。③一侧颈动脉分叉部及颈内动脉的狭窄程度均与一侧颈动脉总的钙化体积具有轻度相关性[分叉部相关系数（rbifurcation）为0.322,颈内动脉相关系数（rICA）=0.418],相关系数（r）的t检验有统计学意义（P〈0.01）。结论联合Agaston Calcium Score和CTA技术可定量定性分析颈动脉钙化,并可指导临床治疗,必将成为无创性活体评价钙化斑块稳定性的新方法。
Objective To quantify and characterize carotid calcification with combined Agatston Calcium Score and muhidetector CT angiography （MDCTA） and to determine whether the combination could be applied as a useful decisionmaking tool for treatment. Methods A total of 136 carotid arteries were examined with MDCTA （67.6±10.2 years; age range from 37-86 years; 11 women, 57 men）. The calcium scores were determined using Agatston method from pre-contrast data. The stenosis was assessed based on North American Symptomatic Carotid Endarterectomy Trial criteria from post-contrast data. Results Symptomatic patients had higher total calcium volume （TCV）, total equiv mass （TEM） and total calcium score （TCS） than asymptomatic patients, but the differences did not reach statistical significance with or without taking the interactive effect of age and stenosis into account. TCV, TEM, and TCS differed significantly between high-grade and mild- grade stenotic vessels （P〈0.001）, and moderate-grade and mild-grade stenotic vessels （P〈0.001）; and they also differed statistically between age groups of 51-69 years and of 〉170 years （P〈0.001）. Pearson＇s correlation test showed a mild but significant correlation between stenotic grade of carotid bifurcation and ipsilateral ICA and total calcium volume （rbifurcation=0.322 and rtcs=0.418 respectively, P〈0.01）. Conclusion Combination of Agatston Calcium Score and CTA is likely to emerge as a noninvasive choice to accurately assess calcification and quantification of the burden in the carotid arteries. It can provide valuable insights into plaque characterization and stability, which is especially important for clinical decision-making.
出处
《国际医学放射学杂志》
2009年第4期317-322,共6页
International Journal of Medical Radiology
