双源CT双能量减影技术在评估严重钙化冠状动脉狭窄程度的应用研究

Research on the Application of Dual-Source CT Dual-Energy Subtraction Technology in Evaluating the Degree of Severe Calcified Coronary Artery Stenosis

摘要: 目的：研究双能CT减影技术在重度冠脉钙化患者斑块狭窄程度判断方面的价值。方法：选取2022年4月到2023年9月在济宁市第一人民医院就诊，临床疑诊或确诊冠心病受检者53例。所有受检者均行双能量CCTA检查(DECTA)，于60天内行导管法冠状动脉血管造影(CAG)检查，且钙化积分 > 400。根据重建方法的不同分为标准重建组、双能量重建组。结果：以CAG诊断为重度狭窄及闭塞为标准，标准重建组的诊断准确率和特异度为86.9% (53/61)、54.8% (40/73)，双能量减影组为82% (50/61)、93.2% (68/73)。双能量减影组与CAG对冠状动脉检出的狭窄结果有较好的一致性和相关性。结论：双能减影CTA技术在重度冠脉钙化患者斑块狭窄程度判断方面具有较好的临床应用价值。

Abstract: Objective: To investigate the value of dual-energy CT subtraction technology in assessing the degree of stenosis caused by calcified plaques in patients with severe coronary artery calcification. Methods: A total of 53 subjects clinically suspected or diagnosed with coronary heart disease at Jining No. 1 People’s Hospital between April 2022 and September 2023 were selected. All subjects underwent dual-energy CCTA (DECTA) and catheter-based coronary angiography (CAG) within 60 days, with a calcium score > 400. Based on the reconstruction method, they were divided into a standard reconstruction group and a dual-energy reconstruction group. Results: Using CAG diagnosis of severe stenosis and occlusion as the standard, the accuracy and specificity of the standard reconstruction group were 86.9% (53/61) and 54.8% (40/73), respectively, while those of the dual-energy subtraction group were 82% (50/61) and 93.2% (68/73). The dual-energy subtraction group showed relatively good consistency and a high correlation with CAG in detecting coronary artery stenosis. Conclusion: Dual-energy subtraction CTA technology holds significant clinical value in evaluating the degree of plaque stenosis in patients with severe coronary artery calcification.