纹理分析技术评估冠状动脉粥样硬化患者冠周脂肪组织的变化

目的  应用纹理分析技术初步评估冠状动脉粥样硬化患者冠周脂肪组织学的改变。方法  选取解放军总医院海南医院220例行冠状动脉CT血管成像的患者, 其中正常组110例, 病变组(包含钙化、非钙化及混合斑块)110例, 分别对其在冠状动脉三支主干近端(右冠状动脉、左冠前降支、回旋支)多平面重建图像上选取显示靶斑块周围脂肪组织较清晰层面进行纹理特征分析, 选取角二阶矩、对比度、自相关、逆差距、熵5个纹理特征参数, 采用Mann-Whitney U检验各组之间的纹理特征差异。结果  正常组与病变组的5个纹理特征参数的差异均有统计学意义(P_角二阶矩 < 0.001, P_对比度 < 0.001, P_自相关 < 0.001, P_逆差距 < 0.001, P_熵 < 0.001), 两组间冠周脂肪组织纹理特征存在差异, 各纹理参数均具有较好的诊断价值。ROC曲线证实5个纹理特征的曲线下面积均大于0.8, 具有较高的诊断价值。结论  正常组与病变组的冠状动脉周围脂肪组织的纹理特征不同, 纹理特征分析技术可基于冠状动脉CT血管成像检查, 初步评估冠状动脉粥样硬化患者的冠周脂肪组织学改变。

Evaluation of pericoronal adipose tissue changes in patients with coronary atherosclerosis by texture analysis

  Objective  To explore preliminary evaluation of pericoronal adipose tissue changes in patients with coronary atherosclerosis by texture analysis.  Methods  We selected 220 patients with coronary artery CT angiography from Hainan Hospital of PLA General Hospital, including 110 in the normal group and 110 in the coronary atherosclerosis group (including calcified, non-calcified and mixed plaques).The texture features of pericoronal adipose tissue around the target plaque were analyzed.We analyzed MPR images of the proximal three main coronary arteries (including right coronary artery, left anterior descending branch and circumflex branch), selected five texture feature parameters: angular second moment, contrast, correlation, inverse difference moment, and entropy.Mann-Whitney U was used to test differences in texture characteristics between groups.  Results  All the texture feature parameters showed significant differences between the two groups (P_ASM < 0.001, P_contrast < 0.001, P_corelation < 0.001, P_IDM < 0.001, P_entropy < 0.001).There were differences in the texture features of pericoronary adipose tissue between the normal group and the coronary atherosclerosis group, and each texture parameter has good diagnostic value.ROC analysis confirmed that the area under the curve of the five texture features was greater than 0.8, which had good diagnostic value.  Conclusion  The texture features of pericoronary adipose tissue differ between the normal group and the coronary atherosclerosis group.Therefore, the texture feature analysis can be based on coronary CT angiography examination, preliminary evaluation of pericoronal adipose tissue changes in patients with coronary atherosclerosis.