多层螺旋CT两种重建方式检测冠状动脉钙化斑块的比较与评价

目的选择和建立多层螺旋CT检测冠状动脉钙化斑块的最佳重建技术。方法采用16层CT螺旋扫描回顾性心电门控技术对55例患者行冠状动脉钙化积分检查，每一病例原始数据进行两种不同模式的薄层重建：2mm层厚组（层厚2mm，层间隔1mm）和3mm层厚组（层厚3mm，层间隔1．5mm）；计算每组图像钙化斑块的Agatston积分（agatston score，AS），容积积分（volume score，VS），质量积分（mass score，MS），比较两种重建方式在冠状动脉钙化斑块检出及计算钙化积分的差别。结果2mm层厚组检出的钙化斑块较3mm层厚组多38个，其中多为小钙化斑块；全部钙化斑块的钙化积分VS、MS、AS 2mm层厚组较3mm层厚组高（P〈0．05）。结论在探测冠状动脉钙化灶时2mm层厚的图像较普遍应用的3mm重建方式能发现更多、更小的钙化斑块，对于临床冠状动脉钙化斑块早期发现，冠心病的早期预防及早期治疗有重要意义。

Optimization and comparison of two kinds of image reconstruction methods with retrospectively ECG-gated multislice CT for coronary artery calcium plaques

Objective To choose and establish the optimal reconstruction method for detection of coronary artery calcification.Methods 55 patients underwent coronary artery calcification(CAC) studies with retrospectively ECG-gated multislice CT. Data of each patient was reconstructed with two different slice thickness(2,3 mm) and increment(1,1.5 mm).Volume score(VS),Mass score(MS) and Agatston score(AS)were measured and compared.Results The number of all calcification plaques defected were 234 the number of and small calcification plaques were 185 in images with 2 mm slice thickness;Compared with 2mm slice thickness images,the sensitivity to detect all calcification plaques and small calcification plaques was 84% and 82% in images with 3mm slice thickness.VS,MS and AS in 3mm group were less than those of 2mm group(P<0.05).Conclusion Thinner slice imaging with overlapping reconstruction methods should be used in detecting and quantifying coronary artery calcium plaques.2mm slice images can detect more and smaller calcium plaques than routine 3mm slice.It is essential to detect coronary artery calcium plaques and to prevent coronary events in early stage in clinical practice.