视觉和自动冠状动脉评分的预后价值来自低剂量计算机断层扫描-[15O]-水正子辐射断层扫描
M M Dobrolinska1,2, R A Jukema3, S G M van Velzen4,5,6
1Department of Radiology, Medical Imaging Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
European heart journal. Cardiovascular Imaging
|March 25, 2024
概括
来自低剂量CT扫描的冠状动脉 (CAC) 评分,无论是视觉还是人工智能驱动的,都与专用扫描相适度一致. 来自LDCT的CAC评分可以帮助识别患有重大心脏不良事件风险较高的患者.
科学领域:
- 心脏病学 心脏病学
- 放射学 放射学是一门学科.
- 医疗成像医学成像
背景情况:
- 冠状动脉 (CAC) 评分对于心血管风险评估至关重要.
- 低剂量计算机断层扫描 (LDCT) 越来越多地使用,这引发了对其用于CAC评分的有用性的质疑.
- 将CAC评分集成到心肌输液成像 (MPI) 工作流中可以提高效率.
研究的目的:
- 为了验证LDCT扫描的CAC得分与专用评分CT (CSCT) 扫描相比.
- 评估 LDCT 衍生 CAC 的附加值,用于预测主要心脏不良事件 (MACE).
- 为了评估从15O-水-PET MPI中获得的LDCT中CAC得分.
主要方法:
- 572名怀疑冠状动脉疾病的患者接受了LDCT和CSCT的 [15O]-水-PET MPI.
- 在CSCT上,CAC的得分是手动的,在LDCT上,CAC的得分是视觉和自动的 (深度学习).
- 分析了CSCT和LDCT之间的心血管风险分类协议.
主要成果:
- 在LDCT CAC评分 (视觉/自动) 和参考CSCT手动评分 (κ=0.66和0.58) 之间发现了适度的一致性.
- 由LDCT衍生的CAC评分>100 (视觉) 和>400 (自动) 表示MACE风险增加.
- 这种风险预测独立于来自 [15O]-水-PET MPI 的缺血信息.
结论:
- 对LDCT的CAC评分显示,对于风险分层来说,与专门的CSCT有中等的协议.
- 来自LDCT的视觉和自动CAC评分都改善了对MACE高风险患者的识别.
- LDCT CAC评分可以成为评估心血管风险的有价值工具.
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