探討生化參數與640切CT冠狀動脈鈣化指數影像之相關性

The Relation between Biochemical Parameters and Calcium Scores of Coronary Angiography Generated by 640 slice CT

楊玉婷(Yu-Ting Yang)

指導教授 ： 陳泰賓

共同指導教授 ： 黃詠暉(Yung-Hui Huang)

義守大學/電機資訊學院/資訊工程學系/碩士(2018年)

摘要

對於冠心病高危險族群而言，冠狀動脈鈣化指數(Coronary artery calcium score，CACS)為一項具有診斷參考價值之指標；在許多文獻中表示，並非鈣化指數為0分者即能排除冠狀動脈疾病(Coronary artery disease，CAD)的可能性，而在常規鈣化指數檢查中所使用切面厚度3.0 mm之影像，可能因切片厚度較大而忽略微小鈣化點。因此本研究將針對低鈣化指數族群進行重建細切0.5 mm切面厚度影像，評估使用厚度較小之重建影像所偵測到微小鈣化點的比率與心血管疾病相關生化參數之關聯性。
本研究採回溯性實驗設計，分別收集執行冠狀動脈鈣化指數檢查之患者其鈣化指數為0者共計108例(2017年9月至2017年10月)，以及鈣化指數大於0且小於10者共計48例(2015年11月至2017年10月)，將其重建為厚度0.5 mm之影像，經手動圈選鈣化指數區域(ROI)並由Vital後處理工作站計算CACS。同時收集上述案例之心血管疾病危險因子之生化參數進行相關性分析。本研究使用影像特徵值進行描述性統計、皮爾森卡方檢定及Mann-Whitney 檢定等分析。
統計分析結果顯示，經重建細切(0.5 mm)影像後，分別所偵測到微小鈣化點的比例佔39.8 %與52.0 %，但在生化參數之相關性均無顯著差異；而無鈣化指數與有鈣化指數之年齡(P = 0.011)和危險因子HDL(P = 0.010)有顯著性。
根據本研究結論，對於鈣化指數(0分)之患者使用細切影像重建並無明顯優勢，但對於低鈣化指數(1-10分)且生化參數HDL過低(< 35 mg/dl)的患者，使用重建細切影像進行評估有其必要性。

關鍵字

鈣化指數 ； 微小鈣化點

並列摘要

The coronary artery calcium score(CACs) is a crucial indicator for diagnostic cardiovascular disease in the high risk group. Published literatures had revealed coronary artery disease can be ruled out with a calcium score of zero. However, CT utilizes slice thickness of 3.0 mm in the clinical setting which may overlook micro calcification. In this study, we picked up low calcium score group to reconstruct images with finer slice of 0.5 mm and discussed the relation between micro calcification and other clinical scores in the cardiovascular diseases.
This study was a retrospective experiment, 108 patients with calcium score of 0 during September 2017 to October 2017 and 48 cases with calcium score ranged from 0 to 10 during November 2015 to October 2017 were collected respectively. Images were being reconstructed with slice thickness of 0.5 mm, in addition positioned region of interest (ROI) and calculated CACs at vital station. In the meantime, other clinical data for cardiovascular disease was also being analyzed. This study will use descriptive statistics, Pearson chi-square test and Mann-Whitney test to analyze the eigenvalue.
The statistical results showed that the discovered micro calcification after reconstructing finer slices was 39.8 % and 52.0 %, despite the fact that there was no difference in its biochemical data. On the other hand, in the category that CACs rated score 1 to 10 compare with calcium score of 0, there was difference in its biochemical data (p=0.011) and HDL (p=0.010).
Based on the findings of this study, there is no significant advantage for fine-shaded imaging reconstruction in patients with a CACs (0 score), but for patients with a low CACs (1-10 score) and a low biochemical parameter HDL (< 35 mg/dl). It is necessary to use a reconstructed thin image for evaluation.

並列關鍵字

CACs ； calcium score ； micro-calcification ； CAD

參考文獻

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