肺部低劑量電腦斷層估算冠狀動脈鈣化分數之研究

Low-dose Computerized Tomography for Lung to Estimate Coronary Artery Calcification Score

廖志浩(Chih-Hao Liao)

指導教授 ： 陳泰賓

共同指導教授 ： 丁慧枝(Hueisch-Jy Ding)

義守大學/智慧科技學院/資訊工程學系/碩士(2021年)

摘要

心臟血管疾病位居十大死因第二位，而在心臟血管疾病中死亡率最高的類型是冠狀動脈心臟病(Coronary Artery Disease, CAD)，簡稱冠心症。肺部低劑量電腦斷層(Low-Dose Computerized Tomography, LDCT)被視為能早期診斷肺癌的重要工具，相反的心臟血管疾病高死亡率卻因為沒有明顯症狀而被忽略。本研究目的是評估LDCT影像估算冠狀動脈鈣化分數(Coronary Artery Calcium Score, CACS)的可行性。
本研究採回顧性研究，收集同時執行LDCT和CACS之患者共43例的冠狀動脈鈣化分數，根據Agatston等人所發展的鈣化積分系統，將冠狀動脈四條主要分支(右冠狀動脈、左主冠狀動脈、左前降支動脈及左迴旋支動脈)的鈣化總和加總後定義為鈣化的總積分。本研究中將LDCT和CACS影像透過VITAL軟體計算出的冠狀動脈鈣化分數稱為Total_LS和Total_CS；肺部低劑量影像透過程式估算冠狀動脈鈣化分數稱為Total_MS；其中Total_CS作為本研究的黃金標準；統計分析包括相關性、線性迴歸及羅吉斯特迴歸分析。
研究結果發現Total_CS、Total_LS、Total_MS都跟年齡和體重有顯著的關係(P<0.05)。再者，利用年齡和體重建構之羅吉斯特迴歸預測(Total_CS=0與Total_CS>0)、(Total_LS=0與Total_LS>0)與(Total_MS=0與Total_MS>0)模型準確度與(Area Under Receiver Operating Characteristic Curve, AUC)分別為(0.767、0.85)、(0.84、0.84)與(0.65、0.78)。因此，透過LDCT估算Agatston Score (AS)的結果與黃金標準非常相近；由羅吉斯特迴歸預測能力較CACS高；故經由肺部低劑量電腦斷層估算冠狀動脈鈣化分數是可行的。

關鍵字

冠心病 ； 肺部低劑量電腦斷層

並列摘要

Cardiovascular disease is the second leading cause of the top ten causes of death. The type with the highest mortality rate of cardiovascular diseases is Coronary Artery Disease (CAD), coronary heart disease for short. Low-Dose Computerized Tomography (LDCT) of the lungs is regarded as essential equipment for diagnosing lung cancer's early stage. On the contrary, the high mortality of cardiovascular diseases is disregarded because of no apparent symptoms. The purpose of this study is to evaluate the feasibility of LDCT images to estimate the Coronary Artery Calcium Score (CACS).
In this study, a retrospective study was used. The researcher collected the coronary artery calcification scores from 43 patients who performed both LDCT and CACS. According to the calcification scoring system developed by Agatston et al., the Agatston Score is obtained by adding the calcification of the coronary arteries. In this study, the coronary artery calcification scores from LDCT and CACS images calculated by VITAL software are Total_LS and Total_CS. The coronary artery calcification scores from LDCT images calculated by the program are Total_MS. Total_CS is the gold standard in this study. Statistical analysis includes correlation, linear regression, and logistic regression analysis.
The results show that Total_CS, Total_LS, and Total_MS are all significantly related to ages and weights (P<0.05). Furthermore, the logistic regressions for (Total_CS=0 and Total_CS>0), (Total_LS=0 and Total_LS>0) and (Total_MS=0 and Total_MS>0) were constructed by age and weight with accuracy and AUC (Under Receiver Operating Characteristic Curve, AUC) (0.767, 0.85), (0.84, 0.84) and (0.65, 0.78) respectively.
Therefore, the Agatston score (AS) result estimated by LDCT is very close to the gold standard; Logist regression has higher predictive ability than CACS; Therefore, LDCT of the lungs is feasible to estimate the coronary artery calcification score.

並列關鍵字

Coronary Artery Disease ； Agatston Score ； Low-Dose Computerized Tomography

參考文獻

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