The diagnostic criteria for optic neuromyelitis spectrum diseases propose six core clinical features, including optic neuritis, acute myelitis, posterior region syndrome, acute brainstem syndrome, symptomatic sleep attacks or acute diencephalic syndrome with typical diencephalic MRI lesions, and symptomatic brain syndrome with typical brain MRI lesions, among which imaging plays an important role. This article aims to explore the imaging changes corresponding to its six core clinical features and analyze the differential diagnosis of common diseases, so that imaging and neurologists can better understand and master the diagnostic criteria of optic neuromyelitis spectrum diseases.
{"title":"Imaging diagnosis and differential diagnosis of neuromyelitis optica spectrum disorders","authors":"Xin Zhang, Mei-hua Ye, Wenqian Chen, Xiao-Qin Zhu, Zheng-guo Wang, Bing Zhang","doi":"10.3760/CMA.J.ISSN.1005-1201.2020.02.021","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-1201.2020.02.021","url":null,"abstract":"视神经脊髓炎谱系疾病的诊断标准提出了6大核心临床特征，包括视神经炎、急性脊髓炎、极后区综合征、急性脑干综合征、症状性睡眠发作或急性间脑综合征伴典型的间脑MRI病灶、症状性大脑综合征伴典型大脑MRI病变，其中影像学具有重要的作用。本文拟通过对其6大核心临床特征所对应影像学改变的探讨以及常见疾病鉴别诊断的分析，使影像科和神经科医师更好地认识视神经脊髓炎谱系疾病，同时更好地理解并掌握其诊断标准。","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49498959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This article reports two cases of IgG4 related diseases involving coronary artery imaging manifestations. Coronary artery CT angiography (CCTA) examination showed the formation of irregular circular masses around coronary artery lesions. Among them, one case was affected by both the middle segment of the left anterior descending branch and the proximal segment of the right coronary artery, resulting in severe stenosis of the local lumen. The other case was affected by the proximal segment of the right coronary artery, resulting in mild stenosis of the local lumen. The clinical diagnosis is IgG4 related disease with coronary artery involvement.
{"title":"Coronary artery involvement in IgG4-related disease: two cases report","authors":"Yu Sun, J. Hou, K. Xu, Benqiang Yang","doi":"10.3760/CMA.J.ISSN.1005-1201.2020.02.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-1201.2020.02.014","url":null,"abstract":"本文报道IgG4相关性疾病累及冠状动脉影像表现二例。冠状动脉CT血管成像（CCTA）检查见冠状动脉病变血管周围环形分布不规则形肿物生成，其中1例为左冠状动脉前降支中段和右冠状动脉近段同时受累，局部管腔重度狭窄，另1例为右冠状动脉近段受累，局部管腔轻度狭窄。临床诊断为IgG4相关性疾病合并冠状动脉受累。","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49631315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This article reports a case of primary lumbar myoepithelioma with imaging findings. The patient is a 59 year old male. Plain CT scan shows osteolytic bone destruction and expansive growth in the L4 vertebral body and right appendix. MRI shows multiple cystic signals within the lesion, with clear edges. The cystic components of the lesion are not enhanced, while the septal and solid components are significantly enhanced. The vertebral tumor was removed and the postoperative pathology revealed a myoepithelial tumor.
{"title":"Lumbar myoepithelioma: a case report","authors":"Q. Chen, S. Gong, Maotong Liu","doi":"10.3760/CMA.J.ISSN.1005-1201.2020.02.016","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-1201.2020.02.016","url":null,"abstract":"本文报道原发性腰椎肌上皮瘤影像表现一例。患者男，59岁，平扫CT示腰4椎体及右侧附件见分房样溶骨性骨质破坏，膨胀性生长。MRI示病灶内呈多发分房囊性信号，边缘清晰，病灶囊性成分不强化，分隔及实性成分明显强化。遂行椎骨肿瘤切除，术后病理提示为肌上皮瘤。","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47691617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Medical imaging equipment is undergoing rapid updates, and imaging technology is changing rapidly. The validation and application of various new technologies in clinical practice has become a research focus of medical imaging technology. The development of X-ray photography technology is reflected in digital tomography fusion technology, contrast-enhanced breast X-ray photography, and other aspects; The progress of CT includes iterative algorithms, low dose, dual energy or energy spectrum imaging, etc; The progress of MRI includes aspects such as MR ensemble sequence, compressed sensing technology, multi-layer MR imaging technology, MR elastography, and four-dimensional blood flow analysis MRI; Artificial intelligence has great potential for development in intelligent positioning, inspection process optimization, and quality control.
{"title":"Research progress and prospect of medical imaging technology","authors":"C. Xia, Zhenlin Li","doi":"10.3760/CMA.J.ISSN.1005-1201.2020.02.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-1201.2020.02.001","url":null,"abstract":"医学影像设备更新换代快，成像技术日新月异，在临床上各种新技术的验证和应用成为医学影像技术的研究重点。X线摄影技术的发展体现在数字断层融合技术、对比增强乳腺X线摄影等方面；CT进展包含迭代算法、低剂量、双能量或能谱成像等方面；MRI进展包括MR集合序列、压缩感知技术、多层MR成像技术、MR弹性成像及四维血流分析MRI等方面；人工智能在智能摆位，检查流程优化和质量控制等方面有较大的发展空间。","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44769883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-10DOI: 10.3760/CMA.J.ISSN.1005-1201.2020.02.009
Chenxin Zhang, Xiao-guang Cheng, Li Xu, Ling Wang, Yong Zhang, Y. Duanmu, Tianyuan Zhang, Haisong Zhang
Objective To investigate the quantitative relationship between liver fat content and bone mineral density (BMD) in middle-aged and elderly people. Methods Totally 184 middle-aged and elderly community residents were recruited from March to June 2016, including 68 males and 116 females. MRI mDIXON-Quant and quantitative CT (QCT) examinations were performed to determine the content of liver fat and L1-L3 vertebral BMD. The subjects were divided into four groups according to the quartiles of liver fat content, and the baseline characteristics and other variables of different groups were were identified by using one-way analysis of Variance. The relationship between liver fat content and lumbar vertebral BMD was assessed with Spearman correlation and partial correlation analysis. Result Subjects with higher hepatic fat content had lower spine BMD and higher body mass index (BMI), waist circumference. Liver fat content was negatively correlated with BMD (r=-0.203, P=0.003). After age and body weight were controlled, the negative correlation between liver fat content and BMD was still significant (r=-0.291, P<0.001), in males (r=-0.283, P=0.021) and in females (r=-0.210, P=0.025). Conclusion Liver fat content is negatively correlated with lumbar vertebral BMD in middle-aged and elderly people. Key words: Fatty liver; Bone density; Tomography, X-ray computed; mDIXON-Quant technique
{"title":"A correlative study of liver fat content and bone mineral density in middle-aged and elderly people","authors":"Chenxin Zhang, Xiao-guang Cheng, Li Xu, Ling Wang, Yong Zhang, Y. Duanmu, Tianyuan Zhang, Haisong Zhang","doi":"10.3760/CMA.J.ISSN.1005-1201.2020.02.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-1201.2020.02.009","url":null,"abstract":"Objective \u0000To investigate the quantitative relationship between liver fat content and bone mineral density (BMD) in middle-aged and elderly people. \u0000 \u0000 \u0000Methods \u0000Totally 184 middle-aged and elderly community residents were recruited from March to June 2016, including 68 males and 116 females. MRI mDIXON-Quant and quantitative CT (QCT) examinations were performed to determine the content of liver fat and L1-L3 vertebral BMD. The subjects were divided into four groups according to the quartiles of liver fat content, and the baseline characteristics and other variables of different groups were were identified by using one-way analysis of Variance. The relationship between liver fat content and lumbar vertebral BMD was assessed with Spearman correlation and partial correlation analysis. \u0000 \u0000 \u0000Result \u0000Subjects with higher hepatic fat content had lower spine BMD and higher body mass index (BMI), waist circumference. Liver fat content was negatively correlated with BMD (r=-0.203, P=0.003). After age and body weight were controlled, the negative correlation between liver fat content and BMD was still significant (r=-0.291, P<0.001), in males (r=-0.283, P=0.021) and in females (r=-0.210, P=0.025). \u0000 \u0000 \u0000Conclusion \u0000Liver fat content is negatively correlated with lumbar vertebral BMD in middle-aged and elderly people. \u0000 \u0000 \u0000Key words: \u0000Fatty liver; Bone density; Tomography, X-ray computed; mDIXON-Quant technique","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49242261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This article reports a 56 year old male with a space occupying lesion under the left frontal skull plate. On MRI, there is an abnormal signal shadow resembling a circular mass with abundant blood supply in the left frontal region of the brain. On T1WI, it shows isolow signal, while on T2WI and fluid attenuation inversion recovery sequence (FLAIR), it shows slightly high signal. There are empty blood vessels inside, and surrounding edema is seen. DWI shows no diffusion restriction and low signal, while on ADC image, it shows high signal. The pathological diagnosis is angioblastoma, WHO grade I.
{"title":"Subcranial hemangioblastoma of the left frontal lobe of the brain: a case report","authors":"Weichuan Ye, Hailin Wang, J. Ji","doi":"10.3760/CMA.J.ISSN.1005-1201.2020.02.018","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-1201.2020.02.018","url":null,"abstract":"本文报道1例56岁男性左侧大脑额部颅板下占位性病变。MRI表现为左侧大脑额部富血供类圆形团块状异常信号影，T1WI呈等低信号，T2WI及液体衰减反转恢复序列（FLAIR）呈等稍高信号，内见流空血管，周围见片状水肿，DWI未见扩散受限呈低信号，ADC图上为高信号。病理诊断为血管母细胞瘤，WHO Ⅰ级。","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42503631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To investigate the clinical value of preoperative selective arterial embolization for spinal tumors. Methods The clinical data of 42 consecutive patients who underwent spinal tumor resection in department of orthopedics Shengjing Hospital of China Medical University from January 2017 to December 2018 were retrospectively analyzed. Patients were divided into embolization group (20 cases) and non-embolization group (22 cases) according to whether they underwent arterial embolization before tumor resection. Two surgical treatments including vertebral resection and laminectomy were performed. The embolization group included 12 cases of vertebral resection and 8 cases of laminectomy; while the non-embolization group included 13 cases of vertebral resection and 9 cases of laminectomy. The difference of intraoperative estimated blood loss, total number of transfused packed red blood cell, calibrated estimated blood loss, operation time and hospitalization time were compared using independent sample t test. Results Twenty patients in the embolization group underwent successful interventional embolization without serious complications. There were no significant differences between the embolization group and the non-embolization group in terms of intraoperative estimated blood loss, total number of transfused packed red blood cell, calibrated estimated blood loss, operation time, and hospitalization time (P>0.05). Among the patients who underwent vertebral resection, intraoperative estimated blood loss, total number of transfused packed red blood cell and calibrated estimated blood loss were (1 966.7±898.8) ml, (7.42±3.27) U and (91.3±39.2) g/L in the embolization group, and (2 838.5±1 143.5) ml, (11.04±4.08) U and (133.0±46.4) g/L in the non-embolization group, respectively, with statistically significant differences (t=-2.107, -2.436, -2.419, P 0.05). Among the patients who underwent laminectomy, there were no significant differences in the above-mentioned indicators between the embolization group and the non-embolization group (P>0.05). Conclusion Selective arterial embolization for spinal tumors is a relatively safe interventional procedure. Preoperative embolization does not significantly reduce the amount of blood loss during surgical procedures. After the surgical procedures were differentiated, preoperative embolization significantly reduces the amount of blood loss in patients underwent vertebral resection, while patients who underwent laminectomy do not benefit significantly. Key words: Neoplasms; Spine; Embolization, therapeutic; Preoperative period; Blood loss, surgical
{"title":"Clinical application of preoperative selective arterial embolization for spinal tumors","authors":"Chuanzhuo Wang, Zhaoyu Liu, Hairui Wang, De-Shuo Dong","doi":"10.3760/CMA.J.ISSN.1005-1201.2020.02.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-1201.2020.02.010","url":null,"abstract":"Objective \u0000To investigate the clinical value of preoperative selective arterial embolization for spinal tumors. \u0000 \u0000 \u0000Methods \u0000The clinical data of 42 consecutive patients who underwent spinal tumor resection in department of orthopedics Shengjing Hospital of China Medical University from January 2017 to December 2018 were retrospectively analyzed. Patients were divided into embolization group (20 cases) and non-embolization group (22 cases) according to whether they underwent arterial embolization before tumor resection. Two surgical treatments including vertebral resection and laminectomy were performed. The embolization group included 12 cases of vertebral resection and 8 cases of laminectomy; while the non-embolization group included 13 cases of vertebral resection and 9 cases of laminectomy. The difference of intraoperative estimated blood loss, total number of transfused packed red blood cell, calibrated estimated blood loss, operation time and hospitalization time were compared using independent sample t test. \u0000 \u0000 \u0000Results \u0000Twenty patients in the embolization group underwent successful interventional embolization without serious complications. There were no significant differences between the embolization group and the non-embolization group in terms of intraoperative estimated blood loss, total number of transfused packed red blood cell, calibrated estimated blood loss, operation time, and hospitalization time (P>0.05). Among the patients who underwent vertebral resection, intraoperative estimated blood loss, total number of transfused packed red blood cell and calibrated estimated blood loss were (1 966.7±898.8) ml, (7.42±3.27) U and (91.3±39.2) g/L in the embolization group, and (2 838.5±1 143.5) ml, (11.04±4.08) U and (133.0±46.4) g/L in the non-embolization group, respectively, with statistically significant differences (t=-2.107, -2.436, -2.419, P 0.05). Among the patients who underwent laminectomy, there were no significant differences in the above-mentioned indicators between the embolization group and the non-embolization group (P>0.05). \u0000 \u0000 \u0000Conclusion \u0000Selective arterial embolization for spinal tumors is a relatively safe interventional procedure. Preoperative embolization does not significantly reduce the amount of blood loss during surgical procedures. After the surgical procedures were differentiated, preoperative embolization significantly reduces the amount of blood loss in patients underwent vertebral resection, while patients who underwent laminectomy do not benefit significantly. \u0000 \u0000 \u0000Key words: \u0000Neoplasms; Spine; Embolization, therapeutic; Preoperative period; Blood loss, surgical","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47601122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Imaging findings of pulmonary amyloidosis: a case report","authors":"Jun Wang, Hai-bing Zhou, Jian-Wen Chen","doi":"10.3760/CMA.J.ISSN.1005-1201.2020.02.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-1201.2020.02.017","url":null,"abstract":"本文报道肺淀粉样物质沉积症影像表现1例。患者，男，61岁，胸部CT表现为右肺下叶后基底段团块样占位影，大小约30 mm×40 mm，边界清楚，边缘不规则，密度均匀，CT值约43 HU，增强扫描未见明显强化。病理诊断：考虑肺淀粉样物质沉积症。","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47047707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"CT and MRI features of three cases of the lower extremity aggressive angiomyxoma and literature review","authors":"Guoping Zhang, Xiaoli Chen, Xiaolong Chen, Guodong Fang, Min Huang","doi":"10.3760/CMA.J.ISSN.1005-1201.2020.02.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-1201.2020.02.012","url":null,"abstract":"结合我院3例及文献报道3例下肢软组织侵袭性血管黏液瘤的影像检查资料，总结其特点。结果显示，下肢软组织侵袭性血管黏液瘤可位于皮下、肌间或肌间隙，CT表现为团块状低密度或等密度影，增强呈明显不均匀强化，部分病例可见血管穿行、环绕。MRI表现为T1WI等低信号、T2WI稍高或高信号，扩散加权成像呈高信号，病变有包膜或间隔，增强呈明显强化、增强曲线呈上升型改变，1例T2WI呈旋涡状改变，增强为环形强化。下肢侵袭性血管黏液瘤有一定的影像特征，认识该特征有利于术前诊断。","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48003266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-10DOI: 10.3760/CMA.J.ISSN.1005-1201.2020.02.008
Yan Gao, Hui Gu, Shifeng Yang, Shuo Zhao, Xinxin Yu, Baojin Chen, Ximing Wang
Objective To analyze the quantitative features of coronary plaque and evaluate its diagnostic performance for myocardial ischemic injury in patient with coronary artery disease. Methods Retrospectively enrolled 109 patients with suspected coronary artery disease, who successively underwent coronary CT angiography(CCTA) and coronary angiography in Shandong Provincial Hospital from June 2018 to September 2019. Elevated myocardial enzyme with segmental wall motion abnormalities (SWMA) in ultrasound was defined as myocardial ischemic injury, with which the subjects were divided into two groups, with and without myocardial ischemic injury (n=75,34) respectively. CCTA images of each target vessel were quantitatively analyzed by automated plaque analysis software to obtain the following indexes: minimal lumen area(MLA), plaque length(PL), total plaque volume(TPV), total plaque burden(TPB),calcified plaque volume(CPV), calcified plaque ratio(CPR), fibrous plaque volume(FPV), fibrous plaque ratio(FPR), lipid plaque volume(LPV), lipid plaque ratio(LPR), napkin-ring sign(NRS), spotty calcification(SC), remodeling index (RI) and eccentric index (EI). Chi-square, Mann-Whitney U tests, logistic regression and area under the receiver operating characteristics were determined. Results For the degree of coronary artery stenosis, MAS% was 85.00% (80.00%, 92.00%) and 63.00% (60.00%, 65.00%) in myocardial ischemic group and without myocardial ischemic injury group, which was statistically significant (Z=-4.32, P=0.001). For the quantitative plaque features, TPV 150.13 (104.44,202.20) mm3, TPB (75.67%±9.90%), FPV 95.73 (66.57, 134.23)mm3, LPV 32.18 (18.93,54.55) mm3, LPR (25.13%±13.71%) in the group with myocardial ischemic injury were larger than those in group without myocardial ischemic injury 109.94 (79.39, 121.67) mm3, 65.37%±6.94%, 67.35 (57.67, 90.11) mm3, 16.64 (13.26, 24.73) mm3, 18.44%±7.09% respectively with statistically significant (Z=-2.59, P=0.010; t=3.11, P=0.003; Z=-2.16, P=0.031; Z=-2.18, P=0.029; t=2.19, P=0.037). In logistic regression analysis, MAS%(OR=1.55,P=0.021) was independent significant predictors of myocardial ischemic injury. The AUC of MAS%, LPV, LPR, TPV, TPB, FPV were 0.84, 0.82, 0.77, 0.72, 0.74, 0.67, respectively, which were all statistically significant (P<0.05). Conclusions In quantitative plaque analysis by coronary CT angiography, MAS%, TPV, TPB, FPV, LPV, LPR were affecting factors of myocardial ischemic injury, in which MAS% was independent predictors. MAS% and LPV have higher diagnostic accuracy in myocardial ischemic injury. Key words: Coronary disease; Myocardial ischemia; Tomography, X-ray computed
目的分析冠状动脉斑块的定量特征，评价其对冠心病患者心肌缺血损伤的诊断价值。方法回顾性选取2018年6月至2019年9月在山东省立医院先后行冠状动脉CT血管造影(CCTA)和冠状动脉造影的109例疑似冠状动脉疾病患者。将超声显示心肌酶升高并伴有节段性壁运动异常(SWMA)定义为心肌缺血性损伤，将受试者分为有心肌缺血性损伤组和无心肌缺血性损伤组(n=75、34)。通过自动斑块分析软件对各靶血管的CCTA图像进行定量分析，得到以下指标:最小管腔面积(MLA)、斑块长度(PL)、斑块总体积(TPV)、斑块总负荷(TPB)、钙化斑块体积(CPV)、钙化斑块比(CPR)、纤维斑块体积(FPV)、纤维斑块比(FPR)、脂质斑块体积(LPV)、脂质斑块比(LPR)、纸环征象(NRS)、点状钙化(SC)、重塑指数(RI)和偏心指数(EI)。卡方检验、Mann-Whitney U检验、logistic回归和受试者工作特征下面积进行测定。结果心肌缺血组和无心肌缺血损伤组冠状动脉狭窄程度MAS%分别为85.00%(80.00%、92.00%)和63.00%(60.00%、65.00%)，差异有统计学意义(Z=-4.32, P=0.001)。定量斑块特征方面，心肌缺血损伤组TPV 150.13(104.44、202.20)mm3、TPB(75.67%±9.90%)、FPV 95.73(66.57、134.23)mm3、LPV 32.18(18.93、54.55)mm3、LPR(25.13%±13.71%)分别大于心肌缺血损伤组109.94(79.39、121.67)mm3、65.37%±6.94%、67.35(57.67、90.11)mm3、16.64(13.26、24.73)mm3、18.44%±7.09%，差异均有统计学意义(Z=-2.59, P=0.010;t = 3.11, P = 0.003;Z = -2.16, P = 0.031;Z = -2.18, P = 0.029;t = 2.19, P = 0.037)。logistic回归分析中，MAS%(OR=1.55,P=0.021)是心肌缺血损伤的独立显著预测因子。MAS%、LPV、LPR、TPV、TPB、FPV的AUC分别为0.84、0.82、0.77、0.72、0.74、0.67，差异均有统计学意义(P<0.05)。结论在冠状动脉CT血管造影定量斑块分析中，MAS%、TPV、TPB、FPV、LPV、LPR是影响心肌缺血损伤的因素，其中MAS%是独立的预测因子。MAS%和LPV对心肌缺血性损伤有较高的诊断准确性。关键词:冠心病;心肌缺血;x线计算机断层扫描
{"title":"Correlation study of coronary plaque quantitative analysis and myocardial ischemic injury based on coronary CT angiography","authors":"Yan Gao, Hui Gu, Shifeng Yang, Shuo Zhao, Xinxin Yu, Baojin Chen, Ximing Wang","doi":"10.3760/CMA.J.ISSN.1005-1201.2020.02.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-1201.2020.02.008","url":null,"abstract":"Objective \u0000To analyze the quantitative features of coronary plaque and evaluate its diagnostic performance for myocardial ischemic injury in patient with coronary artery disease. \u0000 \u0000 \u0000Methods \u0000Retrospectively enrolled 109 patients with suspected coronary artery disease, who successively underwent coronary CT angiography(CCTA) and coronary angiography in Shandong Provincial Hospital from June 2018 to September 2019. Elevated myocardial enzyme with segmental wall motion abnormalities (SWMA) in ultrasound was defined as myocardial ischemic injury, with which the subjects were divided into two groups, with and without myocardial ischemic injury (n=75,34) respectively. CCTA images of each target vessel were quantitatively analyzed by automated plaque analysis software to obtain the following indexes: minimal lumen area(MLA), plaque length(PL), total plaque volume(TPV), total plaque burden(TPB),calcified plaque volume(CPV), calcified plaque ratio(CPR), fibrous plaque volume(FPV), fibrous plaque ratio(FPR), lipid plaque volume(LPV), lipid plaque ratio(LPR), napkin-ring sign(NRS), spotty calcification(SC), remodeling index (RI) and eccentric index (EI). Chi-square, Mann-Whitney U tests, logistic regression and area under the receiver operating characteristics were determined. \u0000 \u0000 \u0000Results \u0000For the degree of coronary artery stenosis, MAS% was 85.00% (80.00%, 92.00%) and 63.00% (60.00%, 65.00%) in myocardial ischemic group and without myocardial ischemic injury group, which was statistically significant (Z=-4.32, P=0.001). For the quantitative plaque features, TPV 150.13 (104.44,202.20) mm3, TPB (75.67%±9.90%), FPV 95.73 (66.57, 134.23)mm3, LPV 32.18 (18.93,54.55) mm3, LPR (25.13%±13.71%) in the group with myocardial ischemic injury were larger than those in group without myocardial ischemic injury 109.94 (79.39, 121.67) mm3, 65.37%±6.94%, 67.35 (57.67, 90.11) mm3, 16.64 (13.26, 24.73) mm3, 18.44%±7.09% respectively with statistically significant (Z=-2.59, P=0.010; t=3.11, P=0.003; Z=-2.16, P=0.031; Z=-2.18, P=0.029; t=2.19, P=0.037). In logistic regression analysis, MAS%(OR=1.55,P=0.021) was independent significant predictors of myocardial ischemic injury. The AUC of MAS%, LPV, LPR, TPV, TPB, FPV were 0.84, 0.82, 0.77, 0.72, 0.74, 0.67, respectively, which were all statistically significant (P<0.05). \u0000 \u0000 \u0000Conclusions \u0000In quantitative plaque analysis by coronary CT angiography, MAS%, TPV, TPB, FPV, LPV, LPR were affecting factors of myocardial ischemic injury, in which MAS% was independent predictors. MAS% and LPV have higher diagnostic accuracy in myocardial ischemic injury. \u0000 \u0000 \u0000Key words: \u0000Coronary disease; Myocardial ischemia; Tomography, X-ray computed","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44344259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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