摘要
目的对颈动脉内膜剥脱术(Carotid Endarterectomy,CEA)前的颈动脉分叉处粥样硬化患者同期行^(18)F-NaF正电子发射断层显像/X线计算机体层成像仪(^(18)F-NaF Positron Emission Tomography/Computed Tomography,^(18)F-NaF PET/CT)与高分辨率磁共振血管壁成像(High-Resolution Vessel Wall Imaging,HR-VWI)检查。将两种检查对易损斑块的识别结果与“金标准”病理结果进行对比。探究两者分别识别易损斑块的能力以及两者联合识别易损斑块的能力。方法前瞻性选取内蒙古医科大学附属医院2020年12月至2021年12月收治的确诊颈动脉分叉处粥样硬化的CEA术前患者31例,1周内分别行^(18)F-NaF PET/CT检查和HR-VWI检查。两种影像学检查结果与病理金标准对照,计算两者分别识别以及联合识别易损斑块的灵敏度(Sensitivity,SE)、特异度(Specificity,SP)、阳性预测值(Positive Predictive Value,PV+)、阴性预测值(Negative Predictive Value,PV-)及诊断符合率,并绘制ROC曲线,对比ROC曲线下面积(Area Under ROC Curve,AUC)。以期评价^(18)F-NaF PET/CT检查和HR-VWI检查及两者联合的诊断效能。结果^(18)F-NaF PET/CT识别易损斑块的SE、SP、PV+、PV-及诊断符合率分别为73.08%、80.00%、95.00%、36.36%、74.19%,AUC为0.765。HR-VWI诊断易损斑块的SE、SP、PV+、PV-及诊断符合率分别为84.62%、60.00%、88.00%、50.00%、80.65%,AUC为0.723。两种检查联合诊断易损斑块的SE、SP、PV+、PV-及诊断符合率分别为92.31%、80.00%、96.00%、66.67%、90.03%,AUC为0.774。结论^(18)F-NaF PET/CT和HR-VWI均是有效的易损斑块影像检测手段。两者联合检测效果更佳,日后有潜力成为一种较理想的检测易损斑块的无创影像学方案。
Objective ^(18)F-NaF positron emission tomography/computed tomography(^(18)F-NaF PET/CT)and high-resolution vessel wall imaging(HR-VWI)were performed in patients with carotid artery bifurcation atherosclerosis before carotid endarterectomy(CEA).The identification of vulnerable plaques by the two tests was compared with the“gold standard”pathological findings.The ability of the two to identify vulnerable plaques separately and in combination was investigated.Methods In this study,patients diagnosed with atherosclerosis at carotid artery forking before CEA from December 2020 to December 2021 in the Affiliated Hospital of Inner Mongolia Medical University were prospectively selected and underwent ^(18)F-NaF PET/CT examination and HR-VWI examination within one week.The sensitivity(SE),specificity(SP),positive predictive value(PV+),negative predictive value(PV-),and diagnostic coincidence rate of the two imaging examinations were calculated by comparing the results of the two imaging examinations with the pathological gold standard.The area under the ROC curve(AUC)was compared to evaluate the diagnostic efficacy of ^(18)F-NaF PET/CT,HR-VWI and their combination.Results The SE,SP,PV+,PV-and diagnostic coincidence rate of ^(18)F-NaF PET/CT in identifying vulnerable plaques were 73.08%,80.00%,95.00%,36.36%,74.19%and the AUC was 0.765.The SE,SP,PV+,PV-and diagnostic coincidence rate of HR-VWI in diagnosing vulnerable plaques was 84.62%,60.00%,88.00%,50.00%,80.65%and AUC was 0.723.The SE,SP,PV+,PV-and diagnostic coincidence rate of the combined diagnosis of vulnerable plaque were 92.31%,80.00%,96.00%,66.67%,90.03%and AUC was 0.774.Conclusion ^(18)F-NaF PET/CT and HR-VWI are both effective imaging methods for vulnerable plaques.The combination of the two has the potential to be an ideal noninvasive imaging protocol for the detection of vulnerable plaques in the future.
作者
刘昭言
欧阳雪晖
LIU Zhaoyan;OUYANG Xuehui(Graduate School,Inner Mongolia Medical University,Hohhot Inner Mongolia 010017,China;Department of Imaging Medicine,Inner Mongolia People’s Hospital,Hohhot Inner Mongolia 010017,China)
出处
《中国医疗设备》
2022年第8期137-141,共5页
China Medical Devices
基金
内蒙古自治区卫生健康科技计划项目(202201031)。
