宝石能谱CT成像结合血清标志物在冠状动脉粥样硬化斑块特征分析中的应用
| 作者: |
1田小荀
1 河南省中医药研究院附属医院影像科，郑州 450000 |
| 通讯: |
田小荀
Email: 13523451601@163.com |
| DOI: | 10.3978/j.issn.2095-6959.2018.04.014 |
摘要
目的：研究宝石能谱CT成像(gemstone spectral imaging，GSI)结合血清标志物在冠状动脉粥样硬化斑块(coronary atherosclerotic plaque，CAP)特征分析中的应用价值。方法：对河南省中医药研究院附属医院收治的118例冠心病患者均行GSI扫描，将58例无斑块者纳为对照组，60例有斑块者根据斑块分类分为A(11例纤维斑块)、B(13例脂质斑块)、C(钙化斑块)、D(混合斑块)4组，比较其血清标志物浓度和能谱数据，并对两者间关系进行相关性分析。结果：60例斑块患者中，共检出146个斑块，其中纤维斑块27个，脂质斑块32个，钙化斑块22个，混合斑块65个。斑块组血清MMP-9、活化的血管平滑肌细胞高表达致炎因子高迁移率族蛋白1(high mobility group protein 1，HMGB1)和高敏C反应蛋白(high sensitivity C-reactive protein，hs-CRP)浓度均显著高于对照组(P<0.05)；除A、D两组间血清标志物浓度无显著差异外(P>0.05)，其余各组间血清标志物浓度均存在显著差异(P<0.05)。斑块组4组间能谱数据均存在显著差异(P<0.05)，B，A，D，C组CT值、能谱曲线(spectral curve，SAC)斜率、有效原子序数(effective atomic number，EAN)和水-羟基磷灰石(water-hydroxyapatite，HAP)呈上升趋势(P<0.05)，而水-脂(water-fat，FAT)浓度呈下降趋势(P<0.05)；血清标志物浓度与CT值、SAC斜率、EAN和HAP均呈负相关(P<0.05)，与FAT浓度呈正相关(P<0.05)。结论：GSI可准确分析CAP斑块性质，结合血清标志物可准确判定斑块特征，临床应用价值较高。
关键词：
宝石能谱CT成像；血清标志物；冠状动脉粥样硬化斑块；特征
Application of gemstone spectral imaging combined with serum markers in the analysis of coronary atherosclerotic plaques features
CorrespondingAuthor: TIAN Xiaoxun Email: 13523451601@163.com
DOI: 10.3978/j.issn.2095-6959.2018.04.014
Abstract
Objective: To study the application values of gemstone spectrum CT imaging (GSI) combined with serum markers in the analysis of coronary atherosclerotic plaques (CAP) features. Methods: A total of 118 cases of patients with coronary heart disease admitted to our hospital were given the GSI scanning, including the 58 cases of patients without plaque were included in the control group and 60 cases with plaque were divided into the A (n=11, with fibro-plaques), B (n=13, with lipid plaque), C (calcified plaque) and D (mixed plaque) the four groups. The serum markers concentrations and energy spectrum data were compared, and the relationship between the two was given the correlation analysis. Results: A total of 146 plaques were detected in 60 plaques patients, of which 27 were fibrous, 32 were lipid, 22 were calcified and 65 were mixed plaques. The concentrations of serum MMP-9 and high expression of proinflammatory cytokine high mobility group box protein 1 (HMGB1) in activated vascular smooth muscle cells, and the high-sensitivity C-reactive protein (hs-CRP) in the plaque group were significantly higher than those in the control group (P<0.05). There was no significant difference in the serum markers concentrations between A and D groups (P>0.05), and there were significant differences in the serum markers concentrations among the other groups (P<0.05). There were significant differences in the spectrum data among the four groups (P<0.05), and the CT value, spectral curve (SAC) slope, effective atomic number (EAN) and water-hydroxyapatite (HAP) in B, A, D, C groups showed an upward trend (P<0.05) while the concentration of Water-fat (FAT) showed a downward trend (P<0.05). The concentrations of serum markers were negatively correlated with CT value, SAC slope, EAN and HAP (P<0.05), and positively correlated with FAT concentration (P<0.05). Conclusion: GSI can accurately analyze the nature of CAP plaques, and the combined with serum markers can accurately determine the features of the plaque and can have the high clinical application values.
Keywords：
gemstone spectral imaging; serum markers; coronary atherosclerotic plaques; features