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目的探讨胸部双能量DR骨骼像在筛查冠脉钙化中的意义。方法35例患者分别行右前斜位胸部双能量DR检查及多排螺旋CT(MDCT)冠状动脉扫描并记录照射后射线的体表入射剂量ESD(mGy)。2位高年资放射科医师及2位低年资医师分析双能量胸片骨骼像,对LAD、LCX、RCA共105条血管的钙化情况进行评估。CT扫描图像进行钙化积分分析。以钙化积分>300为金标准,对双能量DR的结果进行ROC分析。结果DR胸片平均阳性率27.6%(29/105),其中LAD阳性率48.5%(17/35);LCX22.8%(8/35);RCA 11.4%(4/35)。4位医师的ROC结果显示曲线下面积分别为0.866、0.854、0.725、0.642。胸部DR照射平均体表入射剂量为(0.469±0.22)mGy;多排CT入射剂量为(12.29±1.40)mGy。两者经配对t检验有显著差异。结论DR骨骼片可以检出较明显的冠状动脉钙化,对冠心病的筛查和病情的检测有一定的临床意义。
Objective To investigate the significance of chest dual energy DR bone scintigraphy in the screening of coronary artery calcification. Methods Thirty-five patients underwent right-sided oblique chest radiofrequency energy (DR) examination and multislice spiral CT (MDCT) coronary angiography, respectively, and recorded the radiation dose (ESD) after the irradiation. Two senior radiologists and two junior physicians analyzed the dual-energy chest radiographs to evaluate the calcification of 105 vessels in LAD, LCX and RCA. CT scan image calcification integration analysis. Taking the calcification score> 300 as the gold standard, ROC analysis was performed on the results of dual-energy DR. Results The average positive rate of DR chest radiography was 27.6% (29/105). The positive rate of LAD was 48.5% (17/35), LCX was 22.8% (8/35) and RCA was 11.4% (4/35). The ROC results of 4 physicians showed that the areas under the curve were 0.866, 0.854, 0.725 and 0.642, respectively. The average body surface dose of DR was (0.469 ± 0.22) mGy and that of multi-line CT was (12.29 ± 1.40) mGy. The two paired t-test showed significant differences. Conclusion DR bone fragments can detect more obvious coronary artery calcification, coronary heart disease screening and detection of disease has some clinical significance.