心脏CT平扫与CTA定量分析心外膜脂肪体积对比研究

目的：对比研究基于心电门控的心脏CT平扫（NCT）与冠状动脉CTA定量评价冠心病患者心外膜脂肪体积（EFV）的一致性。方法：回顾性分析临床诊断冠心病同期行心脏CT平扫和冠状动脉CTA检查患者40例。心外膜边界由2位具有丰富心血管CT临床工作经验的医师（观察者1和2）采用GE AW4.7工作站自动软件自动勾勒心外膜轮廓，EFV结果由软件自动计算生成。采用线性回归分析、Bland-Altman分析法及组内相关系数（ICC）评价两观察者间的一致性。结果：NCT和冠状动脉CTA测得EFV分别为（99.43±43.78）cm³和（93.66±48.49）cm³，两者差异无明显统计学意义（P>0.05）。观察者1在NCT和CTA的重复系数（CR）误差分别为10.01cm³和7.83cm³；观察者2在NCT和CTA的CR误差分别为11.05cm³和7.58cm³。NCT的CR为8.05cm³；CTA的CR为7.13cm³。各组ICC均大于0.96。结论：基于心电门控的心脏CT平扫和冠状动脉CTA均可用于EFV的评估。

A Comparative Study of Non-contrast Cardiac CT and Coronary CT Angiography in Quantitative Analysis of Epicardial Fat Volume

Objective: To compare non-contrast cardiac CT (NCT) and coronary CT angiography (coronary CTA) for quantitative analysis of epicardial fat volume (EFV) in coronary artery disease cohort. Method: Forty patients underwent retrospective NCT and coronary CTA with ECG-gated. Epicardial boundaries were traced by 2 experienced radiologists (operator 1 and operators 2). EFV was calculated by Autocontour software (AW4.7 workstation, GE). Linear Regression, Bland-Altman method, Coefficient of Repeatability (CR) and Intra Class Correlation (ICC) were computed to analyze the inter-observer variability. Result: There was no significant difference (P>0.05) between NCT (99.43±43.78cm3) and coronary CTA (93.66±48.49cm3) in mean EFV values. For operator 1, CR errors were 10.01cm3 (NCT) and 7.83cm3 (coronary CTA), respectively. For operator 2, CR errors were 11.05 cm3 (NCT) and 7.58cm3(coronary CTA), respectively. ICC values >0.96 were obtained in all cases. CR values were 8.05 cm3 for NCT and 7.13cm3 for CTA. Conclusion: Both NCT and coronary CTA can be used to computer-assist measurements of EFV with ECG-gated.