64层螺旋CT诊断冠状动脉内斑块的临床价值  

Clinical value of diagnosis of plaque within coronary by 64-slice spiral CT coronary angiography

作　　者：张鹏[1] 都基权[1] 田英军[1] 刘禄明[1] 孙百胜[1] 傅振强[1] 

机构地区：[1]武警山东总队医院医学影像中心,山东济南250014

出　　处：《中国医学影像技术》2009年第S1期54-58,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨64层螺旋CT冠状动脉造影显示冠状动脉内斑块的能力及在临床应用中的价值。方法对2007年8月至2008年8月接受64层螺旋CT冠状动脉造影检查的200例患者的影像、临床资料分析对照。结果CT冠状动脉造影(CTCA)检查共发现软斑块148个,钙化斑块256个,混合斑块96个,以左前降支(LAD)近段(35.2%)、左冠状动脉(LMA)主干(17.4%)、LAD中段(10.6%)、右冠状动脉(RCA)近段(8.4%)、RCA中段(7.6%)、左旋支(LMX)近段(6.6%)斑块常见,伴相应冠状动脉分支血管不同程度的狭窄。斑块位置及狭窄程度的诊断与冠状动脉造影(CAG)检查一致性好,软斑块致血管腔狭窄诊断准确性较钙化斑块的高。结论64层螺旋CT诊断冠状动脉内斑块准确性高,尤其对近段血管准确率达95%以上,对冠状动脉狭窄有较高的特异性及阴性预测值,能够为临床提供重要、及时诊断冠心病的信息。Objective To explore the capability and clinical value of 64-slice spiral CT coronary angiography in inspecting plaque in coronary artery.Methods To analyze and contrast with the image data and clinical data of 200 hospitalized patients who took 64-slice spiral CT coronary angiography from August 2007 to August 2008.Results 64-slice spiral CT coronary angiography found 148 cases of soft plaques,256 cases of calcific plaques,96 cases of mixed plaques,among them,176 cases were in the proximal of LAD,the rate was 35.2%(176/500),87 cases were in the LMA(17.4%),53 cases were in the middle-piece of LAD(10.6%),42 cases were in the proximal of RCA(8.4%),38 cases were in the middle-piece of RCA(7.6%),33 case were in the proximal of LCX(6.6%),with varied degree of stenosis in branches of related coronary artery.Twenty of the 200 patients received coronary artery angiography(CAG).The diagnosis of 64-slice spiral CT coronary angiography imaging for the degree of stenosis and area of plaque was consistent with the diagnosis of CAG.The accuracy of diagnosing soft plaque-induced stenosis by 64-slice spiral CT coronary angiography was higher than calcific plaque's.Conclusion The accuracy of diagnosis of plaque within coronary by 64-slice spiral CT coronary angiography is high.Especially,the accuracy of diagnosing plaque within the proximal coronary is above 95%.The accuracy specificity and negative predictive value are high for 64-slice spiral CT in evaluation of arterial stenosis,and provides useful and timely information for reasonable clinical care.

关 键 词：冠状动脉血管造影 冠心病 钙化斑块 软斑块 

分 类 号：R541.4[医药卫生—心血管疾病]