不同形态冠状动脉钙化与冠状动脉狭窄的多层螺旋CT相关性研究  

Study of Morphological Characteristics of Calcified Plaques and Luminal Stenosis of Coronary Artery at 64--slice Computed Tomographic Coronary Angiography

作　　者：鲁锦国[1] 吕滨[1] 唐翔[1] 陈雄彪[1] 侯志辉[1] 蒋世良[1] 戴汝平[1] 吴永健[2] 乔树宾[2] 杨跃进[2] 

机构地区：[1]北京协和医学院中国医学科学院心血管病研究所阜外心血管病医院放射科,北京100037 [2]北京协和医学院中国医学科学院心血管病研究所阜外心血管病医院心内科,北京100037

出　　处：《实用放射学杂志》2010年第4期485-491,共7页Journal of Practical Radiology

基　　金：国家十一五科技支撑计划资助课题（单中心研究内容）,课题号：2007BAI05B02.

摘　　要：目的探讨64层螺旋CT冠状动脉造影图像上不同形态的冠状动脉钙化与局部管腔狭窄的关系。方法回顾性分析111例冠状动脉钙化患者的CT冠状动脉造影（CTCA）和传统冠状动脉造影（CAG）图像。依据冠状动脉长轴和短轴方向上冠状动脉钙化形态对钙化灶进行分类。长轴方向的冠状动脉钙化灶分为：点状钙化，结节状、条状钙化，块状钙化。短轴方向的冠状动脉钙化灶分为：点状钙化、新月形钙化、半月形钙化、满月形钙化、环形钙化。通过CTCA和CAG病灶对病灶的分析，评价不同形态的冠状动脉钙化同局部管腔狭窄的关系。结果共分析了528个冠状动脉节段钙化灶，其中383个节段（72．5％）为点状钙化，145个节段（27．5％）为非点状钙化。在造成冠状动脉局部管腔重度狭窄（≥75％）的34个非点状钙化（占非点状钙化灶的23．4％）中，从长轴方向上看，结节状钙化、条状钙化及块状钙化分别有4（11．8％）、8（23．5％）、22（64．7％）个；从短轴方向上看，新月形、半月形、满月形及环形钙化节段分别有0（0．0％）、8（23．5％）、18（52．9％）、8（23．5％）个。不同形态的冠状动脉钙化斑块造成局部管腔重度狭窄的比例差异均有统计学意义（P〈0．01）。结论冠状动脉CT血管成像显示不同形态的钙化斑块造成局部管腔的狭窄程度不同。冠状动脉长轴方向上的条块状钙化和短轴方向上的满月形钙化、环形钙化斑块是造成局部冠状动脉重度狭窄的主要原因。Objective To study the correlation between morphological characteristics of coronary artery calcified plaques and luminal stenosis of local coronary artery segments with 64--slice computed tomography. Methods One hundred and eleven patients who had undergone 64--slice computed tomographic coronary angiography （CTCA） and conventional coronary angiography （CAG） were retrospectively analyzed. The calcified plaques were classified as punctate, nodular, strip--like and nubbly in long--axis view of coronary artery lumen, and were classified as crescent, semilunar, round moon and circinate in short--axis view. The morphologic characteristics of these calcified plaques on CTCA were retrospectively analyzed and compared with luminal stenosis of CAG results. Results Among 528 calcified coronary segments which were analyzed in 111 patients, there were 383 （72.5%） punctate calcified plaque segments and 145 （27.5%） of non-- punctate plaques. There were 34 （ 23.4%, 34/145 ） non-- punctate calcified plaques which caused severe stenosis （≥75%）, including 4 （11.8%） nodular, 8 （23. 5%） stripe--like and 22 （64.7%） nubbly calcified plaques on the long--axis view, and 0 （0.0%） cresent,8 （23.5%） semilunar,18 （ 52.9% ） round moon and 8 （ 23.5% ） circinate calcified plaques on the short--axis view. The ratios of different morphological coronary artery calcifications which caused severe stenoses were significantly different with each other （all P〈0.01）. Conclusion Different figures of coronary artery calcified plaques demonstrate different degrees of stenoses of local coronary artery lumen. Severe stenoses were mostly caused by nubbly calcified plaque on long--axis view, round moon and circinate calcified plaque on short--axis view.

关 键 词：心脏 冠状动脉钙化 冠心病 体层摄影术 X线计算机 

分 类 号：R543.3[医药卫生—心血管疾病] R814.42[医药卫生—内科学]