三维、二维定量冠脉X射线造影与目测对靶病变血管的评估对比研究  

A comparative study of target vessel assessments by three-and two-dimensional quantitative coronary X-ray angiography and visual estimation

作　　者：郝培远[1] 陈爱华[1] 宋旭东[1] 魏向龙[1] 周珊珊[1] 何非[1] 涂圣贤 

机构地区：[1]南方医科大学珠江医院心内科,广东广州510282 [2]Dpartment of Radiology, Leiden University Medical Center,the Netherlands RC Leiden 22300

出　　处：《南方医科大学学报》2011年第2期333-337,共5页Journal of Southern Medical University

基　　金：广东省医学科研基金(2008B030303019)

摘　　要：目的对比研究三维定量冠状动脉造影(3D QCA)、二维定量冠状动脉造影(2D QCA)与目测法在评估冠脉X射线造影靶病变血管的差异性。方法回顾性随机抽取2009年5月～2009年11月于我院接受冠状动脉造影并行介入治疗的60位患者65处靶病变血管段的影像资料。分析比较Medis 3D QCA、西门子2D QCA、专家目测对靶病变管腔面积狭窄率、病变血管长度、参考血管直径的测量值,分析比较3D QCA、2DQCA的直径狭窄率测量值。结果冠脉X射线造影三维定量分析、二维定量分析、目测定量分析在成功三维重建62处(3例因靶血管少一个投照体位无法实现三维重建)靶病变中最窄处管腔面积狭窄率(%)(73.87±8.98 vs 79.10±8.06 vs 83.53±8.19,P<0.001)、长度(mm)(28.95±17.31 vs 26.20±16.04vs 27.21±16.58,P<0.001)、参考血管直径(mm)(2.67±0.29 vs 2.64±0.26 vs 2.76±0.29,P<0.001)有显著性差异,三维与二维对靶血管病变最窄处直径狭窄率(%)(54.21±9.48 vs 57.84±10.17,P=0.016)有显著性差异。结论 Medis 3D QCA对冠状动脉造影能成功实现三维重建,与专家目测和二维定量分析相比,三维定量分析系统能够恢复三维血管形态从而更准确地分析冠状动脉病变。Objective To compare the efficacy of three-dimensional（3D） and two-dimensional（2D） quantitative coronary X-ray angiography（QCA） and visual estimation in the assessment of target vessels.Methods The radiographic data of 60 patients（65 vessel segments） receiving coronary angiography and interventional stent placement were retrospectively analyzed.The area stenosis,diameter stenosis,lesion length,and reference diameter assessed by Medis 3D QCA,Siemens 2D QCA and visual estimation were compared.Results Three-dimensional reconstruction was successfully performed for 65 vessel segments,and 3 target vessel were excluded due to the lack of a second angiographic view for 3D reconstruction.There were significant differences in the assessments of the area stenosis [（73.87±8.98）% vs（79.10±8.06）% vs（83.53±8.19）%,P0.001],lesion length（28.95±17.31 mm vs 26.20±16.04 mm vs 27.21±16.58 mm,P0.001）,reference diameter（28.95±17.31 mm vs 26.2±16.04 mm vs 27.21±16.58 mm,P0.001） by 3D QCA,2D QCA and visual estimation;the diameter stenosis assessed by 3D [（54.21±9.48）%] and 2D QCA [（57.84±10.17）%] also differed significantly（P=0.016）.Conclusion 3D QCA allows successful three-dimensional reconstruction of the target vessel and restores the actual dimensions of the vessel for a more accurate assessment of coronary artery disease than 2D QCA and visual estimation.

关 键 词：三维重建 二维重建 定量冠状动脉造影 目测法 X射线 靶病变血管 

分 类 号：R816.2[医药卫生—放射医学]