320排CT冠脉造影检查对冠状动脉斑块成分分析可行性初探  

Coronary Plaque Composition Differences in Individuals with and without Obstructive Coronary Artery Disease by 320-detector row Coronary Computed Tomography Angiography

作　　者：董丹丹[1] 曹绍东[1] 卜丽红[1] 王可铮[1] 申宝忠[1] 

机构地区：[1]哈尔滨医科大学第四临床医学院放射科,黑龙江哈尔滨150001

出　　处：《现代生物医学进展》2012年第31期6060-6063,5992,共4页Progress in Modern Biomedicine

基　　金：科技部国际科技合作项目(2009DFB30040)

摘　　要：目的:研究320排CT冠脉造影对分析冠状动脉轻度及重度狭窄患者斑块成分的价值。方法:2011年4月-2012年5月间我院1132例(62±12岁,42%女性)冠心病患者行320排CT冠状动脉造影检查,依据美国心脏协会16分段标准,分析每一例患者每一节段血管狭窄程度及斑块性质,CT斑块分型如下:Ⅰ型为钙化斑块,Ⅱ型为钙化为主的混合斑块,Ⅲ型为非钙化为主的混合斑块,Ⅳ型为非钙化斑块。比较不同狭窄程度组斑块类型差别。结果:共363例为冠脉血管正常人群,冠状动脉狭窄患者共769例,其中管腔狭窄程度<50%的轻度人群为367例,重度狭窄组(≥50%)为402例。重度狭窄患者组冠脉血管混合斑块数量较多,而非钙化斑块相对较少(Ⅰ～Ⅳ型斑块所占比例分别为22%,,39%,21%,18%),轻度狭窄患者组各斑块所占比例分别为29%,29%,26%,16%(p=0.006)。结论:随着冠状动脉狭窄程度的不同,冠状动脉粥样硬化斑块的类型也不尽相同,重度狭窄人群组中混合斑块较多而非钙化斑块较少。320排CT冠脉造影可对冠状动脉斑块成分进行分析。Objective： We aimed to assess whether differences in plaque composition and plaque burden exist across patients with more and 〈50% coronary stenosis by 320-detector row coronary computed tomography. Methods： From April 2011 to May 2012, 1132 patients （62± 12 years, 42% females） with an intermediate risk of CAD referred for 320-slice CCTA were studied in our hospital. Plaque characteristics and burden was analyzed on CCTA images on a per-segment basis （modified 16-segment AHA classification）. Plaques types were classified as： calcified （type 1）, mixed （predominantly calcified） （type 2）, mixed （predominantly non-calcified） （type 3）, and non-calcified （type 4）. Plaque types in patients with more and 〈50% stenosis were compared. Results： Overall 363 （32.1%） patients had normal coronaries without evidence of plaque. In the remaining 769 patients, 367 （32.4%） and 402 （35.5%） were found to have luminal narrowing of 〈50% and/〉 50% in at least one coronary artery segment, respectively. Those with≥ 50% stenotic CAD demonstrated were more likely to have segments with mixed plaque subtype and less likely to be exclusively non-calcified （relative distribution of 58%, 22%, 10%, 11% for type 1-4 respectively） compared to those with 〈50% stenosis with （59%, 11%, 6% and 24%, respectively （p = 0.006）. Conclusions： Plaque composition is different according with severity of CAD with a higher mixed plaque and lesser non-calcified plaque burden among those patients with ≥ 50% stenotic CAD.

关 键 词：冠状动脉粥样硬化 粥样斑块 CTA 血管狭窄 

分 类 号：R541.1[医药卫生—心血管疾病] R814.42[医药卫生—内科学]