多层螺旋CT评价主动脉弹性与冠状动脉斑块性质的相关性  

MSCT in assessment of correlation between aortic elasticity and coronary artery plaques

作　　者：王振威[1] 王志铭[1] 宋丽萍[2] 王玉福[1] 王晗[1] 刘明[3] 朱杰[3] 褚建祎[3] 

机构地区：[1]辽宁医学院附属第三医院,辽宁锦州121000 [2]滕州市中心人民医院重症医学科ICU,山东滕州277500 [3]辽宁医学院附属第一医院,辽宁锦州121000

出　　处：《解放军医学院学报》2013年第7期740-743,共4页Academic Journal of Chinese PLA Medical School

摘　　要：目的利用多层螺旋CT（multislice spiral CT,MSCT）评价主动脉弹性与冠状动脉斑块性质的关系。方法收集2011年7月-2012年6月在辽宁医学院附属第一医院放射科经回顾性心电门控CT冠状动脉成像的受检者资料152例,根据CTA冠状动脉斑块的性质分为非钙化斑块组、钙化斑块组和混合斑块组,无斑块者为对照组。CT原始数据间隔10%R-R间期在5%~95%R-R间期进行图像重建,利用ADW4.5工作站冠状动脉分析软件测量冠状窦上方约15 mm处升主动脉的横断面积并测量主动脉弹性。嘱对照组于CT检查后2周内利用M型超声测量升主动脉内径,记录最大、最小内径值并计算主动脉横断面积。CT和超声检查结束后由专人测量受检者的血压。利用公式计算CT和超声测得的主动脉弹性值,比较两者结果的一致性。结果钙化斑块组（43例）主动脉弹性低于对照组（60例）[1.829±0.466（10-5/Pa）vs 3.122±0.782（10-5/Pa）]（P〈0.001）;混合斑块组（31例）主动脉弹性低于对照组[1.718±0.412（10-5/Pa）vs 3.122±0.782（10-5/Pa）]（P〈0.001）,非钙化斑块组（18例）和对照组弹性值的差异无统计学意义[2.834±0.433（10-5/Pa）vs 3.122±0.782（10-5/Pa）]（P=0.254）。超声和CT测量对照组主动脉弹性值的一致性良好（组内相关系数ICC=0.997,P〈0.000 1）。结论 MSCT可以客观评价主动脉弹性;冠状动脉出现钙化斑块、混合斑块者主动脉弹性减低,出现非钙化斑块者主动脉弹性无明显改变。Objective To assess the correlation between aortic elasticity and coronary artery plaques using MSCT.Methods One hundred and fifty-two patients who underwent retrospective ECG-gated CT angiography in our hospital were divided into control group（n=60）,non-calcified plaque group（n=18）,calcified plaque group（43） and mixed plaque group（n=31）.Their images were reconstructed when the 10% R-R interval of CT primary data was 5%-95% R-R.The cross-sectional area of ascending aorta at about 15 mm above the coronary orifice and aortic elasticity were measured using the coronary analysis software at the ADW4.5 station.Two weeks after CT,the longest and shortest inner diameters of aorta and the cross-sectional area of aorta in control group were measured.The blood pressure of patients was measured after CT and ultrasonography.The aortic elasticity（10-5/Pa） was calculated and compared.Results The aortic elasticity was lower in calcified plaque group and mix plaque group [1.829±0.466（10-5/Pa） vs 3.122±0.782（10-5/Pa）,1.718±0.412（10-5/Pa） vs 3.122±0.782（10-5/Pa）,P 0.001].However,no significant difference was found between non-calcified plaque group and control group [2.834±0.433（10-5/Pa） vs 3.122±0.782（10-5/Pa）,P=0.254].The CT angiography was well correlated with the aortic elasticity（ICC=0.997,P 0.000 1）.Conclusion MSCT can assess the aortic elasticity which decreases in the presence of calcified and mixed plaques,but not in the presence of non-calcified plaques.

关 键 词：体层摄影术 X线计算机 冠状动脉疾病 主动脉 弹性 

分 类 号：R445[医药卫生—影像医学与核医学]