应用多排螺旋CT评价粥样斑块餐巾环征的研究  

Study of napkin-ring sign of atheromatous plaque assessed by multidetector computed tomography

作　　者：朱海东[1] 李晖[1] 任峰[1] 

机构地区：[1]宁波市医疗中心李惠利医院影像科,浙江宁波315000

出　　处：《中国现代医生》2013年第16期88-90,F0003,共4页China Modern Doctor

摘　　要：目的通过多排CT血管造影(MDCTA)方法探讨冠心病患者餐巾环征(NRS)的影像学特点。方法以264例冠心病患者为研究对象,记录其一般临床资料,回顾性分析冠状动脉的MDCTA图像,记录NRS斑块的频数和分布,比较NRS组和无NRS组的罪犯病变的影像学特点和基线特点。结果 264例患者中有50例存在NRS斑块,214例患者无NRS斑块,NRS组的急性冠脉综合征患者比例显著高于无NRS组。264例患者中共有59个NRS斑块,其中50个属于罪犯病变。与无NRS组相比,NRS组罪犯病变斑块血管面积、重塑指数较大,正性重塑比例较高,而CT衰减值较低。NRS斑块在右冠状动脉和左回旋支的分布相对均匀,而左前降支在近段更为多见。结论应用MDCT评估的餐巾环征斑块具有与薄帽纤维粥样斑块类似的临床特点,MDCT可能有助于发现纤维粥样斑块和ACS的预防及早期诊治。Objective To explore the imaging features of napkin-ring sign in patients with coronary heart disease by muhidetector CT angiography （MDCTA）. Methods A total of 264 patients with coronary heart disease were included, and the general clinical datas were recorded. Coronary MDCTA image wrer retrospectively analyzed. The frequency and distribution of plaques with NRS were recorded. Imaging features and baselinecharacteristics of the culprit lesions were compared between NRS group and non-NRS group. Results About 50 patients had NRS plaque and 214 patients had no NRS plaque in 264 patients. ACS was more frequently observed in NRS group than non-NRS group. A total of 59 plaques with the napkin-ring sign from 264 patients were found, of which 50 were belong to the culprit lesion. Vessel area, remodeling index and frequency of positive remodeling were greater in culprit lesion plaques in NRS group than those in non-NRS group. CT attenuation values were lower in NRS group. The distribution of NRS plaque in the right coronary arteries and left circumflex arteries was relatively even, whereas NRS plaque in the left anterior descending artery was common in the proximal sites. Conclusion The napkin-ring sign assessed by MDCT represents similar clinical features of TCFA. MDCT could contribute to the search for fibroatheroma, prevention of ACS and early diagnosis and treatment of ACS.

关 键 词：多排螺旋CT血管造影 餐巾环征 冠心病 

分 类 号：R816.2[医药卫生—放射医学]