冠状动脉粥样硬化的超高速CT检测与病理学对照:II-钙化参数与管腔狭窄之间的关系  

MORPHOLOGICAL STUDY ON CORONARY ARTERY ATHEROSCLEROSIS BY ULTRAFAST CT AND PATHOLOGY II-RELATION BETWEEN CALCIUM PARAMETER AND LUMINAL NARROW

作　　者：李文生[1] 郑黎明[1] 赵淑民[1] 宋志坚[1] 陈丽琏[1] 罗宝国[1] 左焕琛[1] 

机构地区：[1]上海医科大学人体解剖学教研室,上海200032

出　　处：《解剖学杂志》2000年第4期342-346,共5页Chinese Journal of Anatomy

摘　　要：目的 :为探讨超高速 CT检测的冠状动脉钙化与冠状动脉管腔狭窄之间的关系。方法 :从 8例压力灌注固定后的心脏标本中分离出 2 0支冠状动脉 ,拉直后 ,超高速 CT扫描 ;每支冠状动脉分成相应的 3mm血管段 ,组织切片 ,地衣红染色 ,L eica图像分析仪上计算冠状动脉管腔面积狭窄率。结果 :在 4 84个血管段中 ,无粥样病变血管段的钙化率、钙化面积、钙化积分 (0 ,0 ,0 )明显低于有粥样病变的血管段 (2 8% ,1.74 %和 6 .73,P<0 .0 1)和管腔狭窄≥ 75%的血管段 (54.4 % ,5.8和 2 2 .7,P<0 .0 1) ;狭窄程度越大 ,钙化率越高 ;尽管冠状动脉钙化阴性的血管段可能有粥样硬化存在 ,但是只有 8.4 %的血管段属于管腔面积狭窄≥ 75% ;超高速 CT检测管腔面积狭窄≥ 75%的血管段敏感性、特异性分别为 54.4 %、81.5%。结论 :冠状动脉狭窄程度越重 ,粥样硬化内钙化发生率越高 ;冠状动脉钙化阴性有着重要的临床意义 ;CT阈值≥ 130To study the relationship between coronary artery calcification (CAC) detected by ultrafast computed tomography(UFCT) and luminal narrow. Methods: Twenty coronary arteries from eight perfusion fixed autopsy heart were dissected, straightened and scanned by UFCT. Then each coronary artery was divieded into ocrresponding segments, representative histological 3 mm sections were stained with Orcein. Atherosclerotic area(mm 2) and luminal narrow per segment were quantified on Leica Imaging System. Results: In 484 segments, the CAC incidence, calcium area and calcium score(0,0,0) of segments without atherosclerosis were lower than those with atherosclerosis(28%, 1.74 and 6.73, P<0.01) and these with≥ 75% stenosis(54.4%, 5.8 and 22.7,P<0.01); the greater the extent of stenosis, the greater the incidence of CAC; although atherosclerotic area was found in some nonclacified segmens, only 8.4% of these segments were associated with≥ 75% stenosis. The sensitivity and specificity of UFCT in the detection of ≥ 75% stenosis segment was 54.4% and 81.5%, respectively. Conclusion: The greater the extent of stenosis, the greater the incidence of CAC; the use of CAC to predict the extent of coronary artery luminal narrowing is limited, but the absence of CAC has a important clinical significance. Over 130 Hu CT threshold value may be high refered to atherosclerotic plaque of chinese people.

关 键 词：冠心病 超高速CT控制 病理学 Ⅰ-钙化参数 

分 类 号：R361[医药卫生—病理学]