320排动态容积CT与冠脉造影狭窄程度判断差异的因素探讨  

Differential judgment of coronary stenosis by 320-slice dynamic volume computed tomography and coronary angiography

作　　者：李晓燕[1] 张国明[1] 孙钢[2] 刘娟[1] 孙青[1] 李理[2] 李敏[2] 王启蒙[2] 

机构地区：[1]250031济南军区总医院心内科 [2]250031济南军区总医院放射科

出　　处：《中华医学杂志》2013年第31期2496-2498,共3页National Medical Journal of China

摘　　要：目的 320排动态容积CT和冠脉造影对冠脉病变狭窄程度判断不完全一致,本研究比较了两种检查相符组和不相符组的病变特征.方法 选择济南军区总医院2011年1月至2012年5月期间92例在2周内行冠脉CT和冠脉造影患者,共计265个病变,根据病变狭窄程度判断是否一致分为相符组和不相符组.对两组病变的位置、弯曲程度、主要斑块形态、节段性钙化积分、钙化比例等资料进行对照分析.结果 265处病变中不相符组29处,相符组病变236处.不相符组的回旋支病变、远段病变、开口病变和迂曲病变比例显著高于相符组（P＜0.05）；另不相符组中条块型斑块、钙化斑块、主要斑块中条块型＋结节型钙化所占比例显著高于相符组,同时节段性钙化积分（250±210比82±66,P＜0.05）、主要斑块中钙化点数目和钙化比例（55％ ±28％比43％ ±30％,P＜0.05）显著高于相符组（P＜0.05）.结论 当冠脉病变位于开口、远段或迂曲位置时,以及主要斑块为条块型斑块、病变钙化负荷较重时,冠脉CT和冠脉造影对狭窄程度的判断差异较大.Objective To compare the characteristics of lesions with consistent and inconsistent judgments of coronary stenosis on 320-slice dynamic volume computed tomography （DVCT） versus coronary angiography （CAG）. Methods Ninety-two patients （ 265 lesions ） with CAG and DVCT within 2 weeks from January 2011 to May 2012 were enrolled. According to the matching degree of stenotic judgment, all lesions were divided into consistent and inconsistent groups. The position of lesions, degree of bending, plaque morphology and calcification proportion were analyzed. Results There were 236 lesions in consistent group versus 29 lesions in inconsistent group. In inconsistent group,there were more left circumflex artery, distal, ostial and tortuous lesions than that in consistent group （ P 〈 0. 05 ）. At the same time, the proportion of nubbly type plaque, calcified plaque, nubbly and nodular type calcification in the main plaque in inconsistent group was higher than those in consistent group （ P 〈 0. 05 ）. Segmental coronary calcium score （250 ± 210 vs 82 ± 66 ,P 〈 0. 05 ）, number of calcifications and calcification proportion in main plaque （55% ± 28% vs 43%± 30%, P 〈 0. 05） in inconsistent group were higher than those in consistent group （P〈0. 05）. Conclusion When coronary lesion occurs in ostial, distal or tortuous position or its main plaque is of nubbly type with a heavy calcification load, the judgment of stenosis by CTA and CAG is more likely to be inconsistent.

关 键 词：冠状动脉狭窄 体层摄影术 X线计算机 钙化 生理性 

分 类 号：R816.2[医药卫生—放射医学]