冠心病动脉粥样硬化斑块狭窄的测量方法及探讨(附102例)  

Study the Measure of Coronary Atherosclerotic Plaque and Stenosis in Coronary Heart Disease(102 Cases)

作　　者：郭轶虹[1] 谭理连[1] 熊龙根[1] 张成喜[2] 李树欣[1] 

机构地区：[1]广州医科大学附属第二医院放射科,广东广州510260 [2]中山大学第三附属医院,广东广州510630

出　　处：《中国CT和MRI杂志》2013年第6期35-39,共5页Chinese Journal of CT and MRI

基　　金：广东省社会发展领域科技计划项目(20120318091)

摘　　要：目的与冠脉造影(CAG)相对照,研究320排容积CT与对冠状动脉管腔粥样硬化斑块性狭窄程度的诊断准确性,并对粥样硬化斑块成分进行分类研究,探讨影响其准确性的原因。方法 320排CT冠状动脉成像(CTA)发现冠状动脉管腔粥样硬化斑块并狭窄的1 0 2名患者,同期行冠脉造影(CAG)。对造成管腔狭窄的3 7 5个粥样硬化斑块进行研究,以CAG为参照,计算CTA对管腔狭窄分级程度显示的符合率;并应用冠脉探针技术和斑块分析软件按钙化、非钙化斑块进行分类比较。结果 CTA显示375个粥样硬化斑块并狭窄(钙化斑块256个,非钙化斑块119个),测量狭窄分级程度与冠脉造影所示的管腔狭窄的符合率为89.1%,其中非钙化斑块狭窄的符合率为94%,钙化斑块狭窄的符合率为86.7%,具有统计学的显著差异。不符合的41个病灶中92.7%(38个)CTA显示的狭窄程度等级高于CAG,82.9%(34个)为钙化斑块性狭窄,119个非钙化粥样斑块中78.2%发生于大分支近段。应用冠脉探针技术和斑块分析软件显示纤维斑块占53.8%,纤维脂质混合斑块占33.6%,脂质软斑块占12.6%。其中,不稳定斑块占18.5%(22个),稳定性斑块占81.5%(97个),多为稳定性斑块。结论冠脉非钙化粥样斑块多发生于大分支近段,多为稳定性斑块。320排CT对于显示冠脉非钙化斑块狭窄的符合率高于钙化斑块性狭窄。钙化斑块性狭窄CTA与CAG的不符多表现为对狭窄程度的夸大。320排CT应用冠脉探针技术和斑块分析软件对冠状动脉粥样硬化斑块尤其是非钙化斑块性狭窄的诊断具有明显优势。Objectives Using 320-Multidetector computed tomographv （CT） and coro- nary angiographv （CAG） To investigate degree of Coronary Stenosis with rteriosclerosis Plaque and compare for diagnosis value and analysis the component of arteriosclerosis Plaque for discussing the reason. Methods 102 patients with Coronary arteriosclerosis plaques and Coronary Stenosis are discovered by 320-Multidetector computed tomo^aphy Angiogra- phy （CTA） and CAG operation. Compare the value between CTA and CAG for visualization of Coronary Stenosis. And distinguish the non-calcified plaques from calcified plaques by Coronary probe technique and the Analysis software. ResultCTA show the 375 Coronary arteriosclerosis Plaques and Coronary Stenosis （256 calcified plaques and 119 non-calcified plaques）. The image of CTA is corresponding with CAG for 89.1% for evaluation the de^ree of coronary stenosis, and 94% for that with non-calcified plaques and 86.7% for that with calcified plaques. For 41 focus falling short of CAG, CTA show 92.7% （38） aggrandize the de^ree, and 82.9%（34） betide the calcified plaques. The 119 non-calcified plaques are found In the near segment for 78.2%. Coronary probe technique and the Analysis software show the 119 Coronary arteriosclerosis non-calcified Plaques with fibrous plaque for 53.8% and fi- brous-lip combine plaque for 33.6% and lip plaque for 12.6%, and 76.2% for unstable plaques and 81.5% for stable plaques. Conclusioll The non-calcified plaques are found In the near segment for 78.2%. Most of non-calcified Plaques are unstable plaques. The diag- nostic accordance rate for coronary stenosis with non-calcified Plaques is higher than that with calcified plaques. 320-Multidetector Coronary computed tomographv is ascendent in diag- nosis for the Coronary arteriosclerosis Plaque especially for non-calcified Plaque and Stenosis by Coronary probe technique and the Analysis software.

关 键 词：体层摄影术 X计算机 冠脉造影 冠状动脉硬化 斑块 冠状动脉狭窄 

分 类 号：R541.4[医药卫生—心血管疾病]