64-MSCT血管密度比值评价急性冠脉综合征血管易损斑块的价值  

Value of vessel density ratio of 64-MSCT in the evaluation of acute coronary syndrome vulnerable plaques

作　　者：万象新[1] 覃群[1] 秦将均[1] 周祥群[1] 林玲[1] 

机构地区：[1]海南省农垦三亚医院放射科,海南三亚572000

出　　处：《海南医学》2014年第16期2378-2382,共5页Hainan Medical Journal

基　　金：海南省自然科学基金(编号:310183);三亚市医疗卫生科技创新项目(编号:YW1320)

摘　　要：目的 探讨64-MSCT血管密度比值评价急性冠脉综合征（ACS）肇事血管易损斑块价值。方法 追踪随访2011年5月至2012年4月间我院临床拟诊冠心病行64-MSCT冠状动脉成像,并同期（一周内）进行了冠状动脉造诊断为冠心病患者128例,其中冠状动脉内置支架术者、严重心肺肝肾疾病者、图像质量未达优良者予以剔除,最终纳入随访对象65例中31例在1年内发生了ACS。所有纳入随访对象的MSCT原始数据在45%~85%R-R间期、间隔20%重建后传至AW4.4工作站,多平面图像上（MPR）,沿血管长轴测量冠状动脉血管病变,ROIs血管壁、管腔、斑块以及血栓的总体平均密度,并且用主动脉根部的平均血管密度作为比较参考,得出VDR（Vessel density ratio）值。结果 ACS组31例,斑块105个,其中肇事斑块45个,非肇事斑块60个;非ACS组34例,斑块78个。将以上斑块分为ACS斑块组与非ACS斑块两组,经统计学分析结果显示,两组间主动脉根部平均CT值比较差异无统计学意义（P〉0.05）,而斑块血管混合CT值（PVMV）和VDR值差异则均有统计学意义（P〈0.05）。结论 采用64-MSCT血管密度比值比以往单纯测量斑块CT值评价斑块的稳定性更可靠,VDR对早期识别ACS易损斑块具有较高的临床应用价值。Objective To study the value of vessel density ratio （VDR） of 64-MSCT for evaluating vulnerable plaques in patients with acute coronary syndrome （ACS）. Methods Patients diagnosed as coronary heart disease （CHD） and scheduled for 64-MSCT coronary artery imaging from May 2011 to April 2012 were followed up and analyzed. One hundred and twenty-eight patients were confirmed as CHD within a week by coronary artery digital subtraction angiograpy. Then the patients of coronary artery bracket of built-in, severe lung liver and kidney diseases, unqualified image quality were excluded, and 65 patients were enrolled eventually, of which 31 occurred ACS within 1 year （ACS group） and 34 did not had ACS within 1 year （non-ACS group）. All the raw data of MSCT was reconstructed in the range of R-R 45%-85% and with 20% interval, then the data was send to AW4.4 workstations, multiplanar images. The coronary artery vascular lesions, ROIs overall average density of blood vessel walls, lumen, plaques, were tested along the long axis of blood vessels, using the average density of blood vessels of the aortic root as a reference. Then the vessel density ratio （VDR） was calculated. Results ACS group （31 cases） had 105 patches, including 45 culprit plaques and 60 noncuprit plaques. The non-ACS group （34 cases） has 78 plaques. Statistical analysis revealed that the average CT value of the aortic root showed no significant difference between the two groups （P〉0.05）, while plaque vascular mixed CT value （PVMV） and VDR value had significant differences （P〈0.05）. Conclusion 64-MSCT vascular density ratio （VDR） is more reliable than plaques CT value in the evaluation of the stability of the plaques. VDR has higher clinic value in the early identification of ACS vulnerable plaques.

关 键 词：多排螺旋计算机体层扫描 急性冠脉综合征 易损斑块 血管密度比值 

分 类 号：R541.4[医药卫生—心血管疾病]