MSCTA对冠心病患者冠状动脉狭窄程度及斑块稳定性的评估价值分析  

Analysis of the evaluation value of MSCTA on coronary artery stenosis and plaque stability in patients with coronary heart disease

作　　者：孙萍 张怡[2] 王华斌 姚杰 郭兆凌 SUN Ping;ZHANG Yi;WANG Hua-bin;YAO Jie;GUO Zhao-ling(Nanjing Central Hospital,Nanjing 210018,China;Department of Medical Imaging,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京市中心医院,江苏南京210018 [2]南京医科大学第一附属医院医学影像科,江苏南京210029

出　　处：《中国临床医学影像杂志》2021年第12期865-868,共4页Journal of China Clinic Medical Imaging

基　　金：江苏省卫生健康委2020年度医学科研项目(M2020A028)。

摘　　要：目的:探讨多层螺旋CT血管造影(MSCTA)对冠心病(CHD)患者冠状动脉狭窄程度及斑块稳定性的评估价值。方法:选取本院2018年4月—2020年11月收治的120例CHD患者,均行冠状动脉造影(CAG)及MSCTA检查。以CAG检查结果为金标准,计算MSCTA检出冠状动脉狭窄的灵敏度与特异度,比较CAG与MSCTA对冠状动脉狭窄程度分级的评估结果,分析MSCTA检出的稳定型心绞痛与不稳定型心绞痛患者的斑块性质。结果:120例CHD患者完成了2 040个节段的检查。其中CAG检出464个节段狭窄,MSCTA检出468个节段狭窄。MSCTA检测冠状动脉狭窄的灵敏度为95.73%(448/468),特异度为98.73%(1 556/1 576)。CAG与MSCTA对冠状动脉狭窄程度分级的评估结果无明显差异(P>0.05)。74例稳定性心绞痛患者中共检出冠状动脉狭窄258处,46例不稳定心绞痛患者中检出210处。其中软斑块168个、混合斑块142个、钙化斑块158个。稳定型心绞痛以钙化斑块为主,不稳定型心绞痛以软斑块为主,差异有统计学意义(P<0.05)。结论:MSCTA可有效评估冠状动脉狭窄及斑块性质,为CHD患者合理治疗及猝死预防提供重要信息,且具有无创、重复性高的优点,值得推广。Objective: To explore the evaluation value of multi-slice spiral computed tomography angiography(MSCTA) for coronary artery stenosis and plaque stability in patients with coronary heart disease(CHD). Methods: A total of 120 patients with coronary heart disease were admitted to our hospital from April 2018 to November 2020, all of them underwent coronary angiography(CAG) examination and MSCTA examination. Using CAG examination results as the gold standard, calculate the sensitivity and specificity of MSCTA for detecting coronary artery stenosis, CAG and MSCTA assessment results of coronary artery stenosis, and analyze the plaques of patients with stable angina pectoris and unstable angina pectoris detected by MSCTA nature. Results: The 120 patients with coronary heart disease completed the examination of 2 040 segments. Among them,CAG detected 464-segment stenosis, and MSCTA detected 468-segment stenosis. The sensitivity of MSCTA in detecting coronary artery stenosis was 95.73%(448/468), and the specificity was 98.73%(1 556/1 576). CAG and MSCTA had no significant difference in the assessment results of the degree of coronary artery stenosis(P>0.05). A total of 258 coronary artery stenosis were detected in 74 patients with stable angina, and 210 were detected in 46 patients with unstable angina. Among them,168 were soft plaques, 142 were mixed plaques, and 158 were calcified plaques. Stable angina pectoris is dominated by calcified plaques, and unstable angina pectoris is dominated by soft plaques, and the difference is statistically significant(P<0.05).Conclusion: MSCTA can effectively assess the properties of coronary artery stenosis-grade plaques, can provide important information for the rational treatment of CHD patients and the prevention of sudden death, and has the advantages of non-invasive and high reproducibility, and is worthy of promotion.

关 键 词：冠心病 冠状动脉狭窄 计算机体层摄影血管造影术 

分 类 号：R541.4[医药卫生—心血管疾病] R814.42[医药卫生—内科学]