320排CT冠状动脉成像对冠心病患者冠状动脉狭窄和斑块性质诊断价值分析  

Diagnostic value of 320-slice CT coronary artery imaging for coronary artery stenosis and plaque properties in patients with coronary heart disease

作　　者：郑苏萍 赵琳琳[1] 李小潘[1] Zheng Suping;Zhao Linlin;Li Xiaopan(Image Center,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)

机构地区：[1]河南科技大学第一附属医院影像中心,洛阳471000

出　　处：《实用医学影像杂志》2023年第5期337-341,共5页Journal of Practical Medical Imaging

摘　　要：目的分析320排CT冠状动脉成像(CTA)对冠心病(CHD)患者冠脉狭窄和斑块性质诊断价值。方法选择本院2021年3月至2023年3月就诊的65例CHD患者设为CHD组,另选取同期本院体检中心65名健康体检者作为对照组,均给予CTA检查,比较2组左心功能参数、冠状动脉狭窄程度、斑块稳定性、斑块面积,通过ROC曲线分析左心功能参数对CHD的诊断价值。结果CHD组左室舒张末期容积(LVEDV)、左室每搏量(LVSV)、左室收缩末期容积(LVESV)、重构指数(RI)、偏心指数(EI)均高于对照组(P<0.05),CHD组左室射血分数(LVEF)、斑块面积均低于对照组(P<0.05)。CHD组冠状动脉狭窄程度轻度(27.7%)、中度(33.8%)、重度率(38.5%)均高于对照组(6.2%、0、0)(P<0.05)。CHD组混合斑块(26.2%)、钙化斑块(27.7%)、纤维斑块(21.5%)、脂质斑块率(24.6%)均高于对照组(0、0、1.5%、6.2%)(P<0.05)。LVEDV、LVSV、LVESV、RI、EI、LVEF联合检测诊断CHD的AUC(95%CI)=0.906(0.816,0.959),灵敏度(96.3%)、特异度(93.0%)均高于单一检测。结论320排CTA通过检测左心功能参数、斑块面积等对冠状动脉狭窄和斑块性质作出准确判断,联合检测左心功能参数,可提高对CHD诊断效能,具有一定的参考价值。Objective To analyze the diagnostic value of 320-slice CT coronary artery imaging(CTA)for coronary artery stenosis and plaque properties in patients with coronary heart disease(CHD).Methods Sixty-five patients with CHD admitted to our hospital from March 2021 to March 2023 were selected as the CHD group,and another 65 healthy subjects who received physical examination in our physical examination center during the same period were selected as the control group and given CTA examination.Left cardiac function parameters,degree of coronary artery stenosis,plaque stability and plaque area were compared between the two groups.The diagnostic value of left ventricular function parameters in CHD was analyzed by receiver operator characteristic(ROC)curve.Results The left ventricular end-diastolic volume(LVEDV),left ventricular stroke volume(LVSV),left ventricular end-systolic volume(LVESV),remodeling index(RI)and eccentrical index(EI)in CHD group were higher than those in control group(P<0.05).The left ventricular ejection fraction(LVEF)and plaque area in CHD group were lower than those in control group(P<0.05).The rates of mild coronary artery stenosis(27.7%),moderate coronary artery stenosis(33.8%)and severe coronary artery stenosis(38.5%)in CHD group were higher than those in control group(6.2%,0,0)(P<0.05).The rates of mixed plaque(26.2%),calcified plaque(27.7%),fibrous plaque(21.5%)and lipid plaque(24.6%)in CHD group were higher than those in control group(0,0,1.5%,6.2%)(P<0.05).The area under the curve(AUC)(95%CI)of the combined detection of LVEDV,LVSV,LVESV,RI,EI and LVEF for the diagnosis of CHD was 0.906(0.816,0.959),and the sensitivity(96.3%)and specificity(93.0%)were higher than those of the single detection(P<0.05).Conclusion 320-row CTA can accurately determine coronary artery stenosis and plaque nature by detecting left heart function parameters and plaque area,and the combined detection of left heart function parameters can improve the diagnostic efficiency of CHD,which has certain reference value.

关 键 词：冠心病 冠状动脉狭窄 CT冠状动脉成像 斑块性质 

分 类 号：R541.4[医药卫生—心血管疾病] R816.2[医药卫生—内科学]