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,并对粥样硬化斑决成分进行分类研究,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375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％(2 2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.
Abstract
Objectives Using 320-Multidetector computed tomography (CT) and coronary angiography (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 tomography Angiography (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.Result CTA 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 degree 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 degree,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 fibrous-lip combine plaque for 33.6％ and lip plaque for 12.6％,and 76.2％ for unstable plaques and 81.5％ for stable plaques.Conclusion The non-calcified plaques are found In the near segment for 78.2％.Most of non-calcified Plaques are unstable plaques.The diagnostic accordance rate for coronary stenosis with non-calcified Plaques is higher than that with calcified plaques.320-Multidetector Coronary computed tomography is ascendent in diagnosis for the Coronary arteriosclerosis Plaque especially for non-calcified Plaque and Stenosis by Coronary probe technique and the Analysis software.
NETL
NSTL
维普
万方数据