冠状动脉粥样斑块的16层CT成像研究

目的评价冠状动脉粥样斑块的形态特征及其与冠状动脉狭窄的关系。方法对126例拟诊为冠心病的患者行16层CT冠状动脉成像检查，记录斑块数目，目测斑块的密度，测量病变处冠状动脉狭窄程度，分析不同类型斑块的特征及其与冠状动脉狭窄的关系。结果检出57例患者存在111处冠状动脉粥样斑块，其中31例为多发冠状动脉粥样斑块。钙化斑块79处，20处伴冠状动脉狭窄≥50％；软斑块13处，10处伴冠状动脉狭窄≥50％；混合斑块19处，15处伴冠状动脉狭窄≥50％。软斑块及混合斑块伴冠状动脉狭窄≥50％的比例明显高于钙化斑块（均P〈O05）。结论16层CT能同时检出多支冠状动脉病变，尤其是无狭窄的斑块，并发现冠心病患者常存在多发冠状动脉粥样斑块；采用目测斑块密度的方法，16层CT还可以方便的对冠状动脉粥样斑块进行初步分类，发现冠心病患者冠状动脉粥样斑块以钙化斑块居多，但软斑块及混合斑块也较常见，并与冠状动脉狭窄密切相关。

Investigation of coronary plaque with sixteen-slice spiral CT

Objective To investigate the characteristics of coronary plaque and its relation to coronary stenosis. Methods Coronary angiography with 16-slice spiral CT was performed in 126 patients with suspected coronary heart disease. Number of coronary plaques were observed and classified based on the visual inspection. Coronary stenosis was measured quantitatively by selective coronary angiography. The relation between various type of coronary plaque and coronary stenosis were analyzed. Results In total 57 cases, 79 calcific plaques, 13 soft plaques and 19 mixed plaques were found. The coronary stenosis 〉150% was demonstrated in 20 calcific plaques, 10 soft plaques and 15 mixed plaques, respectively. The ratio of coronary stenosis ≥50% in the soft plaque group and mixed plaque groups were significant higher than that in calcific plaque group. Conclusion Multiple coronary arteries disease, especially the plaque with no coronary stenosis can be demonstrated on 16-slice spiral CT angiography. Calcific plaque was the most common one in coronary heart disease; meanwhile soft plaque and mixed plaque were significantly correlated with coronary stenosis.