冠状动脉CT成像与易损斑块

冠状动脉内斑块破裂或侵蚀所致的急性腔内血栓是急性冠状动脉综合征的主要原因。防止急性血栓形成成为了降低冠状动脉粥样硬化性心脏病病死率的唯一有效策略。斑块易破裂的冠状动脉病变与稳定斑块相比,存在不同的形态学改变。因此可以利用特殊的成像方法来识别这些易损斑块。亚毫米空间分辨率和图像质量优良的现代计算机断层扫描方法可以对冠状动脉斑块进行检测、分析和量化。斑块体积较大、低CT衰减、餐巾环征、正性重构以及点状钙化等与斑块容易破裂有密切关系。将冠状动脉斑块的形态学与功能特征等相结合,在未来有可能成为检测易损斑块的新方法。现将就多层螺旋CT与冠状动脉易损斑块的检测做一综述。

Coronary Computed Tomography Angiography and Vulnerable Plaque

Coronary plaque rupture or erosion induced acute thrombosis is a major cause of acute coronary syndrome. The only effective strategy which reduces mortality from coronary heart disease is to prevent acute thrombosis. Compared with stable plaques,vulnerable plaques have a distinct morphology. We can use special imaging methods to identify vulnerable plaques. Sub millimeter spatial resolution and high image quality of modern computer tomography（ CT） can be used in the detection,analysis and quantification of coronary artery plaques. Large plaque volume,low CT attenuation,napkin-ring sign,positive remodeling and punctate calcifications are associated with a high risk of plaque rupture. The coronary artery plaque morphology and function characteristics in combination,may be a new method for the detection of vulnerable plaque in the future. Detection based on multislice spiral CT and coronary vulnerable plaque are reviewed.