双源CTA评价非ST段抬高型急性冠脉综合征

目的:探讨双源CT血管成像(DSCTA)评价非ST段抬高型急性冠脉综合征(NSTE-ACS)的价值.方法:搜集临床疑似NSTE ASC且经DSCTA判断为左冠状动脉前降支管腔临界狭窄(狭窄程度为50％～70％)的患者57例,1周内行冠脉造影(CAG)证实狭窄程度,并行导管法测量血流储备分数(FFR),以FFR 0.80为临界值将57例患者分为A组(FFR＜0.80)和B组(FFR≥0.80),测量左室前壁、侧壁心肌、左心室腔CT值及舒张末期、收缩末期节段室壁厚度,比较两组间前壁与侧壁相对CT值、舒张末期心肌厚度及室壁增厚率.结果:A、B两组前壁与侧壁心肌相对CT值及舒张末期心肌厚度差异均有统计学意义(P＜0.05),A组前壁与侧壁室壁增厚率差异有统计学意义(P＜0.05),B组前壁与侧壁室壁增厚率差异无统计学意义(P＞0.05);前壁心肌相对CT值及室壁增厚率A、B两组间差异有统计学意义(P＜0.05),而舒张末期心肌厚度A、B两组间差异无统计学意义(P＞0.05).结论:DSCTA评价左冠状动脉前降支管腔临界狭窄联合节段心肌CT值、舒张末期心肌厚度及室壁增厚率分析,可为NSTE-ACS的诊断及治疗提供依据.

Study of non-ST-elevation acute coronary syndrome with dual-source CT angiography

Objective:To study the value of dual-source CT angiography (DSCTA) in the evaluation of non-ST-elevation acute coronary syndrome (NSTE-ACS).Methods:57 cases with clinically suspected NSTE-ACS were recruited,which were diagnosed as critical stenosis in the left coronary anterior descending branch (LCAD) by DSCTA,with the degree of stenosis as 50 ％ ～ 70 ％,then were proven by coronary artery angiography (CAG) within one week.Fractional flow reserve (FFR) was measured.Taking FFR 0.8 as threshold,these 57 cases were divided into Group A (FFR＜0.80) and Group B (FFR≥0.80).The CT value of ventricular myocardium in anterior wall,lateral wall and left ventricular cavity as well as the ventricular wall thickness at end systolic and end diastolic phases were measured.The relative CT value of anterior wall and lateral wall,ratio of the myocardium thickness in end diastolic phase and end systolic phase of the 2 groups were compared.Results:In group A and B,significant statistic difference was existed in the relative CT value of the myocardium of anterior and lateral ventricular wall as well as the myocardium thickness (P＜0.05).There was significant difference in the ratio be tween the thickening of anterior and lateral ventricular wall in Group A (P＜0.05),yet there was no statistic difference in group B (P＞0.05).Of the relative CT value and thickening of ventricular wall,statistic difference was existed between Group A and Group B (P＜0.05),yet no statistic difference was existed in the myocardium thickness in end diastolic phase between Group A and B (P＞0.05).Conclusion:Evaluation of LCAD stenosis in combination with segmental CT value of myocardium,myocardial thickness and wall thickening rate by using DSCTA can provide helpful information for the diagnosis and treatment of NSTE-ACS.