16层螺旋CT对冠状动脉粥样斑块的研究

目的探讨16层螺旋CT对冠状动脉斑块诊断的价值。方法35例临床诊断为冠心病患者按危险度分为2组:急性冠状动脉综合征(ACS)组(包括急性心肌梗塞,不稳定型心绞痛)和稳定型心绞痛组。行16层螺旋CT冠状动脉成像及图像后处理,对检出的斑块进行定性分析,并对各种性质斑块所引起的管腔狭窄程度进行分析。结果35例中,ACS组27例,软斑块19个,中间斑块11个,钙化斑块7个;8例稳定型心绞痛组中软斑块3个,中间斑块3个,钙化斑块11个,经统计学卡方检验P<0.05有统计学意义,表明中间斑块和软斑块(尤其是软斑块)与冠心病危险性程度成显著的正相关;非钙化斑块导致管腔狭窄程度:轻度狭窄8处,中度狭窄9处,重度狭窄22处,而钙化斑块:轻度狭窄10处,中度狭窄5处,重度狭窄5处,经统计学卡方检验P<0.05有统计学意义,表明不同性质斑块与其导致管腔狭窄间有显著差别。结论16层螺旋CT冠状动脉造影成像是一种有效、无创、简便、优良的诊断方法,可作为诊断冠心病的可靠手段用于临床。

The Study of 16 -slice Spiral CT for Coronary Artery Atherosclerotic Plaque

Objective To study the diagnostic value of coronary disease with 16-slice spiral CT.Methods 35 patients with coronary heart disease(CHD) were divided into two groups according to the risk rate of CHD:group 1 with acute coronary artery syndrome(ACS)(including acute myocardial infarction,AMI;unstable angina,UA);group 2 with stable angina(SA).They were studied by 16-slice spiral CT(retrospectively ECG-gating,0.5 s ratation),the images were reconstructed by survey methods to display the coronary artery atherosclerosis plaques,then to evaluate the nature of plaques by detecting CT value of plaque(using the standard of the CT value of the coronary artery atherosclerosis plaque of Schroeder)and to analyze the degree of the stenosis of coronary artery caused by the different type of plaque.Results There were 19 soft plaqes,11 middle plaques and 7 calcification plaques in ACS group;3 soft plaqes,3 middle plaques and 11 calcification plaques in SA group.There was a positive relation between soft plaqes and middle plaques with the risk rate of CHD,especially soft plaque(P<0.05);There were 8 slight stenosis,9 middle stenosis and 22 severe stenosis in group 1 which caused by non-calcification plaques,and there were 10 slight stenosis,5 middle stenosis and 5 severe stenosis in group 2 which caused by calcification plaques.So threre was significant difference between two groups(P<0.05),the degree of the stenosis caused by non-calcification plaques were more higher than by calcification plaques.Conclusion 16-slice spiral CT coronary angiography is an effective,noninvasive and simple imaging technique with high quality and it should be used as a reliable examination of CHD in clinical practice.