摘要
目的探讨CT血管造影(CTA)应用于冠状动脉临界病变的诊断效能。方法对83例存在冠脉临界病变患者临床资料进行回顾性分析,分别以冠状动脉血管造影(CAG)、血管内超声(IVUS)检查结果为"金标准",观察CTA对其狭窄程度、斑块性质的诊断效能,比较CTA与CAG下临界病变血管病理参数[外弹力膜(EEM)面积、最小管腔面积(MLA)、斑块面积(PA)、斑块负荷(PB)、斑块偏心指数(EI)、重构指数(RI)]差异。结果 83例患者经CAG确诊临界病变血管97段,CTA准确诊断出80段,其余10段高估为重度狭窄,5段低估为轻度狭窄,2段漏诊;经IVUS确诊钙化斑块35枚、纤维斑块36枚、脂质斑块26枚,CTA诊断出钙化斑块37枚、纤维斑块37枚、脂质斑块23枚,无漏诊情况,诊断准确率为79.38%(77/97)。CTA与CAG下EEM面积、MLA、PA、PB、EI、RI水平比较均无统计学意义(P>0.05)。结论冠脉CTA诊断临界病变准确性较为突出,能在早期定性或定量分析其狭窄程度、斑块性质,为临床病情判定与预后评估提供参考。
Objective To explore the diagnostic efficacy of CT angiography (CTA) on coronary intermediate lesions.Methods The clinical data of 83 patients with coronary intermediate lesions were retrospectively analyzed.The examination results of coronary angiography (CAG) and intravascular ultrasound (IVUS) were regarded as gold standards.Diagnostic efficacy of CTA on stenosis degree and plaque properties were observed,and the vessel pathological parameters of intermediate lesions [external elastic membrane (EEM) area,minimum lumen area (MLA),plaque area (PA),plaque burden (PB),plaque eccentricity index (EI),reconstruction index (RI)] were compared under CTA and CAG.Results Among 83 patients,97 segments of intermediate lesions were accurately diagnosed by CAG and 80 segments were accurately diagnosed by CTA,and the remaining 10 segments were overestimated as severe stenosis,and 5 segments were underestimated as mild stenosis,and 2 segments were missed diagnosis.There were 35 calcified plaques,36 fibrous plaques and 26 lipid plaques diagnosed by IVUS,and there were 37 calcified plaques,37 fibrous plaques and 23 lipid plaques diagnosed by CTA,and there was no missed diagnosis,and the diagnostic accuracy rate was 79.38% (77/97).There were no significant differences in the EEM area,MLA,PA,PB,EI and RI between CTA and CAG (P>0.05).Conclusion Coronary CTA has prominent accuracy in the diagnosis of intermediate lesions,and it can qualitatively or quantitatively analyze the stenosis degree and plaque properties in early stage,and provide reference for clinical disease judgment and prognosis evaluation.
作者
陈豫
魏艳磊
王泽尉
李键
CHEN Yu;WEI Yan-lei;WANG Ze-wei(Department of Radiology,Beijing Daxing Hospital of Integrated Chinese and Western Medicine,Beijing 100076,China)
出处
《中国CT和MRI杂志》
2020年第9期90-92,共3页
Chinese Journal of CT and MRI
关键词
冠状动脉
CT血管造影
临界病变
狭窄程度
斑块性质
Coronary Artery
CT Angiography
Intermediate Lesions
Stenosis Degree
Plaque Properties
