【摘要】 目的:探讨在双源CTA检查中冠状动脉粥样硬化易损斑块和稳定斑块各组份构成比方面的差异,提高对易损斑块的认识。方法:回顾性分析53例行双源CT冠状动脉成像和血管造影(CAG)检查的急性冠脉综合征(ACS)和稳定型心绞痛(SAP)患者的病例资料,分别测量ACS患者罪犯病变处斑块(易损斑块)、稳定斑块及SAP患者稳定斑块的体积,分析比较这3组病变的斑块负荷量;测量3组病变斑块内脂质和钙化成份的体积,并分析其构成比。所有数据采用SPSS 17.0软件进行统计学分析。结果:罪犯病变处的斑块负荷量明显高于稳定性病变处(P<0.05),3组分别为50.45%±10.03%、36.35%±11.17%、42.39%±11.77%。易损斑块组的脂质含量明显高于2组稳定斑块,三者的脂质含量百分比分别为43.82%±14.74%、14.65%±13.11%和14.47%±11.85%,差异有统计学意义(P<0.05);易损斑块钙化所占百分比明显低于稳定斑块,三组分别为23.21%±16.80%、57.68%±26.78%和60.74%±25.74%(P<0.05)。两组稳定斑块之间的脂质和钙化百分比差异无统计学意义(P=0.958)。根据斑块内脂质(>31.5%)和钙化百分比(<41%)诊断易损斑块的敏感度、特异度、阳性预测值(PPV)和阴性预测值(NPV)分别为89.5%、87.0%、79.1%和93.8%。结论:双源CT冠状动脉血管成像可作为冠状动脉粥样硬化易损斑块的有效检测方法。更多还原

【Abstract】 Objective:To quantitatively evaluate the difference of unstable and stable plaques on constituent ratio of their composition with dual-source CT angiography.Methods:The CCTA images of 53 patients with acute coronary syndrome(CAS,n=35) or stable angina pectoris(SAP,n=18) were studied retrospectively.Only DSCT datasets with good or excellent image quality were considered for analysis.Plaque burden and the relative volume of plaque components were measured.Results The plaque burden was significant larger in unstable lesions than stable ones(50.45%±10.03%,36.35%±11.17% and 42.39%±11.77%,P<0.05).Unstable plaques showed higher percentage of lipid(43.82%±14.74%,14.65%±13.11% and 14.47%±11.85%) and lower percentage of calcification(23.21%±16.80%,57.68%±26.78% and 60.74%±25.74%) as regard to stable ones with statistical difference(P<0.05).The sensitivity,specificity,PPV and NPV were 89.5%,87.0%.79.1% and 93.8% for DSCT to detect vulnerable plaques.Conclusion:DSCT angiography can be used to detect vulnerable plaques.There was high incidence for the plaques which contained more than 31.5% of lipid could cause ACS.更多还原