本文選題：冠狀動脈臨界病變　切入點：雙源螺旋CT　出處：《中國醫(yī)學(xué)計算機成像雜志》2017年03期 　論文類型：期刊論文

【摘要】：目的:以血管內(nèi)超聲(IVUS)為金標準,判斷雙源螺旋CT冠狀動脈CT血管造影(DSCTA)對臨界病變的斑塊定量及斑塊穩(wěn)定性評估的價值。方法:回顧性分析經(jīng)冠狀動脈造影(CAG)證實的臨界病變62例(83個部位),男性25人,女性37人,均于來院后先行DSCTA后1~2周內(nèi)做CAG及IVUS檢查。在DSCTA和IVUS圖像上分別測量臨界病變血管外膜內(nèi)面積(EEMCSA)、最小管腔面積(MLA)、斑塊面積(PA)、斑塊負荷(PB)、面積狹窄率及血管重構(gòu)指數(shù)(RI),并進行相關(guān)性分析;進一步以IVUS為金標準,判斷DSCTA診斷易損斑塊的敏感性、特異性、陽性預(yù)測值、陰性預(yù)測值及準確性。結(jié)果:以IVUS為金標準,DSCTA對冠脈臨界病變的管腔狹窄率判斷無明顯統(tǒng)計學(xué)差異,EEMCSA、MLA、PA、PB及RI測量結(jié)果無明顯差異,且相關(guān)性好,但DSCTA對EEMCSA、MLA、PA、PB及RI指標均有低估傾向。83個臨界病變中,DSCTA診斷易損斑塊的敏感性、特異性、陽性預(yù)測值、陰性預(yù)測值及準確性分別為72.92%、74.29%、79.55%、66.67%及73.49%。結(jié)論:以IVUS為金標準,DSCTA可以對冠脈臨界性病變進行較準確的定量和定性診斷。
[Abstract]:Objective: to use intravascular ultrasound (IVUS) as the gold standard. To evaluate the value of dual-source spiral CT coronary angiography (DSCTAs) in evaluating the plaque quantity and plaque stability in patients with critical lesions. Methods: 62 cases (83 sites, 25 males) with critical lesions confirmed by coronary angiography (CAG) were retrospectively analyzed. 37 women, CAG and IVUS were performed within 1 and 2 weeks after admission to hospital. The CAG and IVUS were measured on the DSCTA and IVUS images respectively. The minimum lumen area (MLAA), plaque area (PAA), plaque load, area stenosis rate and vascular remodeling finger were measured on DSCTA and IVUS images, respectively. The correlation analysis was carried out. Furthermore, the sensitivity, specificity and positive predictive value of DSCTA in the diagnosis of vulnerable plaque were determined by IVUS as the gold standard. Results: there was no significant difference between IVUS and RI in judging the stenosis rate of critical coronary artery lesions. There was no significant difference in the results of EEMCSAA MLAA PAPB and RI, and the correlation was good. The sensitivity, specificity and positive predictive value of DSCTA in the diagnosis of vulnerable plaques in 83 critical lesions were significantly lower than those in the control group, but there was a tendency to underestimate the indexes of PAPB and RI in EEMCSAN MLAA. The negative predictive value and accuracy were 72.92% and 79.55%, respectively. Conclusion: using IVUS as the gold standard, DSCTA can be used for accurate quantitative and qualitative diagnosis of coronary critical lesions.
【作者單位】： 上海交通大學(xué)醫(yī)學(xué)院附屬仁濟醫(yī)院放射科;上海市浦東新區(qū)周浦醫(yī)院放射科;
【分類號】：R543.3;R816.2

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