冠脈CT成像血管擴(kuò)張劑的規(guī)范化應(yīng)用及冠脈粥樣硬化斑塊的隨訪研究
本文選題:冠心病 切入點(diǎn):體層攝影術(shù) 出處:《山東大學(xué)》2012年碩士論文 論文類型:學(xué)位論文
【摘要】:研究一目的:探討研究血管擴(kuò)張劑對(duì)多層螺旋CT冠狀動(dòng)脈成像質(zhì)量及血管管腔的影響。方法:隨機(jī)選取200例在我院行64排螺旋CT冠狀動(dòng)脈成像的疑似冠心病患者,其中不使用硝酸甘油噴霧劑組(A組)和使用硝酸甘油噴霧劑組(B組)各100例,根據(jù)美國(guó)心臟病協(xié)會(huì)(AHA)的冠狀動(dòng)脈分段標(biāo)準(zhǔn)分別測(cè)量?jī)山M受檢者右冠狀動(dòng)脈(1、2、3段)、后降支(4段)、左主干(5段)、左前降支(6、7、8段)、左旋支(11、13段)各血管節(jié)段的管腔直徑,統(tǒng)計(jì)分析兩組冠狀動(dòng)脈各分支的成像質(zhì)量,并觀測(cè)B組使用硝酸甘油后的副作用出現(xiàn)率。結(jié)果:經(jīng)統(tǒng)計(jì)學(xué)分析,兩組間冠狀動(dòng)脈各主要血管節(jié)段管腔直徑及小分支顯示率的差異有統(tǒng)計(jì)學(xué)意義,B組明顯大于A組;兩組間副作用出現(xiàn)率無(wú)顯著差異。結(jié)論:使用硝酸甘油可明顯擴(kuò)張冠狀動(dòng)脈血管,提高冠狀動(dòng)脈分支的顯示,而副作用的出現(xiàn)率無(wú)顯著增高。 研究二目的:以選擇性冠狀動(dòng)脈造影(SCA)結(jié)果為標(biāo)準(zhǔn)評(píng)價(jià)血管擴(kuò)張劑對(duì)多層螺旋CT冠狀動(dòng)脈成像狹窄度評(píng)估準(zhǔn)確性的影響。方法:隨機(jī)選取2009年至2011年行MSCT冠狀動(dòng)脈檢查的冠心病患者150例,分為A組(不使用硝酸甘油,75例)和B組(使用硝酸甘油,75例),測(cè)量不同性質(zhì)斑塊處冠狀動(dòng)脈的狹窄程度,并分別與患者近期SCA檢查結(jié)果對(duì)比分析。結(jié)果:與SCA結(jié)果比較,對(duì)于非鈣化斑塊和以非鈣化成分為主的混合斑塊A組MSCT對(duì)狹窄程度有一定的低估,B組MSCT對(duì)狹窄程度有一定的高估,A、B組偏差分別約為-10.11%、+10.54%;對(duì)于鈣化斑塊和以鈣化成分為主的混合斑塊兩組MSCT對(duì)狹窄程度均有一定的高估,A、B組偏差分別約為+8.65%、+16.37%;兩組間的差異有統(tǒng)計(jì)學(xué)意義。A、B組MSCT與SCA測(cè)量結(jié)果間均有較好的相關(guān)性,兩組間相關(guān)系數(shù)的差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論:多層螺旋CT冠狀動(dòng)脈成像檢查中使用血管擴(kuò)張劑會(huì)對(duì)狹窄程度的評(píng)估偏高。 研究三目的:監(jiān)測(cè)冠心病患者經(jīng)內(nèi)科藥物治療后冠狀動(dòng)脈斑塊的變化,評(píng)價(jià)多層螺旋CT在冠狀動(dòng)脈粥樣斑塊隨訪中的應(yīng)用價(jià)值。方法:收集自2009年至2011年間冠脈斑塊陽(yáng)性、采用內(nèi)科保守治療、且行2次以上多層冠狀動(dòng)脈冠狀動(dòng)脈CTA檢查的患者,2次檢查間隔6~18個(gè)月,測(cè)量前后2次檢查非鈣化斑塊和以非鈣化成分為主的混合斑塊的體積變化并進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:患者前、后兩次檢查非鈣化斑塊及以非鈣化成分為主的混合斑塊總體積分別為1542.0mm3、1085.13mm3,經(jīng)內(nèi)科保守治療6~18個(gè)月后斑塊負(fù)荷降低,前后2次檢查問(wèn)的差異有統(tǒng)計(jì)學(xué)意義。結(jié)論:內(nèi)科藥物治療可有效控制冠心病患者病情的進(jìn)展,并可以降低冠狀動(dòng)脈非鈣化斑塊的負(fù)荷。64層螺旋CT在冠狀動(dòng)脈斑塊的隨訪中有重要的應(yīng)用價(jià)值。
[Abstract]:Objective: to investigate the effect of vasodilators on coronary artery imaging quality and vascular lumen in multi-slice spiral CT. Methods: 200 suspected coronary artery disease patients who underwent 64-slice spiral CT coronary angiography in our hospital were randomly selected. Of them, 100 cases were treated with nitroglycerin spray group (group A) and 100 cases with nitroglycerin spray group (group B). The lumen diameters of each segment were measured according to the AHA-American Heart Association (AHA) standard. The diameter of each segment was measured in two groups: right coronary artery, right coronary artery, posterior descending artery, left main trunk, left anterior descending branch, left anterior descending branch, left anterior descending branch, left anterior descending branch, left circumflex branch, and left circumflex branch, respectively, 3 segments of right coronary artery, 4 segments of posterior descending branch, 5 segments of left main trunk, 8 segments of left anterior descending branch, 1113 segment of left circumflex branch. The imaging quality of each branch of coronary artery in two groups was statistically analyzed, and the side effects of nitroglycerin in group B were observed. There were significant differences in lumen diameter and small branch display rate between the two groups. Group B was significantly larger than group A. Conclusion: nitroglycerin can significantly dilate coronary artery and improve the display of coronary artery branch, but the occurrence rate of side effect is not significantly increased. Objective: to evaluate the effect of vasodilators on the accuracy of coronary artery stenosis in multi-slice spiral CT angiography using selective coronary angiography (SCA) as a standard. Methods: MSCT corona was performed from 2009 to 2011 at random. 150 patients with coronary artery disease, Group A (75 cases without nitroglycerin) and group B (75 cases with nitroglycerin) were divided into two groups: coronary artery stenosis at different plaques was measured, and the results were compared with recent SCA findings. Results: the results were compared with those of SCA. For non-calcified plaques and mixed plaques with non-calcified components, MSCT had a certain degree of underestimation to the degree of stenosis. The deviation of MSCT in group B for the degree of stenosis was -10.11 and 10.54, respectively, for calcified plaques and calcified plaques. The deviation of MSCT in group B was about 8.65 and 16.37, respectively, and the difference between the two groups was statistically significant. There was a good correlation between the results of MSCT and SCA in group A and B. Conclusion: the use of vasodilators in multi-slice spiral CT coronary artery imaging can be used to evaluate the degree of stenosis. Objective: to monitor the changes of coronary plaque in patients with coronary artery disease after medical treatment, and to evaluate the value of multislice spiral CT in the follow-up of coronary atherosclerotic plaque. Methods: from 2009 to 2011, coronary plaque positive was collected. Patients who received conservative medical treatment and performed more than 2 multilayer coronary artery CTA examinations had an interval of 618 months. The volume changes of noncalcified plaques and mixed plaques with noncalcified components were measured and analyzed statistically. The total volume of noncalcified plaques and mixed plaques with noncalcified components were 1 542.0 mm 31085.13 mm 3 respectively. The plaque load decreased after 6 ~ 18 months of conservative treatment. Conclusion: medical treatment can effectively control the progress of coronary heart disease. It can reduce the load of coronary artery non-calcified plaque. 64 slice spiral CT has important application value in the follow-up of coronary artery plaque.
【學(xué)位授予單位】:山東大學(xué)
【學(xué)位級(jí)別】:碩士
【學(xué)位授予年份】:2012
【分類號(hào)】:R541.4;R816.2
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 黃小寧;李曉;鄧軍;左敏靜;劉貫清;彭碧波;;64層CT評(píng)價(jià)冠脈粥樣斑塊性質(zhì)與狹窄程度的相關(guān)性[J];放射學(xué)實(shí)踐;2011年04期
2 何珍;萬(wàn)業(yè)達(dá);付菲;張瑞祿;張琳;李寶玖;齊揚(yáng);;舌下含服硝酸甘油對(duì)冠狀動(dòng)脈CT成像質(zhì)量影響的研究[J];臨床放射學(xué)雜志;2006年08期
3 吳奇勇;王勇;錢農(nóng);童繼春;翟光地;袁衛(wèi)東;毛小亮;張明;張科;陳棟;朱征;;64排螺旋CT在冠狀動(dòng)脈旁路移植患者術(shù)后隨訪中的應(yīng)用價(jià)值[J];中國(guó)臨床醫(yī)學(xué);2010年06期
4 毛定飚,朱毅,滑炎卿,王鳴鵬,張國(guó)楨;冠狀動(dòng)脈CT成像與冠狀動(dòng)脈造影的比較研究[J];老年醫(yī)學(xué)與保健;2005年01期
5 王勝和;曲;;朱素娟;鄭司亮;張帥;;64層螺旋CT冠狀動(dòng)脈成像在冠狀動(dòng)脈支架置入術(shù)后隨訪中的價(jià)值研究[J];實(shí)用心腦肺血管病雜志;2011年02期
6 王麗;徐s,
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