急性冠状动脉综合征粥样硬化斑块的多层螺旋CT特征

Multislice CT characteristics of coronary atherosclerotic plaques in acute coronary syndrome

目的比较急性冠状动脉综合征（ACS）与稳定性心绞痛（SA）患者粥样硬化斑块的MSCT特征。方法搜集ACS和SA各27例的MSCT图像进行对照分析。结果ACS组和SA组正性重构的发生率（19／31和6／41）、点状钙化的发生率（10／34和3／48）、偏心性斑块的发生率（29／34和32／48）差异均有统计学意义（χ2值分别为16．95、8．00、3．62，P值分别为〈0．01、〈0．01、〈0．05）。ACS和SA组非钙化斑块的平均CT值[（35．0±15．1）和（67．5±26．5）HU]差异亦有统计学意义（t=4．82，P〈0．01）。结论ACS粥样硬化斑块的MSCT特征包括正性血管重构、低密度斑块、点状钙化和偏心性狭窄。

Objective To compare the plaque characteristics of acute coronary syndrome （ACS） and stable angina（SA） by multislice CT（MSCT）. Methods MSCT images of 27 patients with ACS and SA were compared. Results The frequency of positive vascular remodeling was significantly different in ACS （19/31） and SA （6/41, χ2 = 16.95, P 〈 0.01 ）, the frequency of spotty calcification was significantly higher in ACS （10/34） than in SA （ 3/48,χ2 = 8. 00, P 〈 0. 01 ）, the frequency of eccentric stenosis was significantly different in ACS （29/34） and SA （ 32/48, χ2 = 3.62, P 〈 0.05 ）. The mean CT value of noncalcified plaques in ACS [ （ 35.0 ± 15.1 ） HU ] was lower than in SA [ （ 67.5 ± 26. 5 ） HU （ t = 4. 82, P 〈 0. 01 ） ]. Conclusion The MSCT characteristics of atherosclerotic plaques in ACS include positive vascular remodeling,low plaque density, spotty calcification, and eccentric stenosis.