冠状动脉分叉病变的CT分型

Typing of Coronary Bifurcation Lesions by CT

目的:应用多排螺旋CT(MDCT)确定冠状动脉分叉病变的类型。方法:利用MDCT对分叉病变分叉远端(分叉嵴平面)和分叉近端(分支入口平面)定性、定量分析,研究MDCT下冠状动脉分叉病变的斑块分布特点,提出分叉病变的CT分型。结果:MDCT对分叉近端和远端斑块定性分析无明显区别;分叉两侧外弹力膜面积(16.48±4.51mm2,12.12±3.84mm2,P=0.000)、参照血管外弹力膜面积(15.75±4.30mm2,12.71±4.02mm2,P=0.003)、偏心指数(1.24±0.50,4.61±2.06,P=0.000)、斑块分布弧度(352.42±16.52,228.40±36.90,P=0.000)、重塑指数(1.05±0.05,0.95±0.04,P=0.000)有明显区别;CT下分叉病变可以分为6种类型。结论:MDCT下分叉病变可以分为6种类型,对指导介入治疗策略的选择具有指导意义。

Objective To investigate typing of coronary bifurcation lesions by MDCT.Methods Thirty-five coronary bifurcation lesions were enrolled in our study.We performed qualitive and quantitative analysis in proximal plane and distal plane of bifurcation lesions.We drawed new typing of coronary bifurcation lesions by MDCT.Results There was no difference in quantitative analysis of proximal plane and distal plane.There was significant different in lesion EEM-CSA（16.48±4.51 mm2,12.12±3.84 mm2,P=0.000）,reference EEM-CSA（15.75±4.30 mm2,12.71±4.02 mm2,P=0.003）,eccentric index（1.24±0.50,4.61±2.06,P=0.000）,plaque arc（352.42±16.52,228.40±36.90,P=0.000） and remodeling index（1.05±0.05,0.95±0.04,P=0.000）.There were six types in coronary bifurcation lesions by MDCT.Conclusions There were six types in coronary bifurcation lesions by MDCT.The typing of coronary bifurcation lesions by MDCT contributed to choose suitable strategy in intervention operation.