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64排螺旋CT检测冠状动脉罪犯病变积分对急性冠脉综合征的诊断价值 被引量:5

Clinical value of coronary culprit lesion score determined by 64-slice spiral CT scanning in diagnosing acute coronary syndrome
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摘要 目的应用64排螺旋CT(64-SCT)检测冠状动脉罪犯病变指标,包括斑块类型、斑块衰减(PA)、重构指数(RI),并计算钙化积分(CS)及罪犯病变积分(CLS),探讨其对急性冠脉综合征(ACS)的诊断价值。方法 2009年1月至2010年12月对110例临床明确诊断冠心病(CAD)患者行64-SCT检查,其中ACS 43例,稳定型心绞痛(SAP)67例。测量患者冠状动脉罪犯病变指标,包括斑块类型、PA、RI,并计算CS及CLS。比较ACS和SAP两组患者上述指标的差别。结果 ACS组比SAP组拥有更多的点状钙化(92.30%比9.1%,P<0.05)、更低的PA(41.32±21.08比90.37±48.19,P<0.01)、更高的RI(1.29±0.42比0.89±0.45,P<0.01)、更低的CS(71.43±6.74比154.41±19.02,P<0.05)及更高的C15(1.15.41.12比1.06±0.63;P<0.01)。CLS>2.0可以区分ACS和SAP,其灵敏度和特异度分别为97.7%和67.3%。结论 CLS可用于区分ACS和SAP,对ACS的早期诊断具有一定价值。 Objective To evaluate the coronary culprit lesion indicators determined by 64-slice spiral CT scanning in diagnosing acute coronary syndrome (ACS). Methods During the period from Jan. 2009 to Dec. 2010, a total of 110 patients with clinically-proved coronary heart disease received 64-slice spiral CT scanning in authors' hospital. The diseases included ACS (n = 43) and stable angina pectoris (SAP, n = 67). The coronary culprit lesion indicators, including the plaque type, the plaque attenuation, the remodeling index, the calcium score and the culprit lesion score, were measured and calculated. Tile results were compared between ACS group and SAP group. Results The incidence of spotty calcification in ACS group was 92.30% which was significantly higher than that in SAP group (19.1%) with P 〈 0.05. The plaque attenuation in ACS group was 41.32± 21.08, which was significantly lower than that in SAP group (90.37 ± 48.19) with P 〈 0.01. The difference in remodeling index was statistically significant (P 〈 0.01 ) between ACS group (1.29± 0.42) and SAP group(0.89± 0.45). The calcium score of ACS group was 71.43 ± 6.74, which was much lower than that of SAP group (154.41± 19.02) with P 〈 0.05. The culprit lesion scores of ACS group and SAP group were 1.15 ± 1.12 and 1.06 ± 0.63, respectively, the difference between the two groups was statistically significant (P 〈 0.01 ). Taking culprit lesion score〉 2.0 as the reference standard, ACS could be distinguished from SAP, with the sensitivity and specificity being 97.7% and 67.3%, respectively. Conclusion The culprit lesion score can be used to distinguish ACS from SAP, which has a certain value in diagnosing early ACS. (J Intervent Radiol, 2012, 21: 456-460)
出处 《介入放射学杂志》 CSCD 北大核心 2012年第6期456-460,共5页 Journal of Interventional Radiology
基金 上海市卫生局科研基金资助项目(2009257)
关键词 急性冠脉综合征 罪犯病变 计算机体层成像 acute coronary syndrome culprit lesion computed tomography
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参考文献13

  • 1Ando H,Amano T,Matsubara T. Comparison of tissue characteristics between acute coronary syndrome and stable angina pectoris. An integrated backscatter intravascular ultrasound analysis of culprit and non-culprit lesions[J].Circulation,2011.383-390.
  • 2张勇,曹中朝,刘滨松.64排螺旋冠脉CT与冠脉造影在老年人冠心病中的诊断价值[J].慢性病学杂志,2010,12(9):996-996. 被引量:2
  • 3Task Force for the Diagnosis and Treatment of Non-ST-Segment Elevation Acute Coronary Syndromes of the European Society of Cardiology,Bassand JP,Hamm CW. Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronnary syndromes[J].European Heart Journal,2007.1598-1660.
  • 4Thygesen K,Alpert JS,White HD. Universal definition of myocardial infarction[J].Circulation,2007,(22):2634-2653.doi:10.1161/CIRCULATIONAHA.107.187397.
  • 5Ueda M. Clinical relevance of coronary artery calcification,as a risk factor for plaque rupture:viewpoint from pathology[J].Clin Calcium,2010.1656-1662.doi:10.1055/s-0028-1104533.
  • 6Hong YJ,Jeong MH,Choi YH. Differences in intravascular ultrasound findings in culprit lesions in infarct-related arteries between ST segment elevation myocardial infarction and non-ST segment elevation myocardial infarction[J].Journal of Cardiology,2010.15-22.
  • 7Dohi T,Miyauchi K,Okazaki S. Plaque regression determined by intravascular ultrasound predicts long-erm outcomes of patients with acute coronary syndrome[J].J Atheroscler Thromh,2011.231-239.
  • 8萧毅,弓静,田建明,李晓明,王敏杰,生晶,秦永文,何忆雯.64层螺旋CT冠状动脉造影评价冠状动脉支架再狭窄[J].介入放射学杂志,2007,16(5):312-315. 被引量:5
  • 9Pundziute G,Schuijf JD,Jukema JW. Evaluation of plaque ch aracteristics in acute coronary syndromes:non-invasive assessment with multi-slice computed tomography and invasive evaluation with intravascular ultrasound radiofrequency data analysis[J].European Heart Journal,2008.2373-2381.
  • 10Leber AW,Becker A,Knez A. Accuracy of 64-slice computed tomography to classify and quantify plaque volumes in the proximal coronary system:a comparative study using intravascular ultrasound[J].Journal of the American College of Cardiology,2006,(3):672-677.doi:10.1016/j.jacc.2005.10.058.

二级参考文献11

  • 1陈喜中.16层螺旋CT冠状动脉血管成像对冠心病的诊断价值[J].实用诊断与治疗杂志,2006,20(11):826-827. 被引量:4
  • 2顾建华,卢定友,孙维高,朱爱民,钱金娣.16层螺旋CT冠状动脉成像的技术与应用[J].医学影像学杂志,2006,16(10):1048-1051. 被引量:3
  • 3Raff GL,Gallagher MJ,O'Neill WW,et al.Diagnostic accuracy of noninvasive coronary angiography using 64-slice spiral computed tomography[J].J Am Coll Cardiol,2005,46:552 -557
  • 4Mollet NR,Cademartin F,Van Meigham CAG,et al.Highresolution spiral computed tomography coronary angiography in patients referred for diagnostic conventional coronary angiography[J].Circulation 2005,112:2318-2323.
  • 5Kitagawa T,Fujii T,Tomohiro Y,et al.Noninvasive assessment of coronary stents in patients by 16-slice computed tomography[J].Int J Cardiol,2006,109:188-194.
  • 6Kefer JM,Coche E,Vanoverschelde JL,et al.Diagnostic accuracy of 16-slice multidetector-row CT for detection of in-stent restenosis vs detection of stenosis in nonstented coronary arteries[J].Eur Radiol,2007,17:87-96.
  • 7Oncel D,Oncel G,Karaca M.Coronary stent patency and instent restenosis:determination with 64-section multidetector CT coronary angiography-initial experience[J].Radiology,2007,242:403-409.
  • 8Rixe J,Achenbach S,Ropers D,et al.Assessment of coronary artery stent restenosis by 64-slice multi-detector computed tomography[J].Eur Heart J,2006,21:2567-2572.
  • 9Ehara M,Kawai M,Surmely JF,et al.Diagnostic Accuracy of Coronary In-Stent Restenosis Using 64-Slice Computed Tomography[J].J Am Coll Cardiol,2007,49:951-959.
  • 10李伟,罗学毛,兰勇,龙晚生.64排螺旋CT冠脉成像技术与常规冠脉造影对比研究[J].海南医学院学报,2008,14(2):162-165. 被引量:18

共引文献5

同被引文献40

  • 1蒋连保,谢荣秋.阿司匹林+辛伐他汀对急性冠脉综合征中高敏性C-反应蛋白的影响及其意义[J].中国实用医药,2007,2(2):67-69. 被引量:5
  • 2无.慢性稳定性心绞痛诊断与治疗指南[J].中华心血管病杂志,2007,35(3):195-206. 被引量:2072
  • 3Ando H,Amano T,Matsubara T,et al.Comparison of tissue characteristics between acute coronary syndrome and stable angina pectoris.An integrated backscatter intravascular ultrasound analysis of culprit and non-culprit lesions[J].Circ J,2011,75:383-390.
  • 4Makaryus AN,Henry S,Loewinger L,et al.Multi-detector coronary CT imaging for the identification of coronary artery stenoses in a“Real-World”population[J].Clin Med Insights Cardiol,2015,8:S13-S22.
  • 5Naghavi M,Libby P,Falk E,et al.From vulnerable plaque to vulnerable patient:a call for new definitions and risk assessment strategies:Part I[J].Circulation,2003,108:1664-1672.
  • 6Hammer-Hansen S,Kofoed KF,Kelbaek H,et al.Volumetric evaluation of coronary plaque in patients presenting with acute myocardial infarction or stable angina pectoris-a multislice computerized tomography study[J].Am Heart J,2009,157:481-487.
  • 7Sato A,Ohiqashi H,Nozato T,et al.Coronary artery spatial distribution,morphology,and composition of nonculprit coronary plaque by 64-slice computed tomographic angiography in patients with acute myocardial infarction[J].Am J Cardiol,2010,105:930-935.
  • 8Hoffmann U,Moselewski F,Nieman K,et al.Noninvasive assessment of plaque morphology and composition in culprit and stable lesions in acute coronary syndrome and stable lesions in stable angina by muhideteetor computed tomography[J].J Am Coil Cardiol,2006,47:1655-1662.
  • 9Burke AP, Farb A, Malcom GT, et al. Coronary risk factors and plaque morphology in men with coronary disease who died suddenly [J]. N Engl J Med 1997,336:1276-1282.
  • 10Nagbavi M, Libby P, Falk E, et al. From vulnerable plaque to vulner- able patient: a call for new definitions and risk assessment strate- gies : part I[ J ]. Circulation ,2003,108 : 1664-1672.

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