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)