冠状动脉易损斑块MSCTA影像特征分析

Analysis of the characteristics of coronary vulnerable plaque MSCTA images

目的探讨冠状动脉易损斑块多层螺旋CT血管曲面重建（MSCTACPR）的影像学特征。方法收集唐山市中医医院2011年9月至2014年12月期间，因急性心肌梗死而行冠状动脉支架开通术的38例患者术前MSCTA影像资料，并对其导致急性心肌梗死的责任斑块的影像学特征进行回顾性分析。结果38例急性心肌梗死患者共确定38个易损斑块，其斑块中心CT值为（29．0＋8．5）HU，出现浅表斑点状钙化13例，斑块所致局部管腔中度狭窄18例、重度狭窄20例，但斑块周围均没有发现纤维帽样结构，对斑块内脂质成分及纤维成分亦很难做出可靠的鉴别。结论冠状动脉MSCTACPR技术能够较好地显示易损斑块的结构特征，并对其脱落风险进行评估，具备一定的应用价值。

Objective To investigate the characteristics of coronary artery plaque by MSCTA CPR images. Methods Focus on the collected MSCTA image data of 38 patients which underwent the operation of percutaneous coronary intervention during the period from 2011 September to 2014 December because of acute myocardial infarc- tion, and the characteristics of the plaque images which led to acute myocardial infarction were analyzed. Results In the 38 cases of acute myocardial infarction, a total of 38 vulnerable plaque were confirmed, and the plaque center CT value was （29.0-＋8.5）HU. Among them, there were 13 cases with superficial punctate calcification, 18 cases with the local lumen moderate stenosis, 20 cases with severe stenosis, but all of them were without the fi- brous cap like structure, it was difficult to identify the lipid composition and fiber composition in plaque. Conclu- sion Coronary artery MSCTA CPR technology can display the structure feature of vulnerable plaques well, and as- sess the risk of falling off. It has application value.