64层螺旋CT与血管内超声对冠状动脉斑块特征评价的对比研究

目的对比研究64层螺旋CT与血管内超声（IVUS）对冠状动脉斑块特征的评价价值。方法以我院收治的52例冠心病患者为研究对象，所有患者均行64层螺旋CT和IVUS检查。以IVUS检查结果为“金标准”，分析64层螺旋CT下显示冠状动脉粥样硬化斑块及检出冠状动脉狭窄的敏感性、特异性；对比分析64层螺旋CT与IVUS对斑块面积、斑块负荷（BP）、管腔面积的检测值；同时，对比分析纤维斑块、纤维脂质、钙化斑块三种类型斑块的CT值。结果64层螺旋CT显示冠状动脉斑块的敏感性为97．92％，特异性为91．30％；64层螺旋CT与IvUS对斑块面积、BP、管腔面积的检测值比较，差异均无统计学意义（P〉0．05）；64层螺旋CT显示冠状动脉狭窄的敏感性为92．73％，特异性为94．29％；钙化斑块的平均CT值均高于纤维斑块和纤维脂质（P〈0．05）。结论64层螺旋CT对冠状动脉斑块及冠状动脉狭窄的检出具有较高的敏感性和特异性，对斑块特征的分析与IVUS具有较高的一致性，尤其是能通过CT值区分斑块性质，可作为不稳定斑块筛查的有效、无创检查方案。

Objective to contrast research 64 layers spiral CT and intravascular ultrasound （IVUS） value to the evaluation of coronary artery plaque characteristics. Methods 52 cases of our hospital patients with coronary heart disease （CHD） was used as the re search object, all the patients were examined by 64 layer spiral CT and IVUS. The IVUS examination results was as the ＂gold standard＂ with, analysis of 64 layer spiral CT showed coronary atherosclerotic plaque and coronary stenosis, the sensitivity and specificity of detection. Comparative analysis of 64 layer of spiral CT with IVUS plaque area, plaque load （BP）, lumen area has values; At the same time, the contrast analysis of fiber patch, lipid, calcified plaque three types of CT values. Results 64 layers spiral CT shows that the sensitivity of the coronary artery plaque was 97.92%o, specificity of was 91.30% ; 64 layers spiral CT with IVUS of plaque area, BP, lumen area values comparison, there were no statistically significant difference （P〉0.05） ; 64 layers spiral CT shows that the sensitivity of the coronary artery stenosis was 92.73%, specificity was 94.29 %; Calcified plaques were higher than the average CT value fiber plaques and lipid （P〈0.05）. Conclusion 64 layer spiral CT on coronary artery plaque and coronary artery stenosis detection has higher sensitivity and specificity of the analysis of patch characteristics and IVUS has high consistency, especially by CT value to distinguish the nature of plaque, can be used as unstable plaque screening effective and noninvasive examination scheme.