冠状动脉CT造影的管腔内衰减梯度在诊断不同类型斑块所致冠状动脉狭窄中的应用价值

Revolution CT in Evaluation on Correlation of The Coronary Plaque and Transluminal Attenuation Gradient in The Lumen of The Coronary Artery

目的探讨冠状动脉CT造影(CCTA)的管腔内衰减梯度(TAG)在诊断不同类型斑块所致冠状动脉狭窄中的应用价值。方法前瞻性收集2017年1月至2018年1月四川省自贡市第一人民医院收治的158例冠心病患者为研究对象,按照是否发生冠状动脉狭窄分为狭窄组(101例)与非狭窄组(57例),所有患者均行CCTA检查,比较两组的TAG值以及不同狭窄程度与不同斑块性质患者的TAG值。结果狭窄组冠状动脉TAG值低于非狭窄组,差异有统计学意义(P<0.05);非狭窄组与狭窄组左前降支(LAD)、左回旋支(LCX)、右冠状动脉(RCA)的TAG值比较,差异均有统计学意义(P<0.05);非狭窄组、轻度狭窄组、中度狭窄组、重度狭窄组的TAG值比较,差异有统计学意义(P<0.05);轻度狭窄组、中度狭窄组、重度狭窄组的TAG值比较,差异有统计学意义(P<0.05);轻度狭窄组与中度狭窄组的TAG值比较,差异无统计学意义(P>0.05);轻度狭窄组、中度狭窄组分别与重度狭窄组的TAG值比较,差异均有统计学意义(P<0.05);不同斑块性质所致冠状动脉轻度狭窄患者的TAG值比较,差异无统计学意义(P>0.05)。结论CCTA的TAG值在冠状动脉狭窄诊断中的应用价值较高,且可用于诊断不同类型斑块导致的冠状动脉狭窄。

Objective To investigate the correlation between intracavitary attenuation gradient(TAG)and different degrees of coronary stenosis caused by various plaques.Methods Prospectively collected 158 patients with coronary heart disease admitted to The First People`s Hospital of Zigong City from January 2017 to January 2018 as the research object.They were divided into stenosis group(101 patients)and non stenosis group(57 patients)according to whether coronary artery stenosis occurred.All patients underwent CCTA examination,and compared the TAG values of stenosis group and non stenosis group,as well as the TAG values of patients with different stenosis degrees and plaque properties.Results The TAG value of coronary artery in stenosis group was lower than that in non stenosis group(P<0.05);The TAG values of left anterior descending artery(LAD),left circumflex artery(LCX)and right coronary artery(RCA)in non stenosis group were significantly different from those in stenosis group(P<0.05);The TAG values of stenosis group,mild stenosis group,moderate stenosis group and severe stenosis group were statistically significant(P<0.05);The TAG values of mild stenosis group,moderate stenosis group and severe stenosis group were statistically significant(P<0.05);There was no significant difference in TAG between mild stenosis group and moderate stenosis group(P>0.05);The TAG values of mild stenosis group,moderate stenosis group and severe stenosis group were significantly different(P<0.05);The TAG values of patients with mild coronary stenosis caused by different plaque properties had no significant difference(P>0.05).Conclusion TAG value can be used to evaluate the hemodynamics of coronary artery,which is an excellent deal in clinical diagnosis of functional ischemia of coronary artery.