冠状动脉磁共振血管成像和CT对可疑冠心病患者心脏事件的预测价值对比观察

Comparative observation on the predictive value of coronary artery magnetic resonance angiography and CT for cardiac events in suspected coronary heart disease patients

目的 探讨比较冠状动脉磁共振血管成像(CMR)和电子计算机断层扫描(CT)对可疑冠心病患者心脏事件的预测价值。方法 选取106例可疑冠心病患者作为研究对象,根据预后结果分为不良事件组(26例)和非不良事件组(80例)。两组患者均进行CMR与CT检查。对比两组CMR右冠状动脉血管长度与内径, CT斑块特征。结果 CMR显示,不良事件组的右冠状动脉血管长度(81.12±2.18)mm和内径(2.96±0.23)mm均显著小于非不良事件组的(84.36±3.29)、(3.45±0.69)mm,存在显著差异(P<0.05)。在CT成像方面,不良事件组的斑块率为69.23%(18/26),其中钙化斑块3例(11.54%)、纤维斑块10例(38.46%)、混合斑块5例(19.23%);非不良事件组的斑块率为26.25%(21/80),其中钙化斑块13例(16.25%)、纤维斑块3例(3.75%)、混合斑块5例(6.25%);不良事件组与非不良事件组的斑块率、斑块性质存在显著差异(P<0.05);两组的斑块位置对比无统计学差异(P>0.05)。结论 CMR在评估心肌结构和功能以及检测微循环异常和冠状动脉痉挛方面表现出色,对于不耐受辐射暴露或对对比剂过敏的患者来说更为安全。CT在直接评估冠状动脉的解剖结构和疾病程度方面表现出色,是了解冠心病严重程度的有力工具。

Objective To explore the predictive value of coronary artery magnetic resonance angiography(CMR)and computed tomography(CT)for cardiac events in suspected coronary heart disease patients.Methods 106 patients with suspected coronary heart disease were selected as the research subjects.They were divided into adverse event group(26 cases)and non-adverse event group(80 cases)according to their prognosis.CMR and 64-slice spiral CT were performed in both groups.The vessel length and inner diameter of right coronary artery and CT plaque characteristics in CMR were compared between the two groups.Results CMR showed that the vessel length and internal diameter of right coronary artery were(81.12±2.18)and(2.96±0.23)mm in the adverse event group,which were significantly smaller than(84.36±3.29)and(3.45±0.69)mm of the non-adverse event group,and there was significant difference(P<0.05).On CT imaging,the plaque rate in the adverse event group was 69.23%(18/26),with 3 calcified plaques(11.54%),10 fibrous plaques(38.46%),and 5 mixed plaques(19.23%);and in the non-adverse event group,the plaque rate was 26.25%(21/80),with 13 calcified plaques(16.25%),3 fibrous plaques(3.75%),and 5 mixed plaques(6.25%).There were significant differences in plaque rate and plaque properties between adverse event group and non-adverse event group(P<0.05).There was no significant difference in plaque location between the two groups(P>0.05).Conclusion CMR performs well in evaluating myocardial structure and function,as well as detecting microcirculation abnormalities and coronary spasm,making it safer for patients who are intolerant to radiation exposure or allergic to contrast agents.CT performs well in directly assessing the anatomical structure and disease severity of coronary arteries,and is a powerful tool for understanding the severity of coronary heart disease.