冠脉造影轻度病变的血管内超声研究

Intravascular ultrasound study of angiographically mildly diseased coronary arteries

目的 评价血管内超声 (IVUS)对冠脉造影提示冠状动脉轻度狭窄病变的诊断价值。方法 对经冠脉造影发现冠状动脉存在轻度狭窄的 17例患者 6 2处病变进行IVUS检查 ,通过IVUS检查了解病变斑块性质与特征及计算病变血管最大狭窄程度 ,并对这两种检查结果进行比较。结果 CAG检测发现偏心性狭窄 2 4处 ,向心性狭窄 34处 ;IVUS检测发现偏心性斑块 4 8处 ,向心性斑块 13处。CAG不能显示管腔形态及斑块特点 ,而IVUS能清楚显示。病变最窄处血管面积狭窄率IVUS所测值显著高于CAG ,分别为 (4 6± 2 1) %与 (14± 2 2 ) % ,两者比较差异显著 (P <0 .0 5 )。结论 对于CAG显示的轻度狭窄病变 ,IVUS能更准确地判定管腔形态、病变性质及狭窄程度。

Objective To assess the value of intravascular ultrasound in identifying coronary artery narrowing in angiographically mildly diseased coronary arteries.Methods Sixty-two coronary artery segments with mildly stenoses found by coronary artery angiography (CAG) in 17 patients were measured by intravascular ultrasound (IVUS).We analyzed the characteristics of the plaques by IVUS.The stenostic morphology and the severity of mildly stenoses in two techniques were compared.Results Essentric stenosis in 24 arteries,concentric in 34 ones were found by CAG and 48 essentric plaques and 13 concentric were demonstrated in IVUS.The lumen morphology and plaque characteristics could not be found in CAG,but there could be revealed very well by IVUS.There were significant differences in the parameters of the area stenosis rate of injured vessels between CAG and IVUS.The values of IVUS were higher than those of CAG (46±21)% vs(14±22)%,(P<0.05).Conclusions IVUS is able to accurately identify the lumen morphology and the plaque characteristics and the stenostic severity of angiographically mildly diseased coronary arteries.