北京生物醫(yī)學(xué)工程

血管疾病的超聲影像學(xué)研究血管內(nèi)超聲與64排螺旋CT分析冠狀動(dòng)脈斑塊的對(duì)比研究

Assessment of Coronary Atherosclerotic Plaques Using Intravascular Ultrasound:Comparison with 64-Slice Computed Tomography

作者：楊婭王艷紅李治安孫軍燕張兆琪趙迎新周玉杰謝謹(jǐn)捷張小杉

單位：首都醫(yī)科大學(xué)附屬北京安貞醫(yī)院(北京100029)

關(guān)鍵詞：冠狀動(dòng)脈粥樣硬化斑塊；血管內(nèi)超聲；64排螺旋CT

分類號(hào)：

出版年·卷·期（頁碼）：2010·29·6（561-565）

摘要：

目的對(duì)冠狀動(dòng)脈病變患者進(jìn)行血管內(nèi)超聲（IVUS）和64排螺旋CT（64MDCT）檢查,評(píng)價(jià)兩種檢查手段在冠狀動(dòng)脈病變診斷中的應(yīng)用價(jià)值。方法 24例臨床懷疑或診斷為冠心病的患者接受冠狀動(dòng)脈64MDCT檢查，并應(yīng)用其工作站相關(guān)后處理技術(shù)對(duì)冠狀動(dòng)脈粥樣斑塊進(jìn)行評(píng)估分析。一周內(nèi)實(shí)施冠狀動(dòng)脈內(nèi)IVUS檢查，對(duì)冠狀動(dòng)脈病變進(jìn)行定性和定量分析。結(jié)果分析病變血管52支，其中左主干24支，前降支21支，左回旋5支，右冠狀動(dòng)脈2支。IVUS顯示有斑塊病變的血管段為60段，64MDCT顯示有斑塊病變的血管樣本57段，其中3段病變64MDCT診斷正常而IVUS顯示為斑塊早期病變。64MDCT對(duì)出現(xiàn)任何粥樣硬化斑塊節(jié)段診斷的敏感性為96%，特異性為94.7%。IVUS與64MDCT的管腔面積，外彈力膜面積、斑塊面積的相關(guān)系數(shù)r分別為0.79、0.83、0.81。結(jié)論 IVUS能準(zhǔn)確判斷冠狀動(dòng)脈斑塊的大小和性質(zhì)。64MDCT作為非侵入性方法亦能顯示管壁斑塊的構(gòu)成，判斷病變的類型及程度，具有一定的敏感性和準(zhǔn)確率。

Objective The purpose of this study was to compare the accuracy of 64-slice CT (64-MDCT) with that of intravascular ultrasound (IVUS) for the identification and quantitative analysis to coronary atherosclerotic plaques.Materials and Methods A total of 24 patients with suspected coronary atherosclerotic disease (CAD) were studied using contrast-enhanced 64-MDCT and IVUS within 1 week.The morphology，classification，and quantitative analysis of atherosclerotic plaques were compared between 64-MDCT and IVUS.Results Fifty two arteries satisfied with the diagnosis of atherosclerosis，24 LM(left main coronary artery)，21 LAD(left anterior descending coronary artery)，5 LCX(left circumflex coronary artery) and 2 RCA(right coronary artery) were included.Sixty segments with coronary atherosclerotic plaques were imaged and analyzed by IVUS and 57 segments by 64-MDCT.It was 3 segments were diagnosed differently by IVUS and 64-MDCT，which were early atherosclerotic plaques by IVUS while normal by 64-MDCT.It was indicated that the sensitivity and specificity of 64-MDCT to value coronary artery atherosclerotic plaque were 96% and 94.7%.The correlation coefficients between IVUS and 64-MDCT for determining vascular CSA，lumen CSA，and plaque burden were 0.85，0.82 and 0.77，respectively (P<0.01).Conclusions IVUS can identify the size and character of atherosclerotic plaques and also analyze quantitatively.64-MDCT is a noninvasive way to estimate the plaques and also has well sensibility and specificity.

參考文獻(xiàn)：

［1］Maintz D，Ozgun M，Hoffmeier A，et al.Selective coronary artery plaque visualization and differentiation by contrast-enhanced inversion prepared MRI［J］.European Heart Journal,2006，27(14):1732-1736.
［2］Gaspar T，Halon DA，Peled N.Advantages of multi-detector computed tomography angiography in the evaluation of patients with chest pain［J］.Coronary Artery Disease，2006，17(2):107-113.
［3］Naghavi M，Libby P，F(xiàn)alk E，et al.From vulnerable plaque to vulnerable patient:a call for new definition and risk assessment strategies:partⅠ［J］.Circulation，2003，108(14):1664-1772.
［4］Mintz GS，Nissen SE，Anderson WD，et al.American College of Cardiology clinical expert consensus document on standards for acquisition，measurement and reporting of intravascular ultrasound studies (IVUS): a report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents［J］.J Am Coll Cardiol，2001,37:1478–1492.
［5］Doyley MM，Mastik F，de Korte CL，et al.Advancing intravascular ultrasonic palpation toward clinical applications［J］.Ultrasound in Medicine & Biology,2001,27:1471-1480.
［6］Budoff MJ，Cohen MC，Garcia MJ，et al.ACCF/AHA clinical competence statement on cardiac imaging with computed tomography and magnetic resonance: a report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training［J］.J Am Coll Cardiol，2005，46:383–402.
［7］Ehara S，Kobayashi Y，Yoshiyama M，et al.Spotty calcification typifies the culprit plaque in patients with acute myocardial infarction: an intravascular ultrasound study［J］.Circulation，2004，110:3424-3429.
［8］Nissen SE，Yock P.Intravascular ultrasound:novel pathophy siological insights and current clinical applications［J］.Circulation，2001，103(4):604-616.

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