| 李建蓉,温云,王静,等.破裂和高危动脉粥样硬化斑块的冠状动脉CT血管造影特征与血管内超声的关系[J].安徽医药,2020,24(9):1764-1768. |
| 破裂和高危动脉粥样硬化斑块的冠状动脉CT血管造影特征与血管内超声的关系 |
| Relationship between coronary CTA features and intravascular ultrasound in ruptured and high-risk atherosclerotic plaque |
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| DOI：10.3969/j.issn.1009-6469.2020.09.017 |
| 中文关键词: 斑块，动脉粥样硬化 体层摄影术， X线计算机 超声检查，介入性 心绞痛，稳定型 急性冠状动脉综合征 |
| 英文关键词: Plaque,atherosclerotic Tomography,X-ray computed Ultrasonography,interventional Angina,stable Acute coronary syndrome |
| 基金项目:重庆市万州区科技计划项目( 201203060) |
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| 中文摘要: |
| 目的探讨破裂和高危动脉粥样硬化斑块的冠状动脉 CT血管造影( CTA)特征与血管内超声( IVUS)的关系。方法回顾性以重庆三峡中心医院 2017年 3月至 2019年 3月行经皮冠状动脉介入治疗的稳定型心绞痛和急性冠状动脉综合征( ACS)病人各 32例为研究对象。所有病人在冠状动脉介入治疗前行冠状动脉 CTA、IVUS和虚拟组织学血管内超声( VH-IVUS)检查。比较 VH-IVUS诊断的薄帽型纤维粥样硬化斑块( TCFA)中钙化斑块、低衰减斑块、正性重塑及餐巾环征等 CTA高风险特征的关系。结果冠状动脉 CTA正确诊断出破裂斑块 26/39个，有 3个斑块的诊断为假阳性，灵敏度为 66％，特异度为 91％。融合坏死核心斑块的低衰减斑块、餐巾环征、坏死核心体积、坏死核心 /纤维斑块比值等 CTA特征均显著升高( P＜0.05)。 TCFA的坏死核心体积、坏死核心 /纤维斑块比值等 CTA特征显著升高( P＜0.05)纤维斑块体积显著降低( P＜0.05)。坏死核心体积、坏死核心 /纤维斑块比值等 CTA特征在诊断纤维粥样硬化斑块的受试者工，作特征曲线( ROC)下面积分别为 0.730、0.872(P＜0.05)。 ACS病人中罪犯斑块的 CTA高危特征检出率均显著升高( P＜0.05)。结论与 IVUS相比，冠状动脉 CTA识别破裂斑块的特异度高，但灵敏度低。此外，低衰减斑块、餐巾环征、坏死核心体积、坏死核心 /纤维斑块比值等 CTA高风险特征能很好的识别 VH-IVUS诊断的融合坏死核心的斑块及 TCFA，尤其是在 ACS病人中。 |
| 英文摘要: |
| Objective To investigate the relationship between coronary CT imaging(CTA)and intravascular ultrasound(IVUS)in ruptured and high-risk atherosclerotic plaques.Methods Thirty-two patients with stable angina pectoris and 32 acute coronary syn- drome(ACS)who underwent percutaneous coronary intervention in Chongqing Three Gorges Central Hospital from March 2017 toMarch 2019 were enrolled in the retrospectively study.All patients underwent coronary CTA，IVUS，and virtual histological intravas- cular ultrasound(VH-IVUS)prior to coronary intervention.The relationship between high-risk characteristics of CTA such as calci- fied plaque，low-attenuation plaque，positive remodeling，and napkin ring sign in thin-cap fiber atherosclerotic plaque(TCFA)diag- nosed by VH-IVUS was compared.Results Coronary CTA correctly diagnosed 26/39 ruptured plaques，and 3 plaques were diag-nosed as false positives with a sensitivity of 66% and a specificity of 91%.The CTA features of low-attenuation plaque，napkin ring sign，necrotic core volume，necrotic core/fiber plaque ratio of plaque with necrotic core were significantly increased(P＜0.05).The CTA characteristics of necrotic core volume，necrotic core/fiber plaque ratio of TCFA were significantly increased(P＜0.05)，and the volume of fibrous plaque was significantly decreased(P＜0.05).The ROC curve of the CTA characteristics of the area of the necrotic core volume，necrotic core/fiber plaque ratio diagnostic atherosclerotic plaque were 0.730 and 0.872，respectively(P＜ |
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