斑块钙化对双源CT冠状动脉造影诊断准确性的影响

发布时间：2018-10-26 19:18

【摘要】：目的定性、定量分析斑块钙化对双源CT冠状动脉造影诊断准确性的影响。方法回顾性分析双源CT冠状动脉造影诊断为冠心病,后行选择性冠状动脉造影的患者224例,共375处明显狭窄病变,其中234处为钙化病变。比较斑块不同钙化程度、钙化斑块血管直径、钙化斑块长度和钙化斑块血管分布对双源CT冠状动脉造影诊断冠状动脉狭窄准确性的影响。结果对轻中度钙化斑块和重度钙化斑块,双源CT分别高估管腔狭窄6.8%(P=0.0028)和18.8%(P0.0001),且高估狭窄在重度钙化斑块中更明显(P=0.002)。对血管直径较小和血管直径较大的钙化斑块,双源CT分别高估管腔狭窄7.2%(P=0.0026)和17.1%(P0.0001),且高估狭窄在血管直径较大时更明显(P=0.001)。对不同长度的钙化斑块,双源CT的诊断准确性未见差异(P=0.792)。结论斑块钙化使双源CT高估冠状动脉管腔狭窄,且钙化程度重和血管直径较大时更易出现。
[Abstract]:Objective to qualitatively and quantitatively analyze the effect of plaque calcification on the diagnostic accuracy of dual-source CT coronary angiography. Methods two hundred and twenty-four patients with coronary artery disease diagnosed by dual-source CT coronary angiography and then underwent selective coronary angiography were retrospectively analyzed, with a total of 375 obvious stenosis lesions, of which 234 were calcified lesions. The effects of different calcification degrees, the diameter of calcified plaque, the length of calcified plaque and the distribution of calcified plaque on the accuracy of dual-source CT coronary angiography in the diagnosis of coronary artery stenosis were compared. Results Dual-source CT overestimated lumen stenosis by 6.8% (P0. 0028) and 18. 8% (P0. 0001) respectively for mild to moderate calcified plaque and severe calcified plaque, and overestimated stenosis was more obvious in severe calcified plaque (P0. 002). For calcified plaques with smaller vessel diameter and larger vessel diameter, dual-source CT overestimated lumen stenosis by 7.2% (P0. 0026) and 17. 1% (P0. 0001) respectively, and overestimated stenosis was more obvious when vessel diameter was larger (P0. 001). For calcified plaques of different lengths, there was no difference in the diagnostic accuracy of dual CT (P0. 792). Conclusion plaque calcification makes CT overestimate coronary artery stenosis, and it is more likely to occur when calcification degree and vessel diameter are larger.
【作者单位】：武汉市中心医院心内科;
【基金】：武汉市卫生局临床医学科研项目(WX12B03)
【分类号】：R541.4

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