256层螺旋CT冠脉成像对冠脉迂曲定量研究

发布时间：2018-05-16 02:39

本文选题：冠脉狭窄 + 冠脉迂曲　；参考：《河北医科大学》2012年硕士论文

【摘要】：目的：采用256层螺旋CT冠脉成像，定量研究冠状动脉无狭窄患者迂曲发生率和迂曲程度，并进一步探讨其临床价值。方法：525例疑似冠心病患者，经冠脉CTA成像，冠状动脉均无明显狭窄，其中男240例，女285例，年龄33～78岁，平均55.45±11.26岁。收集心脏薄层原始图像及后处理图像，统计冠脉迂曲发生部位、发生率及程度，并观察与年龄、性别及体重指数的相关性。结果：525例冠脉无狭窄患者中，冠脉迂曲发生率约为40.2%（211例/525例），其中女性冠脉迂曲发生率（25.7%）高于男性（14.3%），冠脉迂曲组平均年龄高于无迂曲组（p＜0.05）。迂曲组与无迂曲组体重指数无明显差异（p＞0.05）。左旋支迂曲发生率最高，为28.6%（150例），左前降支迂曲发生率为24.6%（129例），右冠脉迂曲发生率14.9%（78例）；单支迂曲发生率为18.3%（96例），其中发生在左旋支为8.8%（46例），前降支为6.9%（36例），右冠脉为2.9%（15例）；双支迂曲发生率为15.4%（81例）；三支均迂曲发生率为6.3%（33例）。轻中重度迂曲发生率分别为13.52%（71例）、14.48%（76例）、12.19%（64例）。讨论：256层螺旋CT冠脉成像作为一种无创检查，不仅能够客观显示冠状动脉走行迂曲，在冠心病诊断上具有重要的临床价值。目的：采用256层螺旋CTA定量研究冠状动脉迂曲与冠心病发生率相关性，并进一步探讨其临床价值。方法：对1275例疑似冠心病患者行冠状动脉CTA成像，其中男性693例，女行582例，年龄33～78岁，平均年龄57.65±12.35岁。收集心脏薄层原始图像及后处理图像，统计冠脉狭窄程度及冠脉迂曲发生率，分析他们之间的关系，并观察其与性别的关系。结果：1275例行冠脉CTA成像患者中，冠脉狭窄（狭窄程度≥50%）患者336例，其中男219例（17.2%），女117例（9.2%）。冠脉迂曲患者447例，其中男192例（15.1%），女255例（20%）。冠脉迂曲组在不同冠脉狭窄程度及多支中重度狭窄时，狭窄发生率均低于无迂曲组。（p均＜0.05）讨论：256层螺旋CT可以客观显示冠脉的迂曲和狭窄，冠脉的迂曲和狭窄均引起了血流动力学的改变，两者之间具有相关性，冠脉迂曲可以降低冠脉狭窄的发生率及程度。目的：回顾性分析416例冠脉无明显狭窄患者256层螺旋CTA数据，分析冠状动脉走行迂曲与左室功能相关性。方法：回顾性分析416例临床拟诊冠心病患者，均采用256iCT一次扫描同时完成冠状动脉成像及心功能分析。其中男210例，女206例。40岁以下32例，40-60岁270例，，60岁以上114例。年龄33-83，平均年龄50.73±10.88岁。记录患者冠脉走行有无迂曲，测量患者左室舒张末期容积（EDV）、收缩末期容积（ESV）、每搏输出量（SV）、射血分数（EF）及心输出量（CO）。按照不同迂曲程度、不同年龄、不同性别分组，分析冠脉迂曲对诸心功能参数的影响。结果：不同迂曲程度、不同性别分组及40岁以上年龄分组均显示冠脉迂曲组患者左室舒张末期容积（EDV）、收缩末期容积（ESV）、每搏输出量（SV）、心输出量（CO），均较无迂曲组显著降低（＜0.05）。提示冠脉迂曲组可能影响左心功能，其严重程度与患者年龄及性别无关。讨论：256层螺旋CTA能够同时完成冠脉成像及心功能分析，冠脉迂曲患者左心储备功能的下降。
[Abstract]:Objective: to quantitatively study the tortuosity and tortuosity of patients with coronary artery stenosis by using 256 slice spiral CT coronary angiography, and to further explore its clinical value.
Methods: 525 cases of suspected coronary heart disease, coronary artery CTA imaging, coronary artery stenosis, including 240 men, 285 women, age 33~78 years old, mean 55.45 + 11.26 years old. Collect the original image of the heart thin layer and post-processing image, statistics of the location of coronary circuitous, incidence and degree, and observe the age, sex and body mass index of the phase Customs.
Results: among the 525 patients with no stenosis, the incidence of coronary tortuosity was about 40.2% (211 cases of /525 cases). The incidence of coronary tortuosity in women (25.7%) was higher than that of men (14.3%). The average age of the coronary tortuosity group was higher than that in the non tortuous group (P < 0.05). There was no significant difference between the tortuous group and the non tortuous group (P > 0.05). The incidence of the left circumflex was the highest. For 28.6% (150 cases), the incidence of left anterior descending branch was 24.6% (129 cases), and the incidence of right coronary tortuosity was 14.9% (78 cases), and the incidence of single branch tortuosity was 18.3% (96 cases), including 8.8% (46 cases) in the left lateral branch, 6.9% in the anterior descending branch and 2.9% in the right coronary artery (36 cases), and the incidence of double collateral tortuosity. The incidence of light, moderate and severe tortuosity was 13.52% (71 cases), 14.48% (76 cases) and 12.19% (64 cases) respectively.
Discussion: 256 slice spiral CT coronary angiography, as a noninvasive examination, not only can objectively show the coronary artery to take the tortuosity, but also has important clinical value in the diagnosis of coronary heart disease.
Objective: To study the correlation between coronary artery tortuosity and the incidence of coronary heart disease (CHD) by 256 slice spiral CTA, and to further explore its clinical value.
Methods: 1275 patients with suspected coronary heart disease were performed coronary artery CTA imaging, including 693 males and 582 women, 33~78 years old, with an average age of 57.65 + 12.35 years old. The original image of thin layer of heart and post-processing image were collected, the degree of coronary stenosis and the incidence of coronary tortuosity were counted, the relationship between them was analyzed, and the relationship between them and sex was observed.
Results: of the 1275 patients with coronary CTA imaging, there were 336 cases of coronary stenosis (degree of stenosis more than 50%), of which 219 cases were male (17.2%), 117 cases (9.2%) and 447 cases of coronary tortuosity, including 192 cases (15.1%) and 255 cases (20%). The incidence of stenosis in coronary artery circuitous group was lower than that in non tortuous group. P < 0.05)
Discussion: 256 layers of spiral CT can objectively display the tortuosity and stenosis of the coronary artery. The coronary tortuosity and stenosis all cause the change of hemodynamics. There is a correlation between the two. The coronary tortuosity can reduce the incidence and degree of coronary stenosis.
Objective: To retrospectively analyze 256 slice spiral CTA data of 416 patients with coronary artery stenosis without stenosis, and to analyze the correlation between coronary artery bypass and left ventricular function.
Methods: the coronary artery imaging and cardiac function analysis were performed in 416 cases of coronary heart disease, including 210 male cases, 206 female patients under.40 years, 270 cases of 40-60 years old and 114 cases above 60 years old. The age 33-83 and average age 50.73 + 10.88 years were recorded. Left ventricular end diastolic volume (EDV), end systolic volume (ESV), stroke volume (SV), ejection fraction (EF) and cardiac output (CO). The effects of coronary tortuosity on cardiac function parameters were analyzed according to different degrees of tortuosity, age and sex.
Results: different degrees of tortuosity, different sex groups and age groups over 40 years of age all showed left ventricular end diastolic volume (EDV), end systolic volume (ESV), stroke volume (SV) and cardiac output (CO), which were significantly lower than that in no tortuous group (< 0.05). The age and sex of the patient were not related.
Discussion: 256 slice spiral CTA can simultaneously perform coronary imaging and cardiac function analysis, and the left ventricular reserve function of patients with coronary artery tortuosity is decreased.

【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R541.4;R816.2

【参考文献】