多层螺旋CT冠脉造影对非钙化斑块致血流动力学变化的显示价值
投稿时间:2016-01-05  修订日期:2016-02-03  点此下载全文
引用本文:王星稳,陈伟彬,张惠英.多层螺旋CT冠脉造影对非钙化斑块致血流动力学变化的显示价值[J].医学研究杂志,2016,45(8):97-100
DOI: 10.11969/j.issn.1673-548X.2016.08.026
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作者单位E-mail
王星稳 063000 唐山, 华北理工大学附属医院  
陈伟彬 063000 唐山, 华北理工大学附属医院  
张惠英 063000 唐山, 华北理工大学附属医院 wgczhy2011@163.com 
基金项目:唐山市科学技术研究与发展计划项目(141302708)
中文摘要:目的 初步探讨多层螺旋CT冠状动脉造影对非钙化斑块导致冠脉血管血流动力学变化的显示价值。方法 将疑似冠心病并进行CT冠脉造影及数字减影血管造影(DSA),且两种检查结果一致的86例患者,总计258支主支血管图像经EBW工作站后处理后,以DSA为金标准,根据冠脉血管狭窄程度分为4组(正常组、轻度狭窄组、中-重度狭窄组、闭塞组),首先测量病变组主支血管内非钙化斑块前后3mm内CT值,其次随机测量正常组主支血管管腔CT值。计算单支血管前后CT值比值,并进行统计学分析。结果 正常血管组别和轻度狭窄的组别比较,斑块前后CT值差异无统计学意义(P>0.05);中-重度和闭塞的组别与正常血管和轻度狭窄组别比较,差异有统计学意义(P<0.05);中-重度狭窄和闭塞组别比较,斑块前后CT值,斑块前后CT值差异无统计学意义(P>0.05)。结论 在256层螺旋CT冠状动脉造影中,当非钙化斑块致冠脉狭窄达到中度以上时,对冠状动脉血管血流动力学的变化有显示价值,以此对临床冠心病的诊断和术前预评估有一定意义。
中文关键词:多层螺旋CT  非钙化斑块  体层摄影术  血流动力学
 
Application Value of Multi-slice Spiral CT Coronary Angiography in Evaluating Hemodynamic Changes Caused by Noncalcified Plaques
Abstract:Objective To explore the application value of multi-slice spiral CT coronary angiography in evaluating hemodynamic changes of coronary vessels caused by noncalcified plaques. Methods After dealing with 86 suspected coronary heart disease patients who had taken CT coronary angiography and digital subtraction angiography and achieved the same results, the 258 trunk vascular images handled by EBW software were divided them into 4 groups, according to DSA as the gold standard. The groups included the normal group, the mild, the severe stenosis group and the occlusion group, according to the degree of coronary vascular stenosis.Then, the CT attenuation value of 3 mm before and after the non calcified plaques in the main blood vessels would be measured in neuropathic group, followed by random measurement to the normal group's CT attenuation value of the main vascular lumen. Finally, the researcher calculated the diseased and non-diseased ct value ratio of single vessel and conducted statistical analysis. Results When we compared the normal group with the mild stenosis group, the CT value ratio of plaques had no statistical significance(P>0.05); the ct value ratio had statistical significance in comparing the severe stenosis group with the normal group and the mild stenosis group(P<0.05). But when we compared the severe stenosis group with the occlusion group, the ratio also showed insignificance in statistics(P>0.05). Conclusion In 256 layers spiral CT coronary angiography, when coronary artery stenosis caused by noncalcified plaques reaches to moderate or severe degree, hemodynamic changes will occur to parts of coronary arteries, which is of significance to clinical diagnosis and preoperative evaluation of coronary heart disease.
keywords:Multi-slice spiral CT  Noncalcified plaques  Tomography  Emodynamics
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