斑块钙化对双源CT冠状动脉造影诊断准确性的影响
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(武汉市中心医院心内科,湖北省武汉市 430014)

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周逸,硕士,副主任医师,研究方向为冠心病基础与临床,E-mail为coronary@aliyun.com。

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武汉市卫生局临床医学科研项目(WX12B03)


Influence of plaque calcification on the diagnostic accuracy of dual source CT coronary angiography
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Department of Cardiology, the Central Hospital of Wuhan, Wuhan, Hubei 430014, China)

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    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%(P<0.0001),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%(P<0.0001),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:

    Aim To qualitatively and quantitatively evaluate the influence of plaque calcification on the diagnostic accuracy of dual source CT (DSCT) coronary angiography for coronary stenosis assessment. Methods The retrospective analysis enrolled 224 patients. They were diagnosed as coronary artery disease by DSCT angiography, and then received selective coronary angiography. There were 375 lesions with significant coronary stenosis in 224 patients according to DSCT. Of 375 lesions, 234 lesions were with calcification. The influence of characteristics of lesions on accuracy of DSCT angiography for coronary stenosis assessment was evaluated. These characteristics included calcification degree of lesions, artery external diameter of calcified lesions, length of calcified lesions and location of calcified lesions. Results For mild to moderate calcified plaque and severe calcified plaque, DSCT overestimated coronary stenosis by 6.8% (P=0.0028) and 18.8% (P<0.0001) separately, and the overestimation of stenosis was more obvious in severe calcified lesions (P=0.002). For calcified lesions with artery external diameter<3 mm and artery external diameter≥3 mm, DSCT overestimated coronary stenosis by 7.2% (P=0.0026) and 17.1% (P<0.0001) separately, and the overestimation of stenosis was more obvious in calcified lesions with artery external diameter≥3 mm (P=0.001). There was no difference in the diagnostic accuracy of DSCT for calcified plaques with different lengths (P=0.792). Conclusion The lesion calcification makes DSCT angiography overestimate coronary stenosis. This phenomenon is more likely to occur in the severe calcified lesions and calcified lesions with artery external diameter≥3 mm.

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周逸,陈曼华,戴睿,周炜,廖华.斑块钙化对双源CT冠状动脉造影诊断准确性的影响[J].中国动脉硬化杂志,2017,25(6):594~598.

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  • 收稿日期:2016-07-29
  • 最后修改日期:2017-01-19
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  • 在线发布日期: 2017-06-05