Electron beam computed tomography and coronary artery disease: Scanning for coronary artery calcification
Electron beam computed tomography and coronary artery disease: Scanning for coronary artery calcification
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DOI：
10.4065/71.4.369
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发表时间：
1996-04-01
影响因子：
8.9
通讯作者：
Schwartz, RS
中科院分区：
文献类型：
--
作者：
Rumberger, JA;Sheedy, PF;Schwartz, RS
目的：综述电子束CT(EBCT)检测冠状动脉钙化与冠状动脉粥样硬化的关系及其潜在的临床应用。设计：对冠状动脉钙化、冠状动脉疾病和电子束CT的文献进行综述，并讨论电子束CT的临床应用。结果：最近的研究证实，冠状动脉钙化是一个与动脉粥样硬化斑块演变密切相关的活跃过程。使用EBCT的临床研究表明，冠状动脉钙化的扫描“阴性”在冠状动脉造影结果正常或接近正常的患者中很常见，而严重梗阻性疾病的患者通常扫描“阳性”--冠状动脉钙化越多，管腔疾病越严重。EBCT上评估的冠状动脉钙化遵循反映冠状动脉动脉粥样硬化性疾病的发展与年龄和性别有关的模式。虽然组织学研究已经证实并非所有的动脉粥样硬化节段都有可检测到的钙化，但EBCT上量化的冠状动脉钙化面积与组织病理的冠状动脉斑块面积有直接的正相关关系。结论：长期以来认为冠状动脉随着年龄的增长而退行性钙化的观点是不正确的。虽然冠状动脉钙化的发生率随着患者年龄的增长而增加，但这种关系与冠状动脉粥样硬化的发生率随着年龄的增长而增加是平行的。数据表明，EBCT是一种高度敏感和特异的冠状动脉粥样硬化检测方法，并为临床应用提供了依据，因为EBCT被视为一种无创性方法，可以评估人类冠状动脉粥样硬化的受累程度和斑块负荷。
Objective: To review the association of coronary artery calcification with coronary atherosclerosis and its potential clinical application as detected on electron beam computed tomography (EBCT).Design: A literature review of coronary artery calcification, coronary artery disease, and EBCT is presented, and clinical applications of EBCT are discussed.Results: Recent studies have confirmed that arterial calcification is an active process intimately associated with atherosclerotic plaque evolution. Clinical investigations with use of EBCT have shown that a scan ''negative'' for coronary calcification is common in patients with normal or near-normal findings on coronary angiography, whereas patients with severe obstructive disease most commonly have ''positive'' scans-greater amounts of coronary artery calcium are associated with more severe luminal disease. Coronary artery calcium as evaluated on EBCT follows patterns that reflect the development of coronary atheromatous disease as a function of age and gender. Although histologic studies have confirmed that not all atherosclerotic segments have detectable calcification, the area of coronary artery calcification quantified on EBCT has a direct, positive relationship with the histopathologic coronary plaque area.Conclusion: The long-held notion of ''degenerative'' calcification of the coronary arteries with aging is incorrect. Although the incidence of coronary artery calcification increases with patient age, this relationship simply parallels the increased incidence of coronary atherosclerosis with advancing age. Data suggest that EBCT is a highly sensitive and specific test for coronary atherosclerosis and provide a basis for clinical applications when EBCT is viewed as a noninvasive method to estimate human coronary atherosclerotic involvement and ''plaque burden.''