Heavy Coronary Calcium Mimicking In-Stent Restenosis
Heavy Coronary Calcium Mimicking In-Stent Restenosis
复制标题
模拟支架内再狭窄的重度冠状动脉钙化
DOI：
--
复制
发表时间：
2011
影响因子：
2.9
通讯作者：
Young Kyung Lee
中科院分区：
文献类型：
--
作者：
Jeong;I. Sohn;E. Jin;Jin;C. Kim;Young Kyung Lee
一名49岁的男性被转诊为缺血性心脏病的评估。他被告知在低剂量胸部计算机断层扫描(CT)上进行了冠状动脉钙化检查，以进行常规健康筛查。他否认过去接受过冠状动脉介入治疗，不吸烟的情况下他很健康。跑台运动超声心动图显示正常结果，无运动后室壁运动异常。采用多层螺旋CT(华晨，飞利浦，荷兰)的多层螺旋CT显示冠状动脉钙化严重，钙化程度非常高(阿加斯顿单位1039.7)(图1，白色箭头)。右冠状动脉也有高钙负荷，线状钙类似于冠状动脉支架(图1B，白色箭头)，这被误解为支架内再狭窄。此后不再进行冠状动脉造影术。
图1
多层螺旋CT冠状动脉成像显示冠状动脉钙化严重，钙化积分很高(阿加斯顿积分1039.7)。A：左冠状动脉内的钙化(白色箭头)。B：冠状动脉钙..。
多层螺旋CT提供冠状动脉解剖的无创性成像，被广泛应用于各种临床环境。1-3)然而，冠状动脉钙化会降低其诊断价值，并具有多种特征。仔细记录病史，了解MD-CT冠状动脉钙化的各种特征，可避免误判。
A 49-year-old man was referred for the evaluation of ischemic heart disease. He was told having calcified coronary artery on low-dose chest computed tomography (CT) checked for routine health screening. He denied past coronary intervention and he was healthy without smoking. Treadmill exercise echocardiography showed normal findings without post-exercise wall motion abnormalities. Multislice scanner with 64-row multidetector CT (MDCT) (Brilliance, Philips, Netherlands) revealed heavily calcified coronary arteries with very high calcium score (Agatston unit 1039.7) (Fig. 1, white arrows). Right coronary artery also had high calcium burden with linear calcium mimicking coronary stent (Fig. 1B, white arrow), which was misinterpreted as instent restenosis. Coronary angiography was not performed thereafter.
Fig. 1
Coronary CT angiography with 64-row multidetector computed tomography revealed heavily calcified coronary arteries with a very high calcium score (Agatston score 1039.7). A: coronary calcium (white arrows) in the left coronary artery. B: coronary calcium ...
MDCT provides non-invasive imaging of coronary anatomy and is widely used in the various clinical settings.1-3) However, coronary calcium can reduce its diagnostic value and has various features. Careful history taking and understanding for this various characteristics of coronary calcium on MD-CT may give chance to avoid misinterpretation.