CT features in the early and late stages of chronic total coronary occlusions
CT features in the early and late stages of chronic total coronary occlusions
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DOI：
10.1016/j.jcct.2015.07.010
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发表时间：
2015-11-01
影响因子：
5.4
通讯作者：
Lu, Bin
中科院分区：
文献类型：
--
作者：
Yu, Mengmeng;Xu, Nan;Lu, Bin
目的：探讨慢性冠状动脉全闭塞（CTO）早期和晚期冠状动脉ct血管造影（CTA）的形态学特征。方法：我们回顾性分析了接受冠状动脉CTA和侵入性冠状动脉造影且至少有一次已知持续时间的CTO的患者。在冠状动脉CIA中获得以下参数：闭塞段钙化；树桩形态;病变长度;重构指数;存在闭塞内线性对比增强；和非钙化CTO组分的密度。比较早期（病程12个月）CTO患者的CT参数。结果：对124例慢性冠状动脉闭塞的112例患者进行了分析。59例为早期CTOs（62个病变），53例为晚期CTOs（62个病变）。与早期cto相比，晚期cto的钙化更严重（Agatston评分：早期，27.4 +/- 46.7 vs晚期，58.3 +/- 112.4;p = 0.049）。晚期cto的重塑指数较低（早期，0.96 +/- 0.2 vs.晚期，0.88 +/- 0.22;p = 0.034）。在晚期CTO患者中，更有可能出现牙合内线性增强（45.2% vs 14.5%, p < 0.001），非钙化成分的密度明显更高（85.4 +/- 27.2 HU vs 65.7 +/- 30.1 HU, p < 0.001）。两组树桩形态无明显差异。结论：冠脉CTA显示慢性冠脉全闭塞时间长短的差异。持续时间长与局灶性钙化和负重构以及闭塞内增强和非钙化成分密度增高有关。(C) 2015年心血管计算机断层扫描学会。Elsevier Inc.出版。版权所有。
Objectives: To investigate the morphologic characteristics of early and late stages of chronic total coronary artery occlusions (CTO) in coronary computed tomography angiography (coronary CTA).Methods: We retrospectively analyzed patients who underwent coronary CTA and invasive coronary angiography and had at least one CTO with known duration. The following parameters were obtained in coronary CIA: calcification of the occluded segment; stump morphology; lesion length; remodeling index; presence of intra-occlusion linear contrast enhancement; and density of non-calcified CTO components. CT parameters were compared between patients with early (duration 12 months) stage CTO.Results: One-hundred and twelve patients with 124 chronically occluded coronary arteries were analyzed. Fifty nine patients had early stage CTOs (62 lesions) and 53 patients had late stage CTOs (62 lesions). Calcification was more severe in late-stage versus early CTOs (Agatston score: early stage, 27.4 +/- 46.7 vs. late stage, 58.3 +/- 112.4; p = 0.049). Remodeling index was lower in late-stage CTOs (early stage, 0.96 +/- 0.2 vs. late stage, 0.88 +/- 0.22; p = 0.034). In patients with late stage CTO, the presence of intra-occlusion linear enhancement was more likely (45.2% vs 14.5%, p < 0.001), and the density of non-calcified components was significantly higher (85.4 +/- 27.2 HU vs. 65.7 +/- 30.1 HU, p < 0.001). Stump morphology was not different between the two groups.Conclusions: Coronary CTA reveals differences between chronic total coronary occlusions of longer and shorter duration. A long duration is associated with focal calcification and negative remodeling, as well as intra-occlusion enhancement and a higher density of non-calcified components. (C) 2015 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.