Multidetector computed tomography evaluation of coronary plaque morphology in patients with stable angina
Multidetector computed tomography evaluation of coronary plaque morphology in patients with stable angina
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DOI：
10.1007/s00380-010-0074-4
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发表时间：
2011-07-01
影响因子：
1.5
通讯作者：
Yamashita, Yasuyuki
中科院分区：
文献类型：
--
作者：
Utsunomiya, Daisuke;Fukunaga, Takashi;Yamashita, Yasuyuki
本研究的目的是通过64排多探测器计算机断层扫描（CT）血管造影评估稳定冠状动脉疾病患者冠状动脉粥样硬化斑块的形态和组成。根据心肌灌注显像、有创血管造影及1年临床随访将56例患者分为缺血相关病变组（n = 31）和非缺血相关病变组（n = 25）。对56例CT检出病灶进行分析；评估狭窄程度、病变长度、CT衰减值及斑块钙沉积情况。采用单因素和多因素logistic回归分析比较临床特征和CT表现。缺血相关病变表现出更严重的冠状动脉狭窄，更长（17.8 +/- a 8.5 vs 9.1 +/- a 3.9 mm），更高的CT衰减值（101.7 +/- a 36.7 vs 81.6 +/- a 32.6 HU）和更多的钙沉积。通过单因素logistic分析，狭窄程度、病变长度、CT衰减值和钙沉积与缺血相关斑块显著相关。这些参数的比值比（OR）分别为6.874 （P = 0.007）、1.371 （P = 0.001）、1.018 （P = 0.044）和5.400 （P = 0.004）。经多因素logistic分析，狭窄程度和病变长度与缺血相关斑块显著相关（OR分别为7.588,P = 0.036和1.365,P = 0.003）。综上所述，冠状动脉CT血管造影有助于识别稳定型冠状动脉疾病患者缺血性斑块与非缺血性斑块的形态学差异。
The purpose of this study was to evaluate the morphology and composition of atherosclerotic coronary plaques in patients with stable coronary artery disease by 64-row multidetector computed tomography (CT) angiography. A total of 56 patients were divided into an ischemia-related (n = 31) and a nonischemia-related lesion group (n = 25) based on myocardial perfusion scintigraphy, invasive angiography, and 1-year clinical follow-up. The 56 lesions detected by CT imaging were analyzed; the severity of stenosis, the lesion length, CT attenuation value, and calcium deposition of the plaques were evaluated. Clinical characteristics and CT findings were compared using univariate and multivariate logistic regression analyses. Ischemia-related lesions exhibited a greater severity of coronary stenosis, were longer (17.8 +/- A 8.5 vs 9.1 +/- A 3.9 mm), and had a higher CT attenuation value (101.7 +/- A 36.7 vs 81.6 +/- A 32.6 HU) and larger calcium deposition. By univariate logistic analysis, severity of stenosis, lesion length, CT attenuation value, and calcium deposition were significantly associated with ischemia-related plaques. The odds ratio (OR) of these parameters was 6.874 (P = 0.007), 1.371 (P = 0.001), 1.018 (P = 0.044), and 5.400 (P = 0.004), respectively. By multivariate logistic analysis, the severity of stenosis and lesion length were significantly associated with ischemia-related plaques (OR 7.588, P = 0.036 and OR 1.365, P = 0.003, respectively). In conclusion, coronary CT angiography is useful for the identification of morphological differences between ischemia-related and nonischemia-related plaques in patients with stable coronary artery disease.