CORONARY-ARTERY CALCIUM AREA BY ELECTRON-BEAM COMPUTED-TOMOGRAPHY AND CORONARY ATHEROSCLEROTIC PLAQUE AREA - A HISTOPATHOLOGIC CORRELATIVE STUDY
CORONARY-ARTERY CALCIUM AREA BY ELECTRON-BEAM COMPUTED-TOMOGRAPHY AND CORONARY ATHEROSCLEROTIC PLAQUE AREA - A HISTOPATHOLOGIC CORRELATIVE STUDY
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DOI：
10.1161/01.cir.92.8.2157
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发表时间：
1995-10-15
期刊：
影响因子：
37.8
通讯作者：
SCHWARTZ, RS
中科院分区：
文献类型：
--
作者：
RUMBERGER, JA;SIMONS, DB;SCHWARTZ, RS
背景：电子束CT(EBCT)发现的冠状动脉钙化与管腔狭窄的相关性较差，但作为冠状动脉斑块的重要组成部分，钙化可能与斑块面积有更直接的关系。方法和结果对13例尸检心脏的38支冠状动脉进行解剖、矫直，并以3 mm连续扫描。冠状动脉钙化面积定义为一个或多个像素，密度为>；130 Hounsfield单位(0.18 mm(2)/像素)。每条动脉被分成相应的3 mm段，对具有代表性的组织切片进行染色，并量化每段动脉斑块面积(mm(2))。冠状动脉钙化和冠状动脉斑块面积与心脏整体、单个冠状动脉和单个冠状动脉节段相关。对于每个心脏和每个冠状动脉，组织学斑块面积的总和与钙面积的总和高度相关。而冠状动脉斑块面积约为钙化面积的5倍。结论组织病理学研究证实全心、冠状动脉、节段性冠状动脉斑块面积与EBCT冠状动脉钙化面积之间存在密切关系，但斑块面积存在一个阈值，低于该阈值的斑块面积无钙化或无钙化。
Background Coronary calcium identified by electron-beam computed tomography (EBCT) correlates poorly with luminal atherosclerotic narrowing, but calcium, an intimate part of coronary plaque, may be more directly related to atheromatous plaque area.Methods and Results Thirty-eight coronary arteries from 13 autopsy hearts were dissected, straightened, and scanned with EBCT in 3-mm contiguous increments. Coronary calcium area was defined as one or more pixels with a density >130 Hounsfield units (0.18 mm(2)/pixel). Each artery was divided into corresponding 3-mm segments, representative histological sections were stained, and atherosclerotic plaque area per segment (mm(2)) was quantified. Coronary artery calcium and coronary artery plaque areas were correlated for the hearts as a whole, for individual coronary arteries, and for individual coronary artery segments. The sums of histological plaque areas versus the sums of calcium areas were highly correlated for each heart and for each coronary artery. However, coronary plaque area was on the order of five times greater than calcium area. Furthermore, minimal diffuse segmental coronary plaque could be present despite the absence of coronary calcium detectable by EBCT.Conclusions This histopathologic study confirms an intimate relation between whole heart, coronary artery, and segmental coronary atherosclerotic plaque area and EBCT coronary calcium area but suggests that there is a threshold value for plaque area below which coronary calcium is either absent or not detectable by this methodology.