宝石能谱CT 冠脉成像在隐匿型冠心病冠状动脉粥样斑块性质判断中的价值

目的:探讨宝石能谱CT冠脉成像在隐匿型冠心病冠状动脉粥样斑块性质判断中的价值,为临床隐匿型冠心病的诊断和治疗提供影像学参考依据。方法:选择2014年6月~2015年6月在我院诊断为心肌缺血且无临床症状的隐匿型冠心病患者共360例,所有入选患者均行宝石能谱CT冠脉成像检查,其中155例有冠状动脉狭窄,且伴有不同性质的粥样斑块。分析冠状动脉不同血管狭窄情况、斑块分型和斑块数目。结果:所有冠脉动脉狭窄均为轻度狭窄和中度狭窄,主要集中在左主干和左前降支,分别占35.48%和37.42%。硬斑块数目最多,占75.43%,其次为混合斑块和软斑块,分别占16.19%和8.38%。冠状动脉4支血管粥样斑块均为硬斑块者最多(29.03%)、硬斑块与软斑块同时存在者占29.03%、硬斑块与软斑块、混合斑块同时存在者占14.84%,未见单纯混合斑块或软斑块的患者。结论:隐匿型冠心病患者冠状动脉狭窄主要为轻、中度狭窄,冠状动脉斑块以硬斑块为主。宝石能谱CT冠脉成像能准确的判断隐匿型冠心病冠状动脉粥样斑块性质,值得临床推广借鉴。

Diagnostic Value of 64 Slice Ppiral CT on Property of Atheromatous Plaque in Patients with Latent Coronary Heart Disease

Objective:To explore the diagnostic value of 64 slice spiral CT on the property of atheromatous plaque in patients with latent coronary heart disease, in order to provide the imaging reference for clinical diagnose and treatment.Methods:A total of 360 patients, who were diagnosed as myocardial ischemia and latent coronary heart disease without clinical symptoms in Sanya Maternal and Child Health Hospital during June 2014 to June 2015, were selected and were inspected by 64 slice spiral CT. CT test results showed that there were 155 patients with coronary artery stenosis, complicated with different properties of atheromatous plaque. The stenosis status in different coronary arteries,the property of atheromatous plaque and number were analyzed.Results:All the coronary artery stenosis were mild and moderate, mainly concentrated in the left main artery and left anterior descending artery, which accounted for 35.48% and 37.42% respectively. Hard plaque was the most (75.43%), the next were mixed plaques(16.19%) and soft plaques(8.38%). Atheromatous plaque in four coronary artery were all hard plaque took the most proportion 29.03%,the next were hard plaque complicated with soft plaque or mixed plaque,accounted for 14.84%, and there were no patients with pure mixed plaque or soft plaque.Conclusion:The types of coronary artery stenosis of patients with latent coronary heart disease are mainly mild and moderate; theromatous plaques are mainly hard plaques. 64 slice spiral CT can accurately judge the property of atheromatous plaque in patients with latent coronary heart disease, which is worthy of reference for clinical promotion.