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320排螺旋CT评估 升主动脉弹性与冠 状动脉狭窄的相关 性

作者:陈阿梅 谢佳均 徐向东 魏新华 杨蕊梦 赖丽莎 江新青

所属单位:广州医科大学附属广州市第一人民 医院放射科 (广东 广州 510180)

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摘要

目的 利用320排螺旋CT评估升 主动脉弹性指标与冠状动脉狭窄程度的 相关性。方法 搜集我院拟诊冠心病并行 320排螺旋CT冠状动脉造影138例患者(正 常组31例,狭窄组107例),其中狭窄组 分为轻度狭窄组及中重度狭窄组,比较 不同组间升主动脉弹性指标及与Gensini 评分的相关性。结果 升主动脉弹性指 标[膨胀性(AoD)及僵硬度(AoS)]在冠状 动脉狭窄组与正常组间及不同狭窄程度 组间的弹性指标差异均具有统计学意义 (P<0.05)。ROC曲线评估AoD、AoS预测冠 心病的价值,曲线下面积(AUC)分别为 0.94、0.89。结论 升主动脉弹性与冠 状动脉狭窄与否及狭窄程度有密切相关 性,有可能可以作为冠心病的独立预测 因子。

Objective To evaluate the correlation between the severity of coronary artery stenosis and ascending aortic elasticity by using MDCT. Methods A total of 138 patients with coronary artery disease underwent 320-MDCT coronary angiography. According to the presence of coronary artery stenosis they were divided into coronary stenosis group and no coronary stenosis group, according to the extent of coronary stenosis were divided into mild stenosis and moderate-severe stenosis group; ascending aorta elastic parameters and the Gensini score were compared between different groups. Results The AoD of Coronary stenosis group was significantly lower than that of no stenosis group. AoS and the Gensini score were significantly higher than no stenosis group (P<0.05). Mild group AoD was significantly higher than that of moderate- severe group, AoS and Gensini score were significantly lower than the moderate-severe group(P<0.05). ROC curve was used to evaluate AoD, AoS predicting coronary artery disease and the area under the curve (AUC) was directly 0.94, 0.89. Conclusion The elasticity of ascending aorta is closely related to the extent and extent of coronary stenosis, and may be an independent predictor of coronary artery disease.

【关键词】体层摄影术;X线计算机;冠 状动脉造影;主动脉弹性; 冠状动脉狭窄

【中图分类号】R54;R47

【文献标识码】A

【DOI】10.3969/j.issn.1672- 5131.2017.08.021

前言

冠心病的发生发展与主动脉弹性密切相关,主动脉弹性是左心功 能及冠状动脉血流量的重要决定因素,是亚临床血管病变检测的敏感 性及特异性指标,弹性下降与心脑血管疾病及外周动脉疾病密切相 关[1]。320排螺旋CT(Multi—detector row spiral CT,MDCT)因其高 空间、高时间分辨率,能同时评估主动脉弹性及冠状动脉病变。本研 究旨在应用回顾性心电门控MDCT一站式评价升主动脉弹性与冠状动脉 狭窄程度的相关性。