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目的利用冠状动脉CT血管造影(CTA)探讨左冠脉分支角与冠脉斑块形成及分支直径变化的相关性。方法临床拟诊冠脉疾病(CAD)患者97例,分别行256层和双源CT(DSCT)冠脉血管造影,将获得的原始数据在工作站使用Analyze V 7.0软件进行二维或三维影像重建,在重建图像上测量左冠脉的左前降支(LAD)和左旋支(LCX)的夹角和分支直径,并观察左冠脉分支内形成的斑块。结果 80例左冠脉分支内有斑块形成的分支角平均值(97±12.3)°与17例冠脉正常的分支角平均值(70.8±10.3)°相比较,有明显差异(P=0.018)。左冠脉分支角大于80°患者69例(71%),LAD和LCX均有斑块形成患者62例(89.8%)。80例左冠脉斑块形成的LAD和LCX直径与17例左冠脉正常的LAD和LCX直径相比较,均有明显差异(P<0.001)。夹角大于80°的LAD和LCX直径的69例患者与夹角小于80°LAD和LCX直径的11例患者相比较,LCX直径间存在明显差异(P=0.032),LAD直径间无差异(P=0.46)。结论左冠脉分支角与冠脉斑块形成及分支直径的变化具有相关性。左冠脉分支形成的斑块集中分布在大分支角的左冠脉分支中,形成斑块的大分支角LCX直径重构性增粗明显。
Objective To investigate the relationship between left coronary artery branch angle and coronary artery plaque formation and branch diameter by coronary artery angiography (CTA). Methods Ninety-seven patients with clinically diagnosed coronary artery disease (CAD) underwent 256-slice and dual-source CT coronary angiography respectively. The original data were reconstructed on a workstation using Analyze V 7.0 software for 2D or 3D reconstruction. The angles and branch diameters of the left anterior descending artery (LAD) and left circumflex artery (LCX) of the left coronary artery were measured on the reconstructed image and the plaque formed in the branch of the left coronary artery was observed. Results There was a significant difference (P = 0.018) between the average diameter of the branches in the left coronary artery branches (97 ± 12.3) ° and the average diameter of 17 normal branches (70.8 ± 10.3) ). Sixty-nine patients (71%) had a left branch angle greater than 80 °, and 62 patients (89.8%) had plaque formation in both LAD and LCX. The diameters of LAD and LCX formed in 80 cases of left coronary artery plaques were significantly different from those of 17 cases of normal left and right coronary arteries (P <0.001). There were significant differences in LCX diameters (P = 0.032) and no differences in LAD diameters between the LAD and LCX diameters of more than 80 ° (P = 0.032), as compared with 11 patients with LAD and LCX diameters of less than 80 ° = 0.46). Conclusions The branch angle of left coronary artery has a correlation with the formation of coronary artery plaque and the diameter of branch. The plaques formed by the branches of the left coronary artery were concentrated in the branches of the left coronary artery at the large bifurcation angle. The LCX diameter of the large bifurcation angle of the plaque was significantly thicker.