Feuchtner Gudrun, Postel Thomas, Weidinger Franz, Frick Matthias, Alber Hannes, Dichtl Wolfgang, Jodocy Daniel, Mallouhi Ammar, Pachinger Otmar, Zur Nedden Dieter, Friedrich Guy J
Clinical Department of Radiology II, Innsbruck Medical University, Innsbruck, Austria.
Cardiology. 2008;110(4):241-8. doi: 10.1159/000112407. Epub 2007 Dec 12.
The purpose of this study was to assess whether different coronary plaque types as classified by multislice computed tomography (CT) are retrospectively correlated with acute coronary syndromes (ACS) in an unselected study population.
Sixty-three consecutive patients were examined with 16-slice CT coronary angiography. Coronary plaque types were classified as calcifying type 1, mixed (calcifying > non-calcifying) type 2, mixed (non-calcifying > calcifying) type 3, and non-calcifying type 4. Patients who had an ACS within 17 days were included. All patients underwent invasive coronary angiography.
Fifty-eight patients (92%) had coronary plaques evaluated by CT: 18 type 1 (31%), 10 type 2 (17%), 16 type 3 (28%) and 14 type 4 (24%). The presence of a non-calcifying plaque component (types 2-4; 40 of 63 patients, 63%) was correlated with ACS (n = 15; 24%) (p < 0.001). Only type 3 was significantly correlated with ACS (p = 0.01), but plaque types 2 and 4 were not. The diagnostic accuracy of CT for detection of stenosis >50% in proximal segments was: sensitivity 98%, specificity 90%, negative predictive value 97%, positive predictive value 97% per patient.
Mixed calcifying/non-calcifying plaques with a predominantly non-calcifying component (type 3) as classified by multislice CT are retrospectively correlated with ACS.
本研究旨在评估在一个未经挑选的研究人群中，多层计算机断层扫描（CT）分类的不同冠状动脉斑块类型与急性冠状动脉综合征（ACS）之间是否存在回顾性关联。
连续63例患者接受了16层CT冠状动脉造影检查。冠状动脉斑块类型分为钙化型1、混合（钙化>非钙化）型2、混合（非钙化>钙化）型3和非钙化型4。纳入17天内发生ACS的患者。所有患者均接受了有创冠状动脉造影。
58例患者（92%）的冠状动脉斑块通过CT进行了评估：18例为1型（31%），10例为2型（17%），16例为3型（28%），14例为4型（24%）。非钙化斑块成分的存在（2 - 4型；63例患者中的40例，63%）与ACS相关（n = 15；24%）（p < 0.001）。只有3型与ACS显著相关（p = 0.01），而2型和4型斑块与ACS无关。CT检测近端节段狭窄>50%的诊断准确性为：每位患者的敏感性98%，特异性90%，阴性预测值97%，阳性预测值97%。
多层CT分类的以非钙化成分为主的混合钙化/非钙化斑块（3型）与ACS存在回顾性关联。
