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双源CT冠状动脉造影评估冠状动脉扩张的患病率及形态学

Prevalence and morphology of coronary artery ectasia with dual-source CT coronary angiography.

作者信息

Leschka Sebastian, Stolzmann Paul, Scheffel Hans, Wildermuth Simon, Plass André, Genoni Michele, Marincek Borut, Alkadhi Hatem

机构信息

Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.

出版信息

Eur Radiol. 2008 Dec;18(12):2776-84. doi: 10.1007/s00330-008-1087-6. Epub 2008 Jul 19.

Abstract

To assess the prevalence and morphological characteristics of coronary artery ectasia (CAE) with CT coronary angiography (CTCA) in comparison to conventional catheterangiography (CCA). Dual-source CTCA examinations from 677 consecutive patients (223 women; median age 57 years) were retrospectively evaluated by two blinded observers for the presence of CAE defined as a diameter enlargement > or = 1.5 times the diameter of adjacent normal coronary segments. Vessel diameters and contrast attenuation within and proximal to ectatic segments were measured. CCA was used to compare measurements obtained from CTCA with the coronary flow velocity by using the thrombolysis in myocardial infarction (TIMI) frame count. CTCA identified CAE in 20 of 677 (3%) patients. CCA was performed in ten of these patients. CAE diameter measurements with CTCA (10.0 +/- 5.4 mm) correlated significantly (r = 0.92, p < 0.001) with the CCA measurements (8.8 +/- 4.9 mm), but had higher diameters (levels of agreement: -1.0 to 3.4 mm). Contrast attenuation was significantly lower in the ectatic (343 +/- 63 HU) than in the proximal (394 +/- 60 HU) segments (p < 0.01). The attenuation difference significantly correlated with the CAE ratio (r = 0.67, p < 0.01) and the TIMI frame count (r = 0.58, p < 0.05). The prevalence of CAE in a population examined by CTCA is around 3%. Contrast attenuation measurements with CTCA correlate well with the flow alterations assessed with CCA.

摘要

通过CT冠状动脉造影(CTCA)评估冠状动脉扩张(CAE)的患病率和形态特征,并与传统导管血管造影(CCA)进行比较。对677例连续患者(223例女性;中位年龄57岁)的双源CTCA检查进行回顾性评估,由两名不知情的观察者判断是否存在CAE,CAE定义为直径增大超过或等于相邻正常冠状动脉节段直径的1.5倍。测量扩张节段及其近端的血管直径和对比剂衰减。使用心肌梗死溶栓(TIMI)帧数,通过CCA将CTCA获得的测量值与冠状动脉流速进行比较。CTCA在677例患者中的20例(3%)发现了CAE。其中10例患者进行了CCA。CTCA测量的CAE直径(10.0±5.4mm)与CCA测量值(8.8±4.9mm)显著相关(r = 0.92,p < 0.001),但直径更高(一致性水平:-1.0至3.4mm)。扩张节段的对比剂衰减(343±63HU)显著低于近端节段(394±60HU)(p < 0.01)。衰减差异与CAE比率(r = 0.67,p < 0.01)和TIMI帧数(r = 0.58,p < 0.05)显著相关。CTCA检查人群中CAE的患病率约为3%。CTCA的对比剂衰减测量值与CCA评估的血流改变相关性良好。

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