CT 虚拟血管内内窥镜评估冠状动脉斑块：初步研究。

CT virtual intravascular endoscopy assessment of coronary artery plaques: a preliminary study.

机构信息

Discipline of Medical Imaging, Department of Imaging and Applied Physics, Curtin University of Technology, GPO Box, U1987, Perth 6845, Australia.

出版信息

Eur J Radiol. 2010 Jul;75(1):e112-9. doi: 10.1016/j.ejrad.2009.09.007. Epub 2009 Sep 24.

DOI:10.1016/j.ejrad.2009.09.007

PMID:19781885

Abstract

PURPOSE

The purpose of this study was to investigate the potential value of CT virtual intravascular endoscopy (VIE) in the visualization and assessment of coronary plaques in patients suspected of coronary artery disease.

MATERIALS AND METHODS

20 (13 men, 7 women, mean age 54 years) consecutive patients with suspected coronary artery disease undergoing 64-slice CT angiography were included in the study. Four main coronary artery branches were assessed with regard to the presence of coronary plaques based on 2D axial, multiplanar reformation, 3D volume rendering and VIE visualizations. The coronary plaques were characterized into calcified, noncalcified and mixed plaques. The intraluminal appearances of these coronary plaques were demonstrated with VIE images and correlated with 2D and 3D images to determine the diagnostic value of VIE for the assessment of the plaques.

RESULTS

VIE was able to identify and demonstrate the intraluminal appearances of coronary plaques in 18 patients involving 32 coronary artery branches which were shown as an irregularly intraluminal protruding sign in extensively calcified plaques and smooth protruding appearance in noncalcified or focally calcified plaques. An irregular intraluminal appearance was also noticed in the presence of mixed plaques due to variable components with different CT attenuations contained within the plaques. VIE accurately confirmed the degree of coronary stenosis or occlusion despite the presence of heavy calcification.

CONCLUSION

VIE could be used as a complementary tool to conventional CT visualizations for the analysis of luminal changes and assessment of disease extent caused by the coronary plaques.

摘要

目的

本研究旨在探讨 CT 虚拟血管内镜（VIE）在疑似冠心病患者冠状动脉斑块可视化和评估中的潜在价值。

材料与方法

本研究纳入了 20 例（男 13 例，女 7 例，平均年龄 54 岁）连续疑似冠心病行 64 层 CT 血管造影的患者。基于 2D 轴位、多平面重建、3D 容积再现和 VIE 可视化，对 4 个主要冠状动脉分支进行评估，观察是否存在冠状动脉斑块。将冠状动脉斑块分为钙化斑块、非钙化斑块和混合斑块。VIE 图像显示这些冠状动脉斑块的管腔内部表现，并与 2D 和 3D 图像相关联，以确定 VIE 对斑块评估的诊断价值。

结果

VIE 能够识别并显示 18 例患者的 32 个冠状动脉分支的管腔内部斑块，在广泛钙化斑块中表现为不规则管腔突出征，在非钙化或局灶性钙化斑块中表现为光滑突出征。在混合斑块中，由于斑块内含有不同 CT 衰减值的可变成分，也可观察到不规则的管腔内部表现。尽管存在重度钙化，VIE 仍能准确地确认冠状动脉狭窄或闭塞的程度。