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冠状动脉疾病患者中,通过全身磁共振血管造影检测到的伴随动脉粥样硬化疾病与冠状动脉钙化的关系。

Concomitant atherosclerotic disease detected by whole-body MR angiography in relation to coronary artery calcification in patients with coronary artery disease.

作者信息

Seng K, Breuckmann F, Schlosser T, Barkhausen J, Geckeis K, Budde T, Hoefs C, Schmermund A, Erbel R, Ladd S C

机构信息

Universitätsklinikum Essen, Abteilung für diagnostische und interventionelle Radiologie und Neuroradiologie.

出版信息

Rofo. 2010 Apr;182(4):334-40. doi: 10.1055/s-0028-1109832. Epub 2009 Nov 25.

Abstract

PURPOSE

Patients with coronary artery disease (CAD) show a high prevalence for concomitant atherosclerotic peripheral arterial disease (PAD). On the other hand, PAD seems to be an additional risk factor for cardiac events. We evaluated the correlation between arterial pathologies as found in whole-body MR angiography and coronary artery calcification (CAC) detected by electron beam computed tomography (EBCT) and multislice CT (MSCT).

MATERIALS AND METHODS

Two hundred and twenty-eight patients (161 men; 67 women) with suspicion for CAD/known CAD underwent whole-body contrast-enhanced MR angiography (wb-ce-MRA) and EBCT/MSCT. An atherosclerosis index was calculated for each patient Index = (40)Sigma(n=1) w(i) with w(i) being the grading of the stenosis of the i (ten) of 40 arteria segments (grade: 0 - no plaque; 1 - plaque - < or = 50 % stenosis; 2 - > 50 % stenosis - < or = 90 % stenosis; 3 - > 90 % stenosis - < 100 % stenosis; 4 - occlusion). Correlations between CAC and atherosclerosis index were performed.

RESULTS

Wb-ce MRA and CAC correlate only moderately in this population. An atherosclerosis index 8 renders a positive predictive value for a CAC 100 of 63.3 %.

CONCLUSION

An atherosclerosis index as defined in this study does not fully correlate with the extent of CAD as revealed by catheter angiography or EBCT/MSCT, but it might theoretically mirror the increased risk by PAD. It thus might be a promising complementary parameter for the prediction of cardiac events. Future studies need to show its possible additional predictive impact.

摘要

目的

冠心病(CAD)患者中,合并动脉粥样硬化性外周动脉疾病(PAD)的患病率较高。另一方面,PAD似乎是心脏事件的一个额外危险因素。我们评估了全身磁共振血管造影中发现的动脉病变与电子束计算机断层扫描(EBCT)和多层螺旋CT(MSCT)检测到的冠状动脉钙化(CAC)之间的相关性。

材料与方法

228例疑似CAD/已知CAD的患者(161例男性;67例女性)接受了全身对比增强磁共振血管造影(wb-ce-MRA)和EBCT/MSCT检查。为每位患者计算动脉粥样硬化指数:指数=(40)∑(n=1)w(i),其中w(i)为40个动脉节段中第i个节段(共10个)的狭窄分级(分级:0 - 无斑块;1 - 斑块 - 狭窄≤50%;2 - 狭窄>50% - ≤90%;3 - 狭窄>90% - <100%;4 - 闭塞)。进行了CAC与动脉粥样硬化指数之间的相关性分析。

结果

在该人群中,wb-ce MRA与CAC仅呈中度相关。动脉粥样硬化指数为8时,CAC为100的阳性预测值为63.3%。

结论

本研究中定义的动脉粥样硬化指数与导管血管造影或EBCT/MSCT所显示的CAD程度并不完全相关,但理论上它可能反映了PAD增加的风险。因此,它可能是预测心脏事件的一个有前景的补充参数。未来的研究需要显示其可能的额外预测作用。

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