Zhang WeiGuo, Jin Hang, Cheng WeiZhong, Rao ShengXiang, Lu XiuLiang, Zeng Mengsu
From the *Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai; and †Department of Radiology, The First Affiliated Hospital of Suzhou University, Suzhou, China.
J Comput Assist Tomogr. 2013 Sep-Oct;37(5):701-6. doi: 10.1097/RCT.0b013e318299f006.
This study aimed to evaluate the correlation between coronary atherosclerosis and the phenotype of subclinical carotid artery plaque using 320-row computed tomography via an original single-injection protocol.
A total of 122 patients with suspected coronary artery disease but free of transient ischemic attack and stroke underwent computed tomographic angiography of carotid and coronary artery simultaneously. The mean attenuation was measured at each artery. The plaques in either carotid or coronary were classified into noncalcified, calcified, and mixed. Coronary plaque was evaluated with plaque score. Logistic regression analysis was used to determine the predictive value of coronary plaque score to the phenotype of carotid plaque. The prevalence of each phenotype of carotid plaque in different coronary stenosis groups was also analyzed.
The mean (SD) attenuation of carotid and coronary artery was 456.3 (81.7) Hounsfield units (HU), 466.0 (85.5) HU, 446.5 (84.1) HU, and 476.4 (90.0) HU, respectively. There was a significant correlation between the noncalcified coronary plaque score and noncalcified plaque in carotid artery (odds ratio [OR], 2.9; P < 0.05). The coronary calcified plaque scores were significantly correlated with carotid mixed (OR, 1.8; P < 0.05) and calcified plaque (OR, 2.0; P < 0.05). The noncalcified plaque of carotid artery was more frequent (72.5% vs 67%) in the nonsignificant coronary stenosis group.
The subclinical carotid plaque phenotypes are significantly associated with coronary plaque score and defined grade of stenosis in patients with suspected coronary artery disease. Our tailored computed tomographic angiography protocol may have a positive impact on secondary prevention.
本研究旨在通过一种原始的单次注射方案，利用320排计算机断层扫描评估冠状动脉粥样硬化与亚临床颈动脉斑块表型之间的相关性。
共有122例疑似冠心病但无短暂性脑缺血发作和中风的患者同时接受了颈动脉和冠状动脉的计算机断层血管造影。测量每条动脉的平均衰减值。颈动脉或冠状动脉中的斑块分为非钙化、钙化和混合性。用斑块评分评估冠状动脉斑块。采用逻辑回归分析确定冠状动脉斑块评分对颈动脉斑块表型的预测价值。还分析了不同冠状动脉狭窄组中颈动脉斑块各表型的患病率。
颈动脉和冠状动脉的平均（标准差）衰减值分别为456.3（81.7）亨氏单位（HU）、466.0（85.5）HU、446.5（84.1）HU和476.4（90.0）HU。非钙化冠状动脉斑块评分与颈动脉非钙化斑块之间存在显著相关性（比值比[OR]，2.9；P<0.05）。冠状动脉钙化斑块评分与颈动脉混合性（OR，1.8；P<0.05）和钙化斑块（OR，2.0；P<0.05）显著相关。在冠状动脉狭窄不显著的组中，颈动脉非钙化斑块更为常见（72.5%对67%）。
在疑似冠心病患者中，亚临床颈动脉斑块表型与冠状动脉斑块评分及明确的狭窄程度显著相关。我们定制的计算机断层血管造影方案可能对二级预防有积极影响。
