He Ci, Wang Peng, Du Fei-Zhou, Yang Zhi-Gang
Department of Radiology, West China Hospital of Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041, China.
Curr Vasc Pharmacol. 2017;15(1):59-65. doi: 10.2174/1570161114666160914175627.
To evaluate the epidemiological and morphological characteristics of coronary plaque in diabetic patients with symptomatic coronary heart disease (CHD) by dual-source computed tomography (DSCT).
From June 2013 to December 2014, 267 consecutive patients with type 2 diabetes mellitus were examined by DSCT. Plaque type, distribution, as well as extent and obstructive characteristics were determined for each segment.
A total of 225 patients were included in the final study. Among the 225 cases, patients with calcium score >10 accounted for 76.9%. With the increase in calcium score, the number of obstructive stenoses increased from 17 (22.7%) to 150 (66.4%) segments, and non-obstructive stenosis decreased from 58 (77.3%) to 76 (33.6%) segments. A total of 862 (3.8±3.0 per patient) plaques were detected, of which 448 (52%) were calcified plaque, 272 (32%) mixed plaques and 142 (16%) soft plaques. Regarding the stenosis type, there were significantly more mild (54%), followed by moderate (26%) and severe stenosis (20%); 152 (67.6%) patients had .2 vascular lesions, while 73 (32.4%) patients with single diseased vessel. 190 (84.40%) patients with atherosclerotic plaque were located in left anterior descending (LAD) coronary artery, 146 (64.9%) patients in right coronary artery (RCA), 114 (50.7%) patients in left circumflex (LCX) coronary artery. The most common site of all detected plaques was the proximal segment of the LAD (18.7%).
DSCT showed that coronary arteries of diabetic patients with symptomatic CHD were more prone to calcification. There was more non-obstructive than obstructive lumen narrowing; obstructive stenosis and calcification score was positively correlated; coronary plaques were widely distributed, and mainly located in multiple diseased vessels.
采用双源计算机断层扫描(DSCT)评估有症状冠心病(CHD)糖尿病患者冠状动脉斑块的流行病学及形态学特征。
2013年6月至2014年12月,连续267例2型糖尿病患者接受DSCT检查。确定每个节段的斑块类型、分布以及范围和阻塞特征。
最终纳入研究225例患者。在这225例病例中,钙评分>10的患者占76.9%。随着钙评分增加,阻塞性狭窄节段数量从17个(22.7%)增加至150个(66.4%),非阻塞性狭窄节段从58个(77.3%)减少至76个(33.6%)。共检测到862个斑块(每位患者3.8±3.0个),其中448个(52%)为钙化斑块,272个(32%)为混合斑块,142个(16%)为软斑块。就狭窄类型而言,轻度狭窄(54%)显著居多,其次为中度狭窄(26%)和重度狭窄(20%);152例(67.6%)患者有2支以上血管病变,73例(32.4%)患者为单支血管病变。190例(84.40%)有动脉粥样硬化斑块的患者位于左前降支(LAD)冠状动脉,146例(64.9%)患者位于右冠状动脉(RCA),114例(50.7%)患者位于左旋支(LCX)冠状动脉。所有检测到的斑块最常见部位是LAD近端节段(18.7%)。
DSCT显示有症状CHD的糖尿病患者冠状动脉更易发生钙化。管腔狭窄以非阻塞性多于阻塞性;阻塞性狭窄与钙化评分呈正相关;冠状动脉斑块分布广泛,且主要位于多支血管病变。