Gerber T C, Erbel R, Görge G, Ge J, Rupprecht H J, Meyer J
2nd Medical Clinic, Mainz University, Germany.
Am J Cardiol. 1994 Apr 1;73(9):666-71. doi: 10.1016/0002-9149(94)90931-8.
This study used intravascular ultrasound (IU) to assess the incidence and extent of left main coronary artery (LMCA) disease and the effects of arterial remodeling. Sixty-nine patients undergoing cardiac catheterization were imaged with a 20 MHz rotational-tip IU device. Nine of the 69 studies (13%) could not be analyzed because of technical (n = 2) or anatomic (n = 7) reasons. Of the remaining 60 patients, 38 (63%) had at least 1 lesion in the left coronary artery perfusion territory by angiography; significant LMCA stenosis was present in 2 patients (3%). Intravascular ultrasonography demonstrated plaques in 27 of 60 LMCAs (45%), 6 of them in patients with normal angiograms. Twenty-four plaques (89%) were eccentric and calcium was present in 4 (15%). The mean minimal lumen diameter was 4.9 +/- 0.8 mm, the maximal lumen diameter was 5.6 +/- 0.8 mm, the planimetered lumen area was 22.6 +/- 6.0 mm2, the plaque area was 3.9 +/- 5.8 mm2, the vessel area was 26.5 +/- 5.9 mm2, and the area stenosis was 13 +/- 19%. In the 27 patients with plaque, plaque area was 8.7 +/- 5.7 mm2 and the area stenosis was 30 +/- 17%. The vessel area was significantly larger in diseased LMCAs (p < 0.001) and correlated with plaque area (r = 0.46). IU examination of the LMCA was feasible in 87% of patients and was more reliable for delineating plaques than angiography.
本研究采用血管内超声（IU）评估左主干冠状动脉（LMCA）疾病的发生率和范围以及动脉重塑的影响。69例接受心脏导管插入术的患者用20MHz旋转探头IU设备进行成像。69项研究中的9项（13%）因技术（n = 2）或解剖（n = 7）原因无法分析。在其余60例患者中，38例（63%）经血管造影显示左冠状动脉灌注区域至少有1处病变；2例患者（3%）存在显著的LMCA狭窄。血管内超声显示60条LMCA中的27条（45%）有斑块，其中6例患者血管造影正常。24个斑块（89%）为偏心性，4个（15%）有钙化。平均最小管腔直径为4.9±0.8mm，最大管腔直径为5.6±0.8mm，平面测量的管腔面积为22.6±6.0mm²，斑块面积为3.9±5.8mm²，血管面积为26.5±5.9mm²，面积狭窄为13±19%。在27例有斑块的患者中，斑块面积为8.7±5.7mm²，面积狭窄为30±17%。病变的LMCA血管面积明显更大（p < 0.001），且与斑块面积相关（r = 0.46）。87%的患者可行LMCA的IU检查，且在描绘斑块方面比血管造影更可靠。
