左冠状动脉主干及其分支间的夹角与左冠状动脉斑块形成的相关性分析.docVIP

DOI：10.16016/j.1000-5404.201409054 左冠状动脉主干及其分支间的夹角与左冠状动脉斑块形成的相关性分析 吴渝千，陈 婷，郭大静，方 正，刘 佳 （400010 重庆，重庆医科大学附属第二医院放射科） [摘要] 目的 利用冠状动脉（冠脉）CT血管成像（CT angiography, CTA）探讨左冠脉主干（left main coronary artery，LM）、左前降支（left anterior descending branch，LAD）、左回旋支（left circumflex branch，LCX）三者间的夹角与局部斑块形成和分布特征之间的相关性。方法 对127例行冠脉CTA检查患者进行回顾性研究，分为正常组44例和左冠脉病变组83例，病变组进一步分为LM组（18例）、近段组（57例）、中远段组（8例）。在重建图像上测量LM、LAD、LCX三者之间的夹角，分析左冠脉夹角与局部斑块形成和分布特征之间的相关性。结果 127例患者LM与LAD间的夹角和LAD与LCX夹角(分支角）呈负相关(r=﹣0.356，P＜0.05)；LM与LCX间的夹角和分支角也呈负相关(r=﹣0.662，P＜0.05)。近段组分支角(90.9°±20.0°)与正常组(72.7°±16.7°)比较差异有统计学意义(P＜0.05)。近段组LM与LCX夹角(117.8°±16.0°)与正常组(129.5°±15.9°)比较有明显差异(P＜0.05)。LAD近段斑块形成与分支角呈正相关，和LM与LCX夹角呈负相关。当分支角＞70°时，左冠脉斑块形成机率将会增加。结论 分支角、LM与LCX间夹角均与LAD近段斑块的形成和分布相关，利用多层螺旋CTA能够为左冠脉斑块形成、风险预测及介入治疗术前提供无创、准确、快捷的相关特征信息。 [关键词] 冠脉；CT血管成像；角度；斑块 [中图法分类号] R541.4；R814.42 [文献标志码] A The correlation between intersection angles among left main coronary artery and its branches and formation of atherosclerotic plaques Wu Yuqian, Chen Ting, Guo Dajing, Fang Zheng, Liu Jia (Department of Radiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China) [Abstract] Objective To investigate the relationship between the intersection angles among left main coronary artery (LM), left anterior descending branch (LAD) and left circumflex branch (LCX) and the formation and distribution of atherosclerotic plaques in the left coronary artery by 320-row computed tomography angiography (CTA). Methods A total of 127 patients receiving CTA examinations were retrospectively analyzed and divided into a normal group (n=44), and a left coronary artery lesion group (n=83) which were further divided into three sub-groups: an LM group (n=18), a proximal group (n=57) and a middle and distal group (n=8). The intersection angles among LM, LAD and LCX on the reconstructed images were measured, and then the relationships between the intersection angles among LM, LAD and LCX and the formati