CAJ | 학술논문

　　目的利用多层螺旋CT(multislice spiral CT，MSCT)评价主动脉弹性与冠状动脉斑块性质的关系。方法收集2011年7月-2012年6月在辽宁医学院附属第一医院放射科经回顾性心电门控CT冠状动脉成像的受检者资料152例，根据CTA冠状动脉斑块的性质分为非钙化斑块组、钙化斑块组和混合斑块组，无斑块者为对照组。CT原始数据间隔10%R-R间期在5%~95%R-R间期进行图像重建，利用ADW4.5工作站冠状动脉分析软件测量冠状窦上方约15 mm处升主动脉的横断面积并测量主动脉弹性。嘱对照组于CT检查后2周内利用M型超声测量升主动脉内径，记录最大、最小内径值并计算主动脉横断面积。CT和超声检查结束后由专人测量受检者的血压。利用公式计算CT和超声测得的主动脉弹性值，比较两者结果的一致性。结果钙化斑块组(43例)主动脉弹性低于对照组(60例)[1.829±0.466(10-5/Pa) vs 3.122±0.782(10-5/Pa)](P＜0.001)；混合斑块组(31例)主动脉弹性低于对照组[1.718±0.412(10-5/Pa) vs 3.122±0.782(10-5/Pa)](P＜0.001)，非钙化斑块组(18例)和对照组弹性值的差异无统计学意义[2.834±0.433(10-5/Pa) vs 3.122±0.782(10-5/Pa)](P=0.254)。超声和CT测量对照组主动脉弹性值的一致性良好(组内相关系数ICC=0.997，P＜0.0001)。结论 MSCT可以客观评价主动脉弹性；冠状动脉出现钙化斑块、混合斑块者主动脉弹性减低，出现非钙化斑块者主动脉弹性无明显改变。
　　목적이용다층라선CT(multislice spiral CT，MSCT)평개주동맥탄성여관상동맥반괴성질적관계。방법수집2011년7월-2012년6월재료녕의학원부속제일의원방사과경회고성심전문공CT관상동맥성상적수검자자료152례，근거CTA관상동맥반괴적성질분위비개화반괴조、개화반괴조화혼합반괴조，무반괴자위대조조。CT원시수거간격10%R-R간기재5%~95%R-R간기진행도상중건，이용ADW4.5공작참관상동맥분석연건측량관상두상방약15 mm처승주동맥적횡단면적병측량주동맥탄성。촉대조조우CT검사후2주내이용M형초성측량승주동맥내경，기록최대、최소내경치병계산주동맥횡단면적。CT화초성검사결속후유전인측량수검자적혈압。이용공식계산CT화초성측득적주동맥탄성치，비교량자결과적일치성。결과개화반괴조(43례)주동맥탄성저우대조조(60례)[1.829±0.466(10-5/Pa) vs 3.122±0.782(10-5/Pa)](P＜0.001)；혼합반괴조(31례)주동맥탄성저우대조조[1.718±0.412(10-5/Pa) vs 3.122±0.782(10-5/Pa)](P＜0.001)，비개화반괴조(18례)화대조조탄성치적차이무통계학의의[2.834±0.433(10-5/Pa) vs 3.122±0.782(10-5/Pa)](P=0.254)。초성화CT측량대조조주동맥탄성치적일치성량호(조내상관계수ICC=0.997，P＜0.0001)。결론 MSCT가이객관평개주동맥탄성；관상동맥출현개화반괴、혼합반괴자주동맥탄성감저，출현비개화반괴자주동맥탄성무명현개변。
Objective To assess the correlation between aortic elasticity and coronary artery plaques using MSCT. Methods One hundred and fifty-two patients who underwent retrospective ECG-gated CT angiography in our hospital were divided into control group (n=60), non-calcified plaque group (n=18), calcified plaque group (43) and mixed plaque group (n=31). Their images were reconstructed when the 10%R-R interval of CT primary data was 5%-95%R-R. The cross-sectional area of ascending aorta at about 15 mm above the coronary orifice and aortic elasticity were measured using the coronary analysis software at the ADW4.5 station. Two weeks after CT, the longest and shortest inner diameters of aorta and the cross-sectional area of aorta in control group were measured. The blood pressure of patients was measured after CT and ultrasonography. The aortic elasticity (10-5/Pa) was calculated and compared. Results The aortic elasticity was lower in calcified plaque group and mix plaque group [1.829±0.466(10-5/Pa) vs 3.122±0.782 (10-5/Pa), 1.718±0.412 (10-5/Pa) vs 3.122±0.782 (10-5/Pa), P < 0.001]. However, no significant difference was found between non-calcified plaque group and control group [2.834±0.433 (10-5/Pa) vs 3.122±0.782 (10-5/Pa), P=0.254]. The CT angiography was well correlated with the aortic elasticity (ICC=0.997, P<0.000 1). Conclusion MSCT can assess the aortic elasticity which decreases in the presence of calcified and mixed plaques, but not in the presence of non-calcified plaques.