摘要
目的:探讨中-重度肾功能不全患者冠状动脉(冠脉)病变的CT表现。方法:对36例临床初步诊断为中-重度肾功能不全患者进行回顾分析。所有患者均行钙化积分CT平扫、双能量冠脉扫描,并进一步分析病变节段冠脉所对应的心肌成像。结果:共分析36例中-重度肾功能不全患者的168支冠脉,其中有52支冠脉存在不同程度的钙化[20支左前降支(LAD)存在钙化,35支发生弥漫性钙化]。AJ130≥100有13例,存在冠脉病变26例,其中3支冠脉病变15例;病变总段数为126段,其中LAD近段17段,左回旋支(LCX)近段14段,右冠状动脉(RCA)近段16段;轻度狭窄88段,中度狭窄24段,重度狭窄14段;软斑68块,混合斑19块,钙化斑123块;冠脉中-重度狭窄(管腔狭窄≥50%)者,灌注缺损心肌与正常心肌CT值及碘值差异有统计学意义(P值均<0.01);冠脉轻度狭窄(管腔狭窄<50%)的患者,灌注缺损心肌与正常心肌CT值及碘值差异也有统计学意义(P值亦均<0.01)。结论:中-重度肾功能不全患者的冠脉钙化积分阳性率、冠脉病变阳性率及相应节段心肌灌注缺损率均较高。
Objective To evaluate the CT performance of coronary artery disease in patients with moderate-severe renal insufficiency.Methods A retrospective analysis was made on 36 cases of moderate-severe renal insufficiency diagnosed by clinical data.All patients underwent calcium score scanning and dual energy coronary scanning.All data were further analyzed including coronary artery and heart imaging in the corresponding coronary artery segment.Results A total of 168 coronary branches in 36 patients with moderate-severe renal insufficiency were analyzed.Among which 20 branches had calcification lesions in LAD and 35 had diffuse calcification lesions;13 cases were AJ130≥ 100;26 cases had coronary lesions.The total number of segmental lesions was 126：17 in the proximal segment of left anterior descending coronary artery,14 in the proximal segment of left circumflex coronary artery,16 in the proximal segment of right coronary artery;mild stenosis of the lumen in 88 segments,moderate stenosis in 24 segments,severe stenosis in 14 segments;soft plaques in 68 lesions and mixed plaques in 19 lesions.The corresponding P values of CT and iodine values between perfusion defect myocardium and normal myocardium were 0.01 and 0.01,respectively.Conclusions The positive rate of coronary calcification,the incidence of coronary lesion and the rate of corresponding segment myocardial perfusion defect in patients with moderate-severe renal insufficiency are significantly higher than those in normal people.
出处
《诊断学理论与实践》
2011年第6期523-526,共4页
Journal of Diagnostics Concepts & Practice
关键词
慢性肾功能不全
钙化积分
冠状动脉病变
首过心肌灌注
双能量扫描
Chronic renal insufficiency
Calcium score
Coronary artery disease
First-pass myocardial perfusion
Dual energy scannning
作者简介
通讯作者：潘自来E-mail：zilaipanlilly@yahoo．com．cn
