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目的分析离体冠状动脉内不同病理类型的粥样硬化斑块的 CT 值范围,探讨利用 CT值对不同类型的粥样硬化斑块进行定性诊断的可行性。方法选取25例离体心脏标本,其中冠状动脉内含有粥样硬化斑块的心脏标本9例。将造影剂稀释后,注入冠状动脉标本内,分别应用16排、64排螺旋 CT 机对标本进行薄层扫描,对发现的粥样硬化斑块进行 CT 值测量后,制成切片,进行病理分型。结果 CT 共发现冠状动脉粥样硬化斑块38个,通过与病理对照,得出当管腔 CT 值约为370 HU时,16排 CT 的测量结果为软斑块的平均 CT 值为(53±12)HU,纤维斑块的平均 CT 值为(106±17)HU,钙化斑块的平均 CT 值为(429±94)HU;64排 CT 的测量结果为软斑块的平均 CT 值为(51±13)HU,纤维斑块的平均 CT 值为(110±19)HU,钙化斑块的平均 CT 值为(435±87)HU。3种类型斑块间的 CT 值差异有统计学意义,软斑块的 CT 值明显低于纤维斑块,纤维斑块的 CT 值明显低于钙化斑块。16排和64排螺旋 CT 对3种类型斑块的 CT 值测量结果差异无统计学意义。结论应用 CT 可以对冠状动脉粥样硬化斑块进行无创性评价,CT 值是鉴别不同类型的冠状动脉粥样硬化斑块的一个很有价值的指标,对冠状动脉粥样硬化斑块的鉴别诊断具有重要意义。
Objective To analyze the range of CT value of atherosclerotic plaques with different pathological types in isolated coronary artery and to explore the feasibility of using CT value to diagnose different types of atherosclerotic plaque. Methods Twenty-five isolated cardiac samples were obtained, including 9 cases of coronary heart disease with atherosclerotic plaque. The contrast medium was diluted and injected into the coronary artery specimens. The specimens were scanned with 16-slice and 64-slice spiral CT respectively. The CT values of the atherosclerotic plaques were measured and made into slices for pathological diagnosis type. Results A total of 38 coronary atherosclerotic plaques were detected by CT. The results showed that the average CT value of 16-row CT was soft plaque with a lumen CT value of 370 HU (53 ± 12) HU. The average CT value of fibrous plaque was (106 ± 17) HU, the average CT value of calcified plaque was (429 ± 94) HU. The measurement results of 64-row CT were that the average CT value of soft plaque was 51 ± 13) HU, the average CT value of fibrous plaque was (110 ± 19) HU, and the average CT value of calcified plaque was (435 ± 87) HU. CT value of the three types of plaques was statistically significant difference, soft plaque CT value was significantly lower than fibrous plaque, fibrous plaque CT value was significantly lower than calcified plaque. There was no significant difference in CT value between 16 rows and 64 rows spiral CT on the three types of plaques. Conclusion Coronary artery atherosclerotic plaque can be noninvasively evaluated by CT. CT value is a valuable index to identify different types of coronary atherosclerotic plaque. The differential diagnosis of coronary atherosclerotic plaque It is of great significance.