摘要
目的:探讨基于冠状动脉CT血管成像(Coronary CTA,CCTA)所测得左前降支血管腔内密度梯度相关参数预测收缩期前降支心肌桥压迫程度的诊断价值。方法:回顾性研究81例经CCTA证实有心肌桥的患者,测量并计算左前降支血管腔内密度梯度(Transluminal attenuation gradient,TAG)及其校正值(TAG standardized,TAGs)、校正后壁冠状动脉强化值(Corrected mural coronary opacification,CMCO)之差(壁冠状动脉远端校正后CT值-壁冠状动脉近端校正后CT值)、心肌桥长度、心肌桥深度,分析其在预测心肌桥收缩期压迫壁冠状动脉程度中的诊断效能。结果:TAG、TAGs、CMCO之差在显著压迫组、轻度压迫组、无压迫组中的差异均具有统计学意义(P<0.05),而心肌桥长度、深度不具有显著性差异(P>0.05)。ROC分析TAGs、CMCO之差及其联合诊断指标曲线下面积在显著收缩压迫组分别为0.81、0.83、0.89。结论:TAG、TAGs、CMCO之差与心肌桥收缩压迫程度有关,且在心肌桥具有显著收缩压迫时有较好的诊断价值,TAGs和CMCO之差联合指标的诊断价值高于单一指标,因此可通过这些参数间接判断心肌桥是否具有显著收缩压迫。
Objective: To study the diagnostic value of transluminal attenuation gradient(TAG) indices of left anterior descending artery(LAD) for myocardial bridge(MB) with significant systolic compression measured by coronary computed tomography angiography(CCTA). Materials and Methods: Eighty-one patients with confirmed MB who underwent CCTA were retrospectively included. TAG, the standardized TAG(TAGs) and corrected mural coronary opacification(CMCO) difference, MB length and MB depth were calculated to analyse the diagnostic value on MB with significant systolic compression. Results:TAG, the standardized TAG and corrected mural coronary opacification difference with significant systolic compression, slight systolic compression and without systolic compression had significant statistical differences(all P<0.05), but MB length and MB depth had no significant statistical differences(all P>0.05). ROC curve showed TAGs and CMCO difference had high diagnostic value(AUC 0.81, 0.83), combination TAGs with CMCO difference(AUC 0.89) showed remarkable improvement. Conclusion:TAG, TAGs and CMCO difference have relationship with the extent of dynamic compression of MB and have high diagnostic value on MB with significant systolic compression. So the indices have value to identify significant systolic compression of MB.
作者
张极平
李丽
王敏
ZHANG Ji-ping;LI Li;WANG Min(Jining Medical University of Clinical Medicine,Jining Shandong 272000,China;Department of Radiology,Jining No.1 people’s Hospital,Jining Shandong 272000,China)
出处
《中国临床医学影像杂志》
CAS
2020年第5期338-342,共5页
Journal of China Clinic Medical Imaging
