目的 探讨64层螺旋CT冠状动脉成像在判别冠心病不同类型间斑块性质方面的价值.方法 经冠状动脉造影(CAG)证实明确诊断为冠心病的患者126例,行64层螺旋CT冠状动脉成像,并对主要冠状动脉狭窄节段数、狭窄程度以及斑块性质进行比较.结果 本组患者冠状动脉评估节段数368个,其中狭窄节段195个(35.4％).狭窄＜50％共98个节段,狭窄50％～75％共71个节段,狭窄＞75％共26个节段(左前降支中段、近段、后降支中段、左回旋支近段),其中完全闭塞2个(右冠状动脉近段以远、左回旋支中段以远).软斑块46个(27.3％),纤维斑块42个(31.5％),混合斑块78个(29.5％),钙化斑块93个(12.6％).对应斑块测量的CT值分别为软斑块(17±26)HU,纤维斑块(97±35)HU,钙化斑块(489±195) HU.结论 64层螺旋CT冠状动脉成像有助于显示斑块性质.%Objective To evalue the valuable of 64-detector multi-slice computed tomography (64-MSCT) coronary angi-ography in identified different coronary plaque composition. Methods One hundred and twenty-six Coronary Artery Disease (CAD) patients detected by Coronary Angiography (CAG) were studied by 64-MDSCT and then compared with the narrow section number, narrow degree and plaques stability. Results The segments number was 368, stenosis segments were 195, which were <50% , diameter narrowing segments (n=98) , 50%-75% in diameter narrowing segments (n= 71), >75% in diameter narrowing segments (n=26, the proximal part of left ventricular anterior branches, the middle pieces of left ventricular anterior branches, the middle pieces of posterior descending branches, the proximal part of left circumflex), complete obliterations (n=2, the distal of right coronary artery, the distal of left circumflex artery). The plaques were classified as soft plaques (n=46, 27. 3 %), fibrotic plaques (n=42, 31. 5 %) , calcified plaques (n=93, 12. 6 %), mixed plaques (n=78, 29. 5 %), the CT attenuation of soft plaques were (17 + 26) HU, fibrotic plaques (97 ±35) HU, calcified plaques (489+195) HU. Conclusion 64-MSCT is a useful method in identified different coronary plaque composition.
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