대한영상의학회지 (Journal of the Korean Society of Radiology)

  • 제64권4호
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  • Pages.309-315
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  • 2011
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  • 1738-2637(pISSN)
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  • 2951-0805(eISSN)
대한영상의학회 (The Korean Society of Radiology)
권호 표지

다절편 전산화단층촬영에서 복합성 관상동맥 경화판 분석: 고식적 관상동맥 혈관조영술과의 비교

Analysis of Complex Coronary Plaque in Multidetector Computed Tomography: Comparison with Conventional Coronary Angiography

  • 김동훈 (순천향대학교 부천병원 영상의학과) ;
  • 방덕원 (순천향대학교병원 심장내과) ;
  • 석은하 (서울아산병원 마취통증의학과) ;
  • 조윤행 (순천향대학교 부천병원 심장내과)
  • Kim, Dong-Hun (Department of Radiology, Soonchunhyang University Hospital Bucheon) ;
  • Bang, Duk-Won (Department of Internal Medicine, Soonchunhyang University Hospital) ;
  • Suk, Eun-Ha (Department of Anesthesiology and Pain Medicine, Asan Medical Center) ;
  • Cho, Yoon-Haeng (Department of Internal Medicine, Soonchunhyang University Hospital Bucheon)
  • 발행 : 2011.04.01
⟨ 이전 논문 다음 논문 ⟩

초록

목적: 관상동맥 전산화단층촬영 혈관조영술(coronary CT angiography, 이하 관상동맥 CTA)을 이용하여 안정형 협심증에서 보이는 복합적 경화판의 특성을 분석하고자 하였다. 대상과 방법: 안정형 협심증의 전형적인 흉통으로 관상동맥CTA를 촬영한 환자 중 고식적인 혈관조영술(conventional coronary angiography, 이하 CAG)로 경화반이 확진된 36명을 대상으로 하였다. 혈관내초음파(intravascular ultrasonography, 이하 IVUS)는 14명 (16병변)에서 시행되었다. 경화판 형상에 대해 CTA 결과를 CAG와 비교하였으며 혈관 단절, 혈관내 결손, 혈전의 비정형성, 혈전궤양을 분석하였다. 또한, CTA에서 혈전의 음영을 조사하였다. 결과: CAG 와 CTA상 각각 44예, 34예의 복합적인 경화판(100%, 77%)이 진단되었으며 혈관 단절(27 vs. 16%, ${\kappa}$= 0.57), 혈관 내 결손(32 vs. 30%, ${\kappa}$= 0.77), 경계의 비정형성(75 vs. 52%, ${\kappa}$= 0.52), 궤양(16 vs. 11%, ${\kappa}$= 0.60)이 확인되었다. 관상동맥CTA에서 경화판의 평균 음영은 66 ${\pm}$ 21 HU 였다. 결론: 관상동맥CTA는 전형적인 협심증 환자에서 복합적인 경화판을 검사하는 정확하고 유용한 비침습적인 영상법이다.

Purpose: To delineate complex plaque morphology in patients with stable angina using coronary computed tomographic angiography (CTA). Materials and Methods: 36 patients with complex plaques proven by conventional coronary angiography (CAG), who had taken CTA for evaluation of typical angina, were enrolled in this study. Intravascular ultrasonography (IVUS) was performed in 14 patients (16 lesions). We compared CTA with CAG for plaque features and analyzed vascular cutoff, intraluminal filling defect in a patent vessel, irregularity of plaque, and ulceration. Also, the density of plaque was evaluated on CTA. Results: CAG and CTA showed complex morphology in 44 cases (100%) and 34 cases, (77%), respectively, with features including abrupt vessel cutoff (27 vs. 16%, ${\kappa}$= 0.57), intraluminal filling defect (32 vs. 30%, ${\kappa}$= 0.77), irregularity (75 vs. 52%, ${\kappa}$= 0.52), and ulceration (16 vs. 11%, ${\kappa}$= 0.60). CTA indicated that the complex lesions were hypodense (mean = 66 ${\pm}$ 21 Houndsfield Units). Conclusion: CTA is a very accurate and useful non-invasive imaging modality for evaluating complex plaque in patients with typical angina.

키워드

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