CT理论与应用研究2025，Vol.34Issue(1)：23-30,8.DOI:10.15953/j.ctta.2024.172
CCTA斑块特征在冠状动脉管腔狭窄程度进展预测及预后的价值研究
Predictive Value of CCTA Plaque Characteristics for the Progression and Prognosis of Coronary Artery Stenosis
摘要
Abstract
Objective:To investigate the value of qualitative and quantitative plaque characteristics on coronary computed tomography angiography(CCTA)in predicting coronary stenosis progression and prognosis.Methods:This retrospective study analyzed the data of66 patients who underwent two CCTA examinations in Jining First People's Hospital from May 2018 to August 2023.Patients were categorized into non-progressive and progressive groups.CCTA images were processed with an artificial intelligence software for plaque analysis,identifying 87 plaques.Analysis parameters included general clinical data;plaque characteristics;stenosis range;plaque length;CT values and volumes of calcified,non-calcified,and low-density components;total plaque volume;total calcification score;equivalent mass of calcified plaque;remodeling index;low-density plaque;positive remodeling;"napkin-ring sign;"and punctate calcification.Prognoses were compared between the progression and non-progression groups and between the vulnerable and non-vulnerable plaque groups.Results:The progression group had a higher proportion of patients with diabetes and vulnerable plaques compared to the non-progression group.The calcification score,calcified component volume,proportion of calcified components,and equivalent mass of calcified plaque in the progression group were lower than those in the non-progression group,whereas punctate calcification incidence was higher than that in the non-progression group.Multivariate logistic regression analysis indicated that diabetes(odds ratio OR=3.67,95%confidence interval CI:1.21～11.11),vulnerable plaque(OR=3.97,95%CI:1.32～11.94),and punctate calcification(OR=5.73,95%CI:2.03～16.17)were independent risk factors for stenosis progression,whereas calcification volume(OR=0.986,95%CI:0.976～0.997)was an independent protective factor.Survival analysis curve revealed that major adverse cardiovascular event-free survival rate was significantly lower in the progression group than in the non-progression group and similarly lower in the vulnerable plaque group than in the non-vulnerable plaque group.Conclusions:Diabetes,vulnerable plaques,and punctate calcification are independent risk factors for coronary stenosis progression,whereas calcified component volume is an independent protective factor.The qualitative and quantitative characteristics of plaques on coronary CTA provide a good clinical value for predicting the progression and prognosis of coronary stenosis.关键词
冠状动脉CT血管造影/冠心病/斑块进展Key words
coronary computed tomography angiography/coronary heart disease/plaque progression分类
医药卫生引用本文复制引用
李正腾,王敏,潘冬梅,王宪凯..CCTA斑块特征在冠状动脉管腔狭窄程度进展预测及预后的价值研究[J].CT理论与应用研究,2025,34(1):23-30,8.基金项目
济宁市重点研发计划(双源CT双能量减影技术在评估严重钙化冠状动脉狭窄程度的应用研究(2023YXNS074) （双源CT双能量减影技术在评估严重钙化冠状动脉狭窄程度的应用研究(2023YXNS074）
AI辅助下的冠状动脉CTA预测斑块进展和急性冠脉综合征的价值探讨(2024YXNS173)). （2024YXNS173）
