- 學位論文
利用冠狀動脈電腦斷層檢查量測左分支夾角： 斑塊位置、冠狀動脈疾病及危險因子的關係
Coronary CT Angiography Measurements of Left Bifurcation Angle: Investigation of Relationship among Plaque Location, Risk Factors and Coronary Artery Disease
摘要
研究目的：本研究主要探討疑似有冠狀動脈疾病(coronary artery disease, CAD)的病患中，測量其左冠狀動脈的左前降支(left anterior descending, LAD)和左迴旋支(left circumflex, LCx)之間的夾角角度，並紀錄其斑塊類型和斑塊位置，且分析此類因子與冠狀動脈疾病間之關係，同時也比較其它危險因子。 材料與方法：本研究採回溯性研究，於台中某教學醫院蒐集病例，蒐集時間從2010年1月至2016年5月之間做過電腦斷層冠狀動脈攝影(coronary CT angiography, CCTA)之病患，總計103人，將蒐集案例之DICOM(Digital Imaging and Communications in Medicine)檔匯入分析軟體Analyze 7.0 (AnalyzeDirect, Inc.,Lexana, KS, USA)進行後處理，每位患者以其影像測量左冠狀動脈的夾角，測量三次取平均值，並記錄之。危險因子為蒐集34位病患之膽固醇、三酸甘油脂、飯前血糖和低密度脂蛋白，統計採SPSS電腦統計套裝軟體之t考驗和卡方考驗進行分析。 結果：103位病患中，扣除影像品質不佳的病患，86位患者中，38位病患在冠狀動脈內發現有斑塊，平均夾角角度為84.63°±18.28°，而另外46位沒發現斑塊之病人，其平均角度為62.10°±15.20°，在年齡方面，有冠狀動脈斑塊之病患年齡也大於沒有斑塊之病患，斑塊發生在51歲-60歲年齡層的機率最高，而斑塊分布在LAD比例最高。危險因子方面，有斑塊病患之膽固醇和三酸甘油脂皆高於沒有斑塊病人，但沒有達到統計上之顯著差異。 結論：從結果得知，患有冠狀動脈疾病的病人左冠狀動脈夾角明顯大於正常人，年齡方面，51歲-60歲最常發現在冠狀動脈內有斑塊，而斑塊最常發生的位置在LAD。
並列摘要
Purpose: The purpose of this study is to measured the angle between the left anterior descending coronary artery (LAD) and the left circumflex artery (LCx) in patients with suspected coronary artery disease (CAD).Also record the type of plaque and plaque location, and analysis the relationship between angel and coronary artery disease, in the same time compared the risk factor. Material and Methods: This is a retrospective study involves reviewing consecutive patients who underwent CCTA examination, between January 2010 to May 2016, the total number of 103 patients. Collecting DICOM image were transferred to a separate workstation equipped with Analyze 7.0 software (AnalyzeDirect, Inc., Lexana, KS, USA) for image post-processing and analysis. Each patient was measure three times on 3D volume rendered images at different positions and average. Also analysis the risk factor, cholesterol, triglycerides, blood glucose. Statistical analysis were performed using SPSS, using Chi-square test and t-test. Results: In 103 patients, image quality was found good or excellent in 86 patients. 38 patients had discover plaque in coronary artery, and the mean bifurcation angel was 84.63°±18.28°, and the other 46 had no plaque, the mean bifurcation angel was 62.10°±15.20°. The group of age that got most patients who had plaque were 51 years old to 60 years old, and the distribution of plaque occurs in LAD the most. In risk factor, found out that cholesterol and blood glucose value were higher in those patients who had plaque. Conclusion: The bifurcation angel were wider in patients who had plaque compare to the normal patients.
參考文獻
延伸閱讀
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