The Journal of the Korea Contents Association (한국콘텐츠학회논문지)

The Korea Contents Association (한국콘텐츠학회)
권호 표지
DOI QR코드

DOI QR Code

Analysis of Coronary Artery Atheromatous Plaque by Cardiac Computed Tomographic Angiography : Retrospective Analysis of Intravascular Ultrasound Results

심장전산화단층촬영을 이용한 관상동맥 죽상경화반의 분류 : 혈관내초음파 결과를 통한 후향적 분석

  • 최재성 (전남대학교 생물과학.생명기술학과) ;
  • 한재복 (동신대학교 방사선학과) ;
  • 최남길 (동신대학교 방사선학과)
  • Received : 2012.05.10
  • Accepted : 2012.10.05
  • Published : 2012.10.28
Download PDF
⟨ Previous Next ⟩

Abstract

In the diagnosis of coronary artery atheromatous plaque, Cardiac computed tomography (Cardiac Computed Tomographic Angiography: CCTA) compared with IVUS(Intravascular Ultrasound: IVUS) investigate the diagnostic accuracy, Interested in CCTA atheromatous plaque in computed tomography values (Hounsfield Unit: HU) try to find out. From April 2006 to August 2008 among coronary artery disease(Coronary Artery Disease: CAD) patients with confirmed or suspicious of CAD by CCTA performed atherosclerotic plaques and found 200 patients who underwent IVUS were enrolled. 200 patients who underwent CCTA and IVUS results from the 476 plaque was found, IVUS results of the soft plaque(n; 84), fibrous plaque(n; 63), mixed plaque (n; 97), calcific plaque(n; 232). The results are classified according to the IVUS plaque in HU in the soft plaque : $53.8{\pm}10.5$, fibrous plaque : $108.1{\pm}20.0$, mixed plaque : $371.2{\pm}113.1$, and calcific plaque : $731.0{\pm}160.4$. CCTA had sensitivity of 97% and confidence interval of 95.0-98.3. This study that is the diagnosis of coronary atheromatous plaque for using CCTA, we confirm the high sensitivity and the confidence interval Based on IVUS results CCTA atheromatous plaque with HU in the analysis could be classified to characterize in the treatment of patients with CAD is expected to help.

관상동맥 죽상경화반(atheromatous plaque)의 진단에 있어 혈관내초음파(Intravascular Ultrasound: IVUS)와 비교하여 심장전산화단층촬영(Cardiac Computed Tomographic Angiography: CCTA)의 진단 정확도를 알아보고, IVUS에서 발견된 죽상경화반의 성상을 CCTA에서 전산화단층촬영 수치(Hounsfield Unit: HU)로 구하고자 하였다. 2006년 4월부터 2008년 8월까지 관상동맥질환(Coronary Artery Disease: CAD)으로 확진 되었거나 CAD가 의심스러운 환자들 중 CCTA를 시행하여 죽상경화반을 발견하고 추후 IVUS를 시행한 200명의 환자를 대상으로 하였다. CCTA후 IVUS를 시행한 200명의 환자에서 476개의 죽상경화반이 발견되었으며, CCTA에서는 460개의 죽상경화반이 발견되었다. IVUS의 결과는 soft plaque(n; 84), fibrous plaque(n; 63), mixed plaque(n; 97), calcific plaque(n; 232)이었다. 이 결과에 따라 IVUS에서 분류된 죽상경화반의 HU는 soft plaque : $53.8{\pm}10.5$, fibrous plaque : $108.1{\pm}20.0$, mixed plaque : $371.2{\pm}113.1$, 그리고 calcific plaque : $731.0{\pm}160.4$ 이었으며, CCTA에서 민감도와 신뢰구간은 97%, 95.0-98.3이었다. CCTA를 이용한 관상동맥 죽상경화반의 진단을 위한 이번 연구에서 IVUS와 비교하여 높은 민감도와 신뢰구간을 확인할 수 있었고, IVUS 결과를 기준으로 CCTA에서 분석한 HU를 통해 죽상경화반의 성상을 구분할 수 있어 CAD 환자의 치료에 도움을 줄 수 있을 것으로 기대된다.

Keywords

References

  1. J. Tuomilehto, K. Kuulasmaa, and J. Torppa, "WHO MONICA Project: geographic variation in mortality from cardiovascular diseases. Baseline data on selected population characteristics and cardiovascular mortality," Q. World Health Stat, Vol.40, No.2, pp.171-184, 1987.
  2. 이원로, 홍경표, 박표원, 김덕경, 임상 심장학, 고려의학, pp.14:233-18:338, 1988.
  3. R. A. Nishimura, W. D. Edwards, C. A. Warnes,G. S. Reeder, D. R. Holmes Jr, A. J. Tajik, and P. G. Yock, "Intravascular ultrasound imaging: in vitro validation and pathologic correlation," J. Am Coll Cardiol, Vol.16, No.1, pp.145-154, 1990. https://doi.org/10.1016/0735-1097(90)90472-2
  4. E. J. Gussenhoven, C. E. Essed, C. T. Lancée, F. Mastik, P. Frietman, F. C. van Egmond, J. Reiber, H. Bosch, H. van Urk, and J. Roelandt, "Arterial wall characteristics determined by intravascular ultrasound imaging: an in vitro study," J. Am Coll Cardiol, Vol.14, No4, pp.947-952, 1989. https://doi.org/10.1016/0735-1097(89)90471-3
  5. J. M. Hodgson, K. G. Reddy, R. Suneja, R. N. Nair, E. J. Lesnefsky, and H. M. Sheehan, "Intracoronary ultrasound imaging: correlation of plaque morphology with angiography, clinical syndrome and procedural results in patients undergoing coronary angioplasty," J. Am Coll Cardiol Vol.21, No.1, pp.35-44, 1993. https://doi.org/10.1016/0735-1097(93)90714-C
  6. P. J. Scanlon, D. P. Faxon, A. M. Audet, B. Carabello, G. J. Dehmer, K. A. Eagle, and R. D. Legako, ACC/AHA guidelines for coronary angiography, A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Committee on Coronary Angiography), "Developed in collaboration with the Society for Cardiac Angiography and Interventions," J. Am Coll Cardiol, Vol.33, No.6, pp.1756-1824, 1999. https://doi.org/10.1016/S0735-1097(99)00126-6
  7. M. H. Song, T. Ito, T. Watanabe, and H. Nakamura, "Multidetector computed tomography versus coronary angiogram in evaluation of coronary artery bypass grafts," Ann Thorac Surg, Vol.79, No.2, pp.585-588, 2005. https://doi.org/10.1016/j.athoracsur.2004.08.014
  8. K. Klingenbeck-Regn, S., Schaller, T. Flohr, B. Ohnesorge, A. F. Kopp, and U. Baum, "Subsecond multi-slice computed tomography: basics and applications," J. Eur Radiol, Vol.31, No.2, pp.110-124, 1999. https://doi.org/10.1016/S0720-048X(99)00086-8
  9. B. Ohnesorge, T. Flohr, C. Becker, A. F. Kopp, U. J. Schoepf, U. Baum, A. Knez, K. Klingenbeck-Regn, and M. F. Reiser, "Cardiac imaging by means of electrocardiographically gated multisection spiral CT: initial experience," Radiology, Vol.217, No.2, pp.564-571, 2000. https://doi.org/10.1148/radiology.217.2.r00nv30564
  10. Y. H. Choe, "Noninvasive Imaging of Atherosclerotic Plaques Using MRI and CT," Korean Circ J, Vol.35, pp.1-14, 2005. https://doi.org/10.4070/kcj.2005.35.1.1
  11. B. N. Potkin, A. L. Bartorelli, J. M. Gessert, R. F. Neville, Y. Almagor, W. C. Roberts, and M. B. Leon, "Coronary artery imaging with intravascular high-frequency ultrasound," Circulation, Vol.81, No.5, pp.1575-1585, 1990. https://doi.org/10.1161/01.CIR.81.5.1575
  12. American Heart Association, Heart disease and stroke statistics—, 2005 update, American Heart Association, Dallas.
  13. C. Gaudio, F. Mirabelli, L. Alessandra, B. L. Nguyen, S. Di Michele, F. Corsi, G. Tanzilli, M. Mancone, G. Pannarale, M. Francone, I. Carbone, C. Catalano, R. Passariello, and F. Fedele, "Noninvasive assessment of coronary artery stenoses by multidetector-row spiral computed tomography: comparison with conventional angiography," Eur Rev Med Pharmacol Sci, Vol.9, pp.13-21, 2005.
  14. A. Nair, B. D. Kuban, E. M. Tuzcu, P. Schoenhagen, S. E. Nissen, and D. G. Vince, "Coronary plaque classification with intravascular ultrasound radiofrequency data analysis," Circulation, Vol.106, No.17, pp.2200-2206, 2002. https://doi.org/10.1161/01.CIR.0000035654.18341.5E
  15. K. Fujii, Y. Kobayashi, G. S. Mintz, H. Takebayashi, G. Dangas, I. Moussa, R. Mehran, A. J. Lansky, E. Kreps, M. Collins, A. Colombo, G. W. Stone, M. B. Leon, and J. W. Moses, "Intravascular ultrasound assessment of ulcerated ruptured plaques: a comparison of culprit and nonculprit lesions of patients with acute coronary syndromes and lesions in patients without acute coronary syndromes," Circulation, Vol.108, No.20, pp.2473-2478, 2003. https://doi.org/10.1161/01.CIR.0000097121.95451.39
  16. P. Libby, "Coronary artery injury and the biology of atherosclerosis: inflammation, thrombosis, and stabilization," J. Am Cardiol, Vol.86, No.8, pp.3-8, 2000. https://doi.org/10.1016/S0002-9149(00)01339-4
  17. P. D. Richardson, M. J. Davies, and G. V. Born, "Influence of plaque configuration and stress distribution on fissuring of coronary atherosclerotic plaques," Lancet, Vol.2, No.8669, pp.941-944, 1989.
  18. 장현철, "심장 CT 검사 시 ASIR 적용에 따른 선량 평가", 한국콘텐츠학회논문지, 제11권, 제5호, pp.252-259, 2011.