冠状动脉钙化无创评估和造影评估VIP专享VIP免费

BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally冠状动脉钙化病变无创评价和造影评价BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally冠状动脉钙化可能的影像发现方法Braundwald’sHeartDisease(第9版)胸片SPECTMRI心脏功能冠状动脉CT冠状动脉造影IVUS/OCTBostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally最常用的冠脉钙化评估方法BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally冠状动脉CT对冠脉钙化的评估BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternallyEBCT/MSCT检测冠脉钙化BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternallyEBCT与MDCT检测冠脉钙化的比较BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally冠状动脉钙化（CAC）积分——TheAgatstonScore根据钙化斑块的面积与密度进行评分，结果一般包括:每一支主要冠状动脉的Agatston积分，该患者的Agatston总分、代表性像片多数研究采用以下CAC积分标准对冠脉斑块负荷进行分类：•0未发现病变（Noidentifiabledisease）•1~99轻微病变（MildDisease）•100~399中度病变（ModerateDisease）•≥400严重病变（SevereDisease）BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternallyEBCT检测钙化预测冠脉狭窄BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternallyEBCT检测冠脉钙化与预后的关系BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternallyEBCT/MSCT检测冠状动脉钙化BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternallyMSCT钙化与CTO病变PCI：闭塞段钙化面积BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternallyMSCT钙化与CTO病变PCI：闭塞段钙化面积BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternallyMSCT钙化与CTO病变PCI：闭塞段钙化分布BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally透视/造影对冠状动脉钙化的评估BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally冠状动脉造影时如何评估冠脉钙化BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternallyBostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally透视/造影钙化对冠脉狭窄的预测BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally透视/造影冠脉钙化的分度与类型BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally冠脉钙化程度的判断AccordingtothedensityofimageNone:NocalcificationshadowsMild:LightandfuzzycalcificationshadowswithheartbeatModerate:ClearcalcificationshadowswithheartbeatSevere:ClearcalcificationshadowswithorwithoutheartbeatInterventionalCardiology.199l.l:1052-1068．BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally透视/造影冠脉钙化评估的局限性Lowsensitivity(50%)CannotbeusedforquantitativeanalysisofcalcifiedlesionsCannotaccuratelyevaluatethetruedistributionofcalcifiedlesionsCannotdistinguishbetweensuperficialcalcificationanddeepcalcificationLowdetectionrateoffocalcalcificationandpunctatecalcificationGlobJHealthSci.2012.4:65-93BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally病例BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally透视/造影见冠状动脉狭窄伴局限性钙化BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally思考•介入治疗的术式：单支架或多个支架？•钙化的严重程度？•是否需要IVUS进一步评估？BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally2.5/15mm预扩张球囊和2.75/15mm后扩张球囊预扩（20atm），3.5/24mm支架不能通过BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally1.5burr/145000BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternallyBostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally