Intraluminal microchannel enhancement in coronary total occlusion lesion observed by computed tomogr

• 作 者: ZHANG Jia-yi
• 机 构: Department of Radiology,Sixth Hospital of Shanghai Jiaotong University, Shanghai 2000233,China
• 出 处: 第六届中国放射青年医师论坛
• 发表日期: 2012年5期

　　To study the presence of intra-luminal microchannel enhancement in coronary total occlusion lesions (CTO) observed by coronary computed tomography angiography (CCTA) and its correlation with outcome of percutaneous coronary intervention (PCI).Methods Consecutive clinically-ordered patients,who had CTO lesions confirmed by prior ICA and waited for staged PCI,were prospectively enrolled in our study.Intra-luminal microchannel enhancement was defined as the linear-like enhanced opacity traversing the non-opacified occluded segment,with attenuation larger than 120 hounsfield units.Lesion length,intra-luminal microchannel enhancement length and Agatston calcification score of the lesions were measured by CCTA and other angiographic morphologic characteristics were also recorded.Results Eight patients with 88 CTO lesions were finally included in our study.Fifty one lesions were successfully recanalized by PCI.Lesion length was longer in PCI failure group (P=0.043) while heavier calcification was also noted (P=0.005).Intraluminal microchannel enhancement was revealed in 30 cases of PCI success group (30/51,58.82%),which was markedly more popular than in PCI failure group (7/37,18.92%,P<0.01).Tortuous course was revealed to be the only angiographic parameter associated with unfavorable PCI outcome (P=0.008) in our study.The presence of intraluminal microchannel enhancement was proved by multivariate analysis to be the only independent predictors of PCI success (odds ratio=5.783,P=0.001).Conclusions The presence of CCTA visible intra-luminal microchannel enhancement within the occluded segment may represent intravascular microvessel formation and predicts better outcome of PCI of CTOs.