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本研究旨在评估光学相干层析(OCT)血管内成像在判定斑块形态方面的能力和缺点。将79例人体尸检冠状动脉节段标本分类为纤维帽粥样斑块、钙化斑块、纤维斑块及复合病变。OCT能够识别出45%的纤维帽粥样斑块(κ=0.27,P<0.01)、68%的纤维钙化斑块(κ=0.40,P<0.001)、83%的纤维斑块(κ=0.37,P<0.001)和100%的复合病变(所有血栓;κ=1,P<0.001)。识别错误主要是由OCT信号穿透能力低引起,以至不能探测到厚纤维帽下方的脂质池或钙化,同时也是由于其无法将钙沉积与脂质池区别开来。
The aim of this study was to evaluate the ability and disadvantage of optical coherence tomography (OCT) endovascular imaging in determining plaque morphology. 79 cases of human autopsy coronary artery segment specimens were classified as fibrous capsular plaque, calcified plaque, fibrous plaque and compound lesions. OCT recognized 45% of fibrous capsular plaques (κ = 0.27, P <0.01), 68% of fibrous calcifications (κ = 0.40, P <0.001) and 83% of fibrous plaques (κ = 0.37 , P <0.001) and 100% of compound lesions (all thrombi; κ = 1, P <0.001). Recognition errors are mainly caused by the low OCT signal penetrating ability so that lipid pools or calcification below the thick fiber cap can not be detected and also because they are unable to distinguish calcium deposits from lipid pools.