Koroner Arter Anevrizmalı Hastalarda Koroner Aterosklerozun MDBT Anjiyografi Kullanılarak CAD-RADS Skorlama Sistemi ile Değerlendirilmesi

Yıl 2022, Cilt: 4 Sayı: 2, 209 - 16, 01.05.2022

Tuna Şahin

https://doi.org/10.37990/medr.1080981

Öz

Amaç: Bu makale koroner arter hastalığı ön tanısı ile koroner Multidedektör Bilgisayarlı Tomografi (MDBT) Anjiyografi yapılan ve koroner arter anevrizması (KAA) saptanan hastalarda, ‘’Coronary Artery Disease Raporting And Data System’’ (CAD-RADS) sınıflaması ile aterosklerozun derecesini ve sıklığını araştırmak ve ayrıca KAA’da predispozan faktörleri, yaygınlığını, tanı kriterlerini ve komplikasyonlarını BT görünümleri eşliğinde ele almaktır.
Materyal ve Metot: Koroner MDBT Anjiyografi çekilen 3694 hastanın tetkiklerini retrospektif olarak inceledik. KAA tespit edilen 23 hasta ile birlikte KAA bulunmayan 46 hasta dahil toplam 69 hastayı aterosklerotik tutulum açısından CAD-RADS sınıflama sistemini kullanarak değerlendirdik ve bulguları karşılaştırdık.
Bulgular: KAA en sık sağ koroner arterde (RCA) bulunurken, bunu sol anterior desendan arter (LAD), sol sirkümfleks (LCX), sol ana koroner arter (LMCA) ve posterolateral dal (PLD) izledi. KAA olan hastalarda en sık ateroskleroz görülen damarlar sırasıyla LAD, LCX, RCA ve LMCA iken anevrizması olmayan hastalarda LAD, RCA, LCX, LMCA, PLD ve PDA olarak tespit edildi. KAA olan 5 hastada (21.7 %) ve olmayan 15 hastada (32.6 %) ateroskleroz saptanmadı (p>0.05).
Sonuç: KAA’lı hastalarda CAD-RADS skorlaması kullanılarak hesaplanan aterosklerotik damar sayısı ve darlık derecesi, anevrizması olmayan hastalar ile benzerdir.

Anahtar Kelimeler

Koroner arter anevrizması, koroner ateroskleroz, MDBT anjiyografi

Evaluation of Coronary Atherosclerosis in Patients with Coronary Artery Aneurysm With CAD-RADS Scoring System Using MDCT Angiography

Öz

Aim: This article aims to investigate the degree and frequency of atherosclerosis using the “Coronary Artery Disease Reporting and Data System” (CAD-RADS) classification in patients who underwent coronary Multidetector Computed Tomography (MDCT) Angiography with a preliminary diagnosis of coronary artery disease and were found to have coronary artery aneurysm (CAA) and also to discuss the predisposing factors, prevalence, diagnostic criteria and complications in CAA with CT images.
Material and Methods: We retrospectively evaluated the examinations of 3694 patients who underwent coronary MDCT angiography. We evaluated a total of 69 patients including 23 patients with CAA and 46 patients without CAA, in terms of atherosclerotic involvement using the CAD-RADS classification system and compared the findings.
Results: CAA was most frequently found in the right coronary artery (RCA), followed by the left anterior descending artery (LAD), left circumflex (LCX), left main coronary artery (LMCA), and posterolateral branch (PLB). In patients with CAA, the most frequently atherosclerosis observed vessels were LAD, LCX, RCA, and LMCA, respectively, while LAD, RCA, LCX, LMCA, PLD, and PDA were detected in patients without an aneurysm. No atherosclerosis was detected in 5 patients (21.7 %) with CAA and 15 patients (32.6 %) without CAA (p>0.05).
Conclusion: The number of atherosclerotic vessels and the degree of stenosis calculated using the CAD-RADS scoring in patients with CAA are similar to patients without an aneurysm. The fact that atherosclerosis is an important factor in the etiology of aneurysms may explain this situation.  

Anahtar Kelimeler

Coronary artery aneurysm, coronary atherosclerosis, MDCT angiography

Kaynakça

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