Llerena-Rojas LR, Llerena-Rojas LD, Mendoza-Rodríguez V, Olivares-Aquiles EW, Marcos-Gutierrez Y, Bencomo-Rodriguez L, Rodríguez-Nande LM

Idioma: Español
Referencias bibliográficas: 25
Paginas: 25-32
Archivo PDF: 340.56 Kb.

RESUMEN

Introducción La coronariografía por tomografía computarizada multidetectores (CTCMD) visualiza la pared y la luz coronaria. La coronariografía invasiva (CORINV) solo visualiza la luz pero con mejor resolución.
Objetivo Precisar el aporte de la CTCMD y la CORINV al diagnóstico de la aterosclerosis coronaria.
Método Se estudiaron consecutivamente 85 pacientes de nuestro centro entre 2006 y 2011 por CTCMD y CORINV por sospecha de aterosclerosis. Se formaron dos grupos de pacientes según CORINV. Grupo I: Pacientes con estenosis igual o mayor del 50% (E≥50%) del diámetro de la luz que tuviesen o no, además, estenosis menores del 50% (E<50%) según CORINV y Grupo II: Solo pacientes con E<50%. Se analizaron las variables: edad, sexo, y por CTCMD: número total de placas, su localización y clasificación: calcificadas, blandas y mixtas.
Resultado El Grupo I lo integraron 48 pacientes con 512 placas, 63 con E≥50%, solo el 5% fueron calcificadas y el Grupo II formado por 37 pacientes con 217 placas. El 77% del total de placas de ambos grupos con E<50%, eran calcificadas. De los 35 pacientes con placas en el tronco coronario izquierdo solo dos con E≥50% fueron detectadas por CORINV. En 6 pacientes el diagnóstico por CTCMD resultó erróneo o dudoso por artefactos y fue necesario la CORINV para aclarar el diagnóstico.
Conclusiones La CTCMD y la CORINV contribuyen al diagnóstico integral de la aterosclerosis coronaria. La CTCMD visualiza la placa ateromatosa antes que la CORINV y precisa su composición. La CORINV permite visualizar vasos muy finos y contribuye a precisar imágenes no bien definidas por la CTCMD.

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