Clinical Application Research Of Dual-source CT In Coronary Artery Disease Diagnosis

Objective：1、To explore dual-source CT coronary artery imaging accuracy in diagnosis ofcoronary heart disease, evaluation clinical value of dual-source CT in the diagnosis ofcoronary artery stenosis.2、To explore the clinical value of dual-source CT in the diagnosis of myocardialbridge, comparison examination ability of myocardial bridge between dual-source CTand conventional coronary angiography, explore the relationship between myocardialbridge and coronary atherosclerosis.Methods：The first part: the data of100patients who successively line underwent dual-source CT coronary artery imaging and invasive coronary angiography in1monthfrom April2011to May2012, include81men,19women, age range38~83yearsmean age62.2years. With invasive coronary angiography as the gold standard,evaluate the clinical value of dual-source coronary CTA in the diagnosis of coronaryartery different stenosis.The second part: the data of1226patients who underwent dual-source coronaryartery imaging from April2011to May2012, include808men,418women, agerange22~91years, mean age62.3years. calculation Dual-source CT detection ofmyocardial bridge, analysis whether different clinical features between the group withmyocardial bridge and the group without myocardial bridge, study relationshipbetween myocardial bridge and the proximal coronary atherosclerosis, comparemyocardial bridge be detected rate between dual-source CT and conventionalcoronary angiography.Results：Part one:100patients with1351coronary arteries, respectively calculate thedifferent degree of coronary stenosis(diagnosis of narrow<50%, narrow≥50%andnarrow≥75%) sensitivity, specific, positive predictive value, negative predictive value, the respectively sensitivity:85.92%,93.64%,92.65%; the respectively Specific:97.75%,99.82%,100%; the respectively Positive predictive value:90.62%,99.10%,100%; the respectively Negative predictive value:98.05%,98.49%,99.18%; therespectively accuracy rate are96.31%,98.52%,99.25%. by SPSS11.5softwareWilcoxon rank and inspection, showed no statistical difference between dual-sourceCT and CAG(p>0.05).Part two: in the1226cases patients, dual-source CT detected581patients,650myocardial bridge, total incidence was47.4%.patients who with myocardial bridgegroup and without myocardial bridge group in age, gender, hypertension, diabetes,hyperlipidemia clinical features have no statistical difference (p>0.05). Left anteriordescending coronary myocardial bridge and the proximal coronary atherosclerosiswith narrow and disease are closely related, compared group without myocardialbridge, there is statistically significant differences (p<0.05). there is a statisticallysignificant difference between Dual-source CT and conventional coronaryangiography to detect myocardial bridge (p <0.05).Conclusion：Dual-source CT due to the time resolution is obviously improved, powerfulpost-processing ability, dual-source coronary CTA in the diagnosis of coronary arterystenosis degree compared with invasive coronary angiography has high consistency,dual-source CT examination is convenient, noninvasive advantages as the importantchoice used for patients who suspected coronary artery disease clinical preoperativescreening and PCI in patients with after for the follow-up review. Dual-sourcecoronary CTA can clear display of coronary artery and myocardial structure.Dual-source CT is a noninvasive and effective detection methods used for thedetection of myocardial bridge. The proximal coronary artery with myocardial bridgeis easy to form coronary atherosclerotic plaque.