The Clinical Application And Study Of Atherosclerotic Plaque And Calcification By Dual-source CT Assessments Coronary Artery In Elderly People

Objective: 1.To investigate the imaging findings and characteristics of coronary atherosclerosis and calcification in the elderly. 2.To discuss of the correlation between the different coronary atherosclerotic plaques and the coronary artery stenosis in the elderly people. 3. To analyze the clinical value of dual source CT in the of heart disease. diagnosis coronaryMaterials and methods: Analyzing retrospectively the data of 187 elderly people who did the CTCA with corresponding image quality were in Sichuan People’s hospital from May 2015 to the end of June. Among them(mean age, 68.9±5.9; age range,60~82 years),including 118(63.1%)cases of male and 69(36.9%) cases of female, numbers of them were 102,79 and 6 for age group of 60~,70~ and 80~.The people aged at 60~ were divided into the middle aged group, aged at ≥70 years old were divided into the elderly group. According to the New York Heart Association segmentation, the coronary artery was divided into 15 segments. The classification of the CAS which caused by atherosclerosis can be made with three degree.The degree 1 is mild(<). The degree 2 is moderate( ≤degree of stenosis). The degree 3 is severe(≥).Identically,the classification of the coronary atherosclerotic plaques can be made with three types: the calcified, the non-calcified and the mixed; According to the morphology, the plaques were calssfied into type Ⅰplaques, Ⅱplaques and Ⅲplaques. The statistic of correlation of the CAS’s degree with the different shapes and different characteristics in the elderly was been made. Provincial stenosis 50%stenosis 50% <75%stenosis 75%p la q u e s p la q u e sResults:1. Among the 187 participants, the CAS existed in 108(57.8%) cases [mean age, 69.5 ± 5.8 years, age range, 60 to 81 years old;male,73(67.6%);female, 35(32.4%)], and the differences between the positive rate of CAS in male and female has no statistical significance(61.9% vs50.7%, of P > 0.05),and it has statistical significance in 60-69 age group with 70-79 age group(51.0% vs65.9%, of P < 0.05).2. The 108 patients with coronary calcification were discovered by CTCA, a total of 211( per, range 1 to 5) were found involved( per for female and per for male, per for aged 60~69 and 2.1±1.1 per person for aged 70~79), and male compared with female patients with an average lesion coronary count has no statistical significance(P > 0.05), aged 60~69 compared with aged 70~79 patients with an average lesion coronary count has no statistical significance(P > 0.05).Among the 211 lesions, the left anterior descending arteries(94,40.2%) were the most common. The single-vessel disease existed in 40 cases(37%) which was much higher than the multi-vessel disease. co ro n ary vessels 2.2 1.1± person 2.0 ±1.0person 2.2 ±1.1 person 2.2 ±1.1 person3. 336 plaques were existed in 187 cases(male 118 cases, female 69 cases). The most common of the cases was mixed plaque which the numble is 133(39.6% of total plaques), 101(30.1%)calcified plaques,102(30.3%)non-calcified plaques. The result of the morphological classification is : type I patch 251(74.7%), type II plaque 57(17.0%), type III plaque 28(8.3%).The difference of properties in different patchs was statistically significant(P<0.01). The difference of stenosis which caused by different plaques(including different forms and different properties) was statistically significant(P<0.01).4. The difference between the plaques’ properties of CHD groups and non-CHD groups was statistically significant(P<0.01).5. There has no statistically significant difference by analyzing the age of patients with different degree of CAS(F=0.582, P=0.56).Conclusion: Coronary atherosclerosis and calcification in the elderly may be affected by age,gender and other factors.Different shapes and different properties of plaque were related to the coronary artery stenosis degree. Dual-source CT examination can make more accurate coronary atherosclerosis diagnosis, such as nature, configuration and location of coronary atherosclerotic plaque,it is an effective imaging method for coronary heart disease, and it is beneficial to the early detection, early diagnosis and early treatment of coronary heart disease, so as to reduce the incidence of adverse cardiovascular events.