Study On The Correlation Between CCTA Characteristics And Serum NLR、Cys C、MPV And Hcy

Objective:1.To explore the clinical value of SSF and IBR technique in optimization of CCTA image quality.2.To analyze the correlation between CCTA characteristics of coronary artery lesion and serum NLR,MPV,Cys C,Hcy in order to provide a basis for clinical application of serum markes in predicting the risk of coronary artery disease.Methods:1.To analyze Coronary CT angiography(CCTA)date of 156 patients(622 vessels)in Lanzhou University second hospital from October 2016 to December 2017,and to evaluate the value of SSF and IBR in optimizatiom of CCTA image quality based on the standard algorithm(STD)reconstruction image in different heart rate conditions(group 1-HR < 50 BPM /min,group 2-HR 50 ~ 59 BPM / min,group 3-HR 60 ~ 69 BPM / min,group 4-HR 70 ~79BPMP / min,group 5-HR > 80 BPM / min)and heart rate fluctuation ranges(< 5 BPM,5~10BPM / min,> 10 BPM / min).2.The clinical data of 356 patients undertaken CCTA examination in Lanzhou University second hospital from April 2003 to December 2017 were analyzed retrospectively,and all patients were divided into CCTA positive Group(191 cases)and CCTA negative Group(165 cases)according to CCTA results.(1)Serum NLR,MPV,Cys C and Hcy level in different atherosclerotic plaques(Calcified Plaque,soft plaque,mixed plaque,mixed + soft plaque,mixed +Calcified Plaque,soft + Calcified Plaque)were compared for evaluating the correlation between serum markers and atherosclerotic plaque properties.(2)Serum NLR,MPV,Cys C and Hcy level in different coronary artery(CA)stenosis degree(minor stenosis,mild stenosis,moderate to severe stenosis)were compared for evaluating the correlation between serum markers and CA stenosis degree.(3)Serum NLR,MPV,Cys C and Hcy level in different coronary artery lesions(n = 1,n =2,≥ 3)were compared for evaluating the correlation between serum markers and CA lesions.Results:1.The correlation between heart rate and CCTA image quality(1)The image good rate(? grade)of coronary artery in group 1~ 4-HR was 82.27%,66.40%,56.94% and 22.41%,respectively.There was significant difference in image good rate between each group(P < 0.05);The image good rate(? grade)in heart rate fluctuation < 5 BPM group was 69.72%,which was significantly higher than that in heart rate fluctuation ≥ 5 BPM group(P < 0.01).(2)To eliminate markedly the step artifacts in patient with heart rate 50~ 60 BPM/ min.Meanwhile,SSF companied with IBR was effective for the fault and blur artifacts caused by heart rate 50~90 BPM / min and arrhythmia.(3)Compared with STD,the quality of image reconstructed by SSF,IBR and SSF+ IBR was better than that reconstructed by STD.The image good rate in SSF,IBR,and SSF+IBR was82.22%,96.15% and 90.91%,respectively.There was significant difference in image good rate between STD and SSF,IBR,SSF+IBR(P < 0.05).2.The Correlation between serum markers and the number of CA lesions,the degree of CA stenosis and plaque characteristics(1)Serum Cys C level in two branches and muti-branches lesions was markedly higher than that in the control group(0.99 ± 0.23 and 0.93 ± 0.17 vs 0.80 ± 0.16,p<0.05 and p<0.01).Serum Cys C level in two branches was markedly higher than that in one branches(2.99±2.17 Vs 2.30±1.41,p<0.05).There was no correlation between serum NLR,MPV and the number of CA lesions(p>0.05).(2)Serum Cys C level in mild stenosis group and moderate to severe stenosis group was significantly higher than those in control group(0.87 ±0.18 and 0.96±0.20 Vs 0.80±0.16,p<0.05 and p<0.01),There was significant difference in serum Cys C level between mild stenosis group and moderate to severe stenosis group.Serum NLR level in minor stenosis group and moderate to severe stenosis group were significantly higher than those in control group(2.34±1.00 and 2.82±1.99 Vs 2.30±1.41,p<0.05),and serum Hcy level in minor stenosis group was significantly higher than that in the control group(29.55±18.97 vs 17.85±10.05,p < 0.05).There was no correlation between serum MPV and the degree of CA stenosis(p>0.05).(3)Serum Cys C level was correlated with mixed plaque(0.96 ± 0.23,P<0.01),calcified plaque(0.93 ± 0.16,P<0.01),mixed + calcified plaque(0.99 ± 0.16,P<0.05)and soft plaque group(0.90 ±0.19,P<0.05).The significant difference in Serum Cys C level was found between mixed plaque group and the control group(P <0.01)and between mixed plaque group and soft plaque group(P<0.05).Serum Hcy level in calcified plaque group(22.25 ±12.95)was significantlyhigher than that in control group(17.85 ±10.05)(P < 0.01).Conclusion:1.Heart rate is the main factor affecting the image quality of CCTA.SSF and IBR,or SSF companied with IBR can eliminate markedly the fault artifacts,step artifacts and blur artifacts.2.Serum Cys C、Hcy and NLR is correlated with the number of CA lesions,degree of CA stenosis and characteristic of CA plaque,which can be used to predict the risk of coronary heart disease.