Application Of 64-detector Computed Tomography Coronary Angiography In Eldly Patients With Chd And Dm

Background:Coronary Heart Disease(CHD) is one of the most common diseases that threaten people's life. Diabetes Mellitus(DM) as a CHD risk equivalent promote the progress of atherosclerosis. It is proved that patient with both CHD and DM more common have multivessel atherosclerosis. Invasive coronary angiography is considered the gold standard for diagnosis of CHD. The noninvasive multislice computed tomography coronary angiography is an almost established coronary imaging technique improving day by day.64-Detector computed tomography angiography in diagnosis and assessment of coronary artery disease-especially for old people with both CHD and DM-is increasingly attentioned.Objectives:The aim of this study was to investigate the accuracy of 64-slice computed tomography coronary angiography for assessing quality and severity of coronary stenoses in comparison with invasive coronary angiography.Methods:Fifty-two eldly patients with both CHD and DM, in whom the coronary tree was first studied by 64-detector computed tomography angiography and afterwards, by invasive coronary angiography, were enrolled in the study. All the enhanced scan axial images were processed by multiplanar reconstruction (MPR), volume rendering (VR), maximum intensity projection (MIP), curved planar reconstruction(CPR), vitual endoscopy(VE), and so on. After post-processing, quality and severity of significant coronary stenoses will be assessed. All the patient were accepted invasive coronary angiography in two weeks after being given 64-detector computed tomography angiography. The sensitivity, specificity, predictive positive value and negative predictive value were determined in order to validate the diagnostic accuracy of multislice computed tomography for detection of coronary lesions compared with invasive coronary angiography.Results:In the fifty-two patients,676 coronary artery segments were assessed, 174 coronary artery segments were detected more than 50% diameter stenosis lesion by invasive coronary angiography, the lesions in 4 patients were minimal stenosis, the rest lesions were severe coronary narrow lesions; the occlusive disease have 11 segments, taking 6.3%; long diasease have 26 segments, taking 14.9%; single-vessel disease taking 19.2%(10/52), two-vessel disease taking 38.5%(20/52), three--vessel disease taking 42.3%(22/52). In 174 coronary artery segments detect more than 50% diameter stenosis lesion by invasive coronary angiography, computed tomography angiography checked out 155 coronary artery segments accurately.The sensitivity, specificity, positive predictive value, and negative predictive value were 89.1%,92.8%,81.2%, and 96.1% respectively per segment. The diagnostic accuracy in patients were very high(91.9%).Conclusions:64-detector computed tomography coronary angiography can clearly display the left main and the the main branches. Patients with DM more often have multivessel disease and serious lesions.64-detector computed tomography coronary angiography has a very good diagnostic accuracy in our study.