The Role Of Flash Dual-source Computer Tomography In Diagnosis Of Coronary Heart Disease

Background: With the incidence of coronary heart disease continues to rise,aswell as the research on the pathogenesis of coronary heart disease, people requires forearly detection of coronary heart disease, Computed tomography coronary artery isbecoming more and more important in the diagnosis of coronary heart disease.For a long time coronary angiography is the gold standard of the diagnosis ofcoronary artery disease. Due to complicated operation, invasive, expensive,large equipments and high quality operation person,test results only reflectingthe epicardial the coronary stenosis, the judgment of stenosis affecting by theprojection angle, patients and the doctors exposing to high dose X-rayirradiation etc. obviously, it cannot meet the increasing need.Looking for anew non-invasive, reproducible, easy to operate, low-cost, low-dose X-ray dose newmethod consistent with the results of coronary angiography is becoming more andmore important. The continuous progress of computed tomography technologyprovides a broad space for the early diagnosis of coronary heart disease. Especiallythe invention of Flash dual-source computer tomography greatly enhance the timeand spatial resolution in recent years, and scanning and a variety of imageprocessing technology access to coronary artery imaging quality significantlyimproved is a new hope for alternative to coronary angiography for the diagnosis ofcoronary heart disease, but clinical research is still very limited.Purpose: The search evaluated the diagnostic accuracy of second-generationdual-source computed tomography (DSCT) detecting obstructive coronary arterydisease (CAD).Materials and methods: Between January2012and October2012, we enrolled160patients (85men,75women; mean age62.1±11.9years) with suspected CAD. All patients underwent DSCT and conventional coronary angiography(CCA) in two weeks.For the DSCT scan we use50–60ml of iodinated contrast material. Data sets werereconstructed the left main coronary artery, right coronary artery, left anteriordescending branch of the left circumflex artery and its main branches vascular withmaximun intensity projection、 Curred multiplanar econstruction and volumerendering,hade surface displays,virtual endoscopy,then use convolution kernel B46fsharp algorithm for image reconstruction of a group of optimal diastolic or systolic newbest. Application of General Electric Company INOVA2000digital subtractioncardiovascular contrast, transradial coronary angiography, to Terumo5F multifunctioncatheter coronary angiography, intraoperative injection, as appropriate, iopromideinjection, surgeryafter using a random image analysis software for quantitative coronaryangiography analysis. Comparing two methods obtained the degree of coronaryatherosclerosis stenosis.Results: No patient was excluded from the analysis. Heart rate was65.5±12.6bpm. Disease prevalence was30%(48/160). Sensitivity,specificity and positive andnegative predictive values of DSCT in detecting significant stenosis were90.1%,93.3%,53.2%and99.1%(per segment),97.5%,91.2%,61.4%and99.6%(per vessel) and100%,83%,71.6%and100%(per patient), respectively.Conclusions: The excellent negative predictive value make DSCT anoninvasive method for diagnosing obstructive CAD.