Research On The Application Of Dual-source CT Coronary Angiography In Evaluating Coronary Artery Disease

Objective To evaluate the accuracy of dual-source CT in detectingto varying degrees coronary artery stenoses， compared to coronaryangiography（SCAG）,the golden standard test.Method Total33patients suspected or confirmed coronary heartdisease were examined by64-slice dual-source CT coronary angiographyand SCAG.Results382segments of the coronary arteries of33patients weretaken to the study.121segments were found both by CTA and SCAG,11werefound by SCAG only,19were found by CTA only,and208were showed stenosisby neither CTA or SCAG.The sensitivity，specificity，positive predictivevalue and negative predictive value of64－slice dual-source CT coronaryangiography in diagnosing coronary stenosis were92.9%、91.6%、88.3%、and94.9%， respectively. DSCTA showed good agreement with SCAG (K=0.838)；The sensitivity of DSCTA in diagnosing mild, moderate and severestenosis was79.2%,87.2%and89.4%respectively.There were notstatistically significant differences among64DSCT and SCAG.Conclusion①Compared to coronary angiography（SCAG），Dual sourceCTA had high level of diagnostic sensitivity,specificity,positivevalue,negative predictive value in the detection of coronary heartdisease，there was no statistically different between any two method(p>0.05)，prompted consistent.②Compared to SCAG，Dual-source CTA hadlow level of diagnostic sensitivity,specificity,positive value in thedetection of slight coronary heart disease，prompted the relatively weaknature，be further improved.③Calcified plaque also is affecting thedual-source CTA imaging to accurately evaluate the severity of coronaryartery stenosis. Objective To evaluate the stability of non-obvious and borderlinecoronary stenosis with Dual source CT.Method53patients（62cases）were angiographic non-obvious(SCAGdiameter stenosis <50%) and borderline coronary stenosis(SCAGdiameter stenosis50%～75%).The other lesions which the percentdiameter stenosis was more than70%by the SCAG.All patients underwentthe SCAG and Dual source CT (DSCT) imaging. The DSCT analysis includedplaque forms、 components， remodeling form，et al.Results These plaques of the non-significant and critical stenosisthat filtered by SCAG，and analyzed by Dual-source CTA at the sameparts, were62cases in all,non-calcified plaques accounted for59.7%（37/62)，Eccentric plaque accounted for62.9%(39/62)，Positiveremodeling accounted for59.7%(37/62)；Soft plaque accounted for67.57%(25/37) of the non-calcified plaque. Nodular calcificationaccounted for72.72%(8/11) of the calcification。These plaques of the severe stenosis that filtered by SCAG，and analyzed by Dual-source CTA at the same parts, were45cases inall, Mixed plaque accounted for51.1%(23/45)，concentric plaqueaccounted for62.2%(28/45)，negative remodeling accounted for64.4%(29/45)， Fibers plaque accounted for73.33%(11/15) of thenon-calcified plaque. diffuse calcification accounted for71.42%（5/7) of the calcification。 There was also statistically differentbetween any two classes Conclusion①Dual source CT coronary artery by judging theplaque ’s nature， morphology, structural features to indirectlymeasure stability of plaque.②Non-obvious and borderline coronarystenosis in the soft plaque lesions, positive remodeling,eccentricplaque were more common，non-obvious and borderline coronary stenosisin the punctuate calcification was more common.③Severe stenosis groupin the fiber plaque lesions, negative remodeling, centripetal plaquewere more common，non-obvious and borderline coronary stenosis in thediffuse calcification was more common.④Compared to severe stenosisgroup， Above vulnerable atherosclerotic plaque characteristics innon-significant and and borderline stenosis were more common（P<0.05），prompted more likely to induce acute coronary syndrome。...