Comparative Study Of Dual Source CT Coronary Angiography And Coronary Artery Angiography

Objective: To investigate the accuracy and advantages of dual source CT coronary angiography in coronary heart disease diagnosis; To investigate the clinical value and advantages of dual source CT coronary angiography in the diagnosis of myocardial bridge.Methods: 1.To collect the data of 62 cases who underwent dual-source CT coronary angiography and coronary artery angiography in a short-term during the period from 2014 January to 2015 January, include 36 men,26 women,age range 39~73 years old, average age about 67.5 years old. Coronary angiography as the standard, to evaluate the accuracy and clinical value of dual-source CT coronary angiography in the diagnosis of coronary artery stenosis.2. To collect the data of 338 cases who underwent dual source CT coronary angiography During the period of 2014 January to 2015 January, include 184 males, 154 females, the age range of 25-85 years old, average age about 60.8 years old. To gather statistics of the detection rate of myocardial bridge and the predilection sites of myocardial bridge in dual-source CT. To compare the data of 62 cases who underwent dual-source CT coronary angiography and coronary artery angiography in a short-term during the period from 2014 January to 2015 January,gather statistics of the detection rate of myocardial bridge. To collect the myocardial bridge group(143 cases) and no myocardial bridge group(143 cases) in left anterior descending coronary artery, and compare the detection rate of plaque and lumen stenosis in the proximal vessels.Results: 1.In 62 cases who was performed dual-source CT coronaryartery and coronary angiography in a short-term, coronary angiography as the gold standard, the accuracy, sensitivity, specificity, positive predictive value and negative predictive value of coronary artery stenosis(<50%) are 98.7%、96.9%、98.8%、75.6%、99.9%, coronary artery stenosis(≥50%) are 99.5%、91.1%、100%、100%、99.4%, coronary artery stenosis(≥75%) are 99.0%、83.9%、99.6%、86.7%、99.4%、99.0%.There is no statistical significance between dual-source CT and coronary artery angiography(P=0.965). Do the correlation analysis of two methods, the gamma coefficient =0.996, P < 0.001, indicating the existence of correlation of two methods.2.In 338 cases,dual-source CTA detected 153 cases, a total of 206 segments of myocardial bridge, the detection rate was 45%, include 19 the proximal of left anterior descending branch, 119 the middle of left anterior descending branch, 48 the distal of left anterior descending branch, 3 the proximal of left circumflex coronary artery, 5 the middle of left circumflex coronary artery, 6 the distal of left circumflex coronary artery, 5 diagonal branch, 1 obtuse marginal branch, the incidence rates were9.2%、57.8%、23.3%、1.5%、2.4%、2.9%、2.4%、0.5%. In 62 cases who was performed dual-source CT coronary artery and coronary angiography in a short-term,dual-source CTA detect 23 cases,a total of 26 myocardial bridge, coronary angiography detected 6 cases, a total of 6 myocardial bridge, for the base case the detection rates were 37.1%, 9.7%, There is significant difference between dual-source CT and coronary artery angiography(P<0.001). In the group of left anterior descending coronary artery which is detected myocardial bridges, detection rate of normal proximal vascular was 24.4%, wall plaque and normal lumen was 40.5%, wall plaque and lumen stenosis was 34.9%, while no MB group were 68.5%, 24.4%,6.9%.In the group of left anteriordescending coronary artery which is detected myocardial bridges detected more atherosclerotic plaque and more serious stenosis than the other group, with significant difference(P<0.001).Conclusion With higher temporal resolution and Spatial resolution, and the powerful image processing technology, dual-source CT can show the morphology of coronary atherosclerotic plaques better,and assess the degree of coronary artery stenosis greatly.There was no significant differences between dual-source CT and coronary angiography.Otherwise, the detection rate of myocardial bridge is higher than that of coronary angiography. Dual-source CT coronary artery imaging examination is convenient, non-invasive and moderate price, has become one of the important examination for clinical coronary heart disease screening indispensable.