Study On Clinical Value Of Coronary Angiography In The Diagnosis Of Coronary Diseases

Objective: 1?By comparing the results of 256-slice spiral CT coronary angiography with that of conventional coronary angiography(CAG).To evaluate the accuracy of 256-slice spiral CT coronary angiography in the diagnosis of coronary artery stenosis,by taking the results of CAG as the gold standard.2?To evaluate the difference between 256-slice spiral CT coronary angiography and CAG in the detection of myocardial bridge.Methods: A total of 189 patients with suspected coronary heart disease in the department of cardiology in our hospital from June 2017 to November 2018 were analyzed retrospectively,including 119 males and 70 females,with an average age of 59.8 ±9.9 years.Within two weeks,the patient underwent 256-slice spiral CT coronary angiography and coronary angiography in our hospital.Results of 256-slice spiral CT coronary angiography and CAG were compared.To evaluate the accuracy of 256-slice spiral CT coronary angiography in the diagnosis of coronary artery stenosis and the difference between the two methods in the detection of myocardial bridge.Results: A total of 1890 segments of coronary arteries was selected from multi-slice CT coronary angiography in 189 patients.Contrast coronary angiography with the same 1890 segments of blood vessels:1?The sensitivity,specificity,positive predictive value,negative predictive value and coincidence rate of 256-slice spiral CT coronary angiography in the diagnosis of coronary heart disease were high.2?The sensitivity of 256-slice spiral CT coronary angiography in evaluating mild,moderate and severe coronary artery stenosis was 72.4%,65.1% 68.2%,256-slice spiral CT coronary angiography had higher specificity,negative predictive value and coincidence rate in evaluating mild,moderate and severe coronary artery stenosis.3?The sensitivity of 256-slice spiral CT coronary angiography to mild,moderate and severe stenosis of LAD lumen is 83.1%,68.8% and 75.0%,respectively,and to mild,moderate and severe stenosis of LCX lumen is 53.5%,53.8% and 53.3%,respectively.The sensitivity for evaluating mild,moderate and severe stenosis of RCA is 73.4%,68.0% and 69.1%,respectively.256-slice spiral CT coronary angiography had higher specificity,negative predictive value and coincidence rate in the evaluation of mild,moderate and severe vascular stenosis.The evaluation of LAD and RCA vascular stenosis by 256-slice spiral CT coronary angiography was consistent with CAG,while the evaluation of LCX lumen stenosis by 256-slice spiral CT coronary angiography was generally consistent with CAG.4?Among the 189 patients,48 cases of myocardial bridge were detected by 256-slice spiral CT coronary angiography,15 cases were detected by CAG,and the detection rate of myocardial bridge by 256-slice spiral CT coronary angiography was 25.4%.The detection rate of myocardial bridge was 7.9%.Conclusion: 1?256-slice spiral CT coronary angiography is consistent with CAG in the diagnosis of coronary heart disease and can be used as a non-invasive screening method for coronary heart disease.2?256-slice spiral CT coronary angiography is less sensitive to the grading of coronary artery stenosis and cannot accurately evaluate the degree of stenosis of a certain segment of the artery.3?The diagnostic accuracy of 256-slice spiral CT coronary angiography LAD&RCA stenosis was higher than that of circumflex branch(LCX).4 ? The detection rate of myocardial bridge by 256-slice spiral CT coronary angiography is higher than that of CAG,which can be used as the first choice for non-invasive diagnosis of myocardial bridge.