The Dual-source64-slice Spiral CT Coronary Atherosclerotic Plaque Analysis And Clinical Application

Objective Application SIEMENS dual-source64-slice spiral CT coronary imagingmethods to explore the acute coronary syndrome (acute coronary syndrome. ACS), andunstable angina (stable angina pectoris, SAP), the distribution of plaques between the twogroups. shape, nature, the lumen of the stenosis, vascular remodeling index difference, at thesame time to evaluate the correlation of plaque morphology, plaque, stenosis degree andvascular remodeling index, and comprehensive evaluation of plaque morphology, the naturelumen stenosis, vascular remodeling index and clinical acute coronary events occur, todetermine the comprehensive evaluation criteria for the stability evaluation of coronaryatherosclerotic plaque, early to accurately predict the risk of coronary heart disease, clinicalEarly diagnosis and treatment of coronary heart disease imaging the new standard.Methods Select100cases of coronary CTA, the atherosclerotic plaque and theclinical diagnosis of acute coronary syndrome (acute coronary syndrome, ACS), cases for thestudy group (group A), choose to of100cases of coronary CTA, to determine the presence ofatherosclerotic plaque, but clinical cases of acute coronary events, unstable angina (stableangina pectoris, SAP) for the control group (group B). Processing software for observationafter the statistical distribution of the location and distribution of the number of plaques in theACS group and SAP group, Siemens Medical Solutions and statistics plaque morphologywere measured on the nature of the plaque, luminal stenosis, determination and calculation ofthe two groups plaque eccentricity index (EI), remodeling index (RI). The eccentricity indexEI=(longest axis plaque plaque short axis)/plaque of the longest axis, EI>0.5for eccentricplaque, the EI <0.5, compared with concentric plaques, coronary remodeling index (RI)= stenosis vessel external elastic membrane area (EEMCSA)/reference external elasticmembrane parts of the vascular area (EEMCSA), if the RI≥1for the expansion of (positive)reconstruction, RI <1for constrictive (negative) reconstruction [1]; two sets of results anddata for statistical treatment, analysis of the ACS group and SAP group, whether significantdifferences. Simultaneous analysis of plaque and plaque shape, luminal stenosis, vascularremodeling index without statistical significance. Statistical methods related to statisticalanalysis using the SPSS130statistical software, in this experiment are count data, using theχ~2test.Results①Atherosclerotic plaques in ACS, SAP, each branch location of thevascular distribution of the difference not statistically significant (χ2=1.144, P=0.767>0.05), but differences in plaque distribution of the number of blood vessels in the variousbranches of LAD179at (probability of occurrence of plaque up to41.06%), followed by thethe RCA149Department (34.17%), LCX81Department (18.58%) the the LM27Office(6.20%), the best location of the LAD plaque.②ACS, SAP two groups plaque constitute soft plaque CT value (-42to47Hu) HU, fibrousplaque CT value (61~112Hu) HU, calcified plaque CT value (126~736) HU [2]. ACSgroup were detected in261patches,135of soft plaque (51.72%,135/261), fibrous plaquesand74(28.35%,74/261), calcified plaque in52(19.92%,52/261), the SAP group weredetected in175plaque, soft plaque35(20.00%,35/175), fibrous plaques and39(22.29%,39/175), and calcified plaques of101(57.71%101/1751). Soft plaque in the ACS group,fibrous plaques the proportion of80.08%,19.92%in the proportion of calcified plaque, softplaque in the SAP group, fibrous plaques the proportion of42.29%, calcified plaqueproportion57.71%, soft plaque, fibrous plaque is common in the ACS group, calcified plaquein the SAP group, the different nature of the plaque in the distribution of differences in thetwo groups was statistically significant (χ2=71.162, P=0.000<0.05).③ACS, SAP two groups of plaque-shaped configuration differences, eccentric plaque in the ACS group165to96concentric plaques, SAP group, eccentric plaque77and98concentricplaques. Eccentric plaque in the ACS group plaques more common, the proportion was63.22%in the SAP group plaque more common concentric plaques, the proportion was59.39%, two groups of plaque morphology difference was statistically significant (χ2=15.667, P=0.000<0.05).④ACS, SAP two groups of different plaque stenosis caused by differences in luminalnarrowing caused by plaque in ACS group,57mild, moderate85, severe119SAP group,plaque caused by stenosis,86with mild, moderate55, severe34. ACS group plaque stenosis,severe stenosis of the main, caused by the SAP group plaque stenosis with mild stenosis, ACS,and SAP in both groups plaque stenosis difference statistics significance (χ2=44.292, P=0.000<0.05).⑤ACS, SAP vascular remodeling index between the two groups was statistically significant(χ~2=35.890, P=0.000<0.05). Vascular positive remodeling in ACS group117cases,144cases of negative remodeling, the SAP group of vascular positive remodeling of145cases,30cases of negative remodeling, positive remodeling rate in SAP group was significantly lowerthan the ACS group.⑥the nature of the plaque and plaque morphology in170soft plaque, eccentric104,concentric66;13fibrous plaques, the eccentric71, concentric42and153calcified plaques,67eccentric, concentric86. Plaques of different nature of the morphological differences arestatistically significant (χ~2=13.171, P=0.000<0.05).⑦the nature of the plaque and lumen stenosis,170soft plaque stenosis,26with mild,moderate,61severe and83,113caused by the fibrous plaque stenosis,20with mild,moderate,59severe and34,153stenosis caused by calcified plaque in97, mild, moderate20,severe36. Soft plaques likely to cause the lumen of the severe stenosis; fibrous plaques likelyto cause a moderate stenosis of the lumen; calcified plaques likely to cause the lumen of themild stenosis. The different nature of the plaques lead to stenosis, the difference was statistically significant (χ~2=115.432, P=0.000<0.05).⑧the nature of the plaque and coronary remodeling index170due to soft plaque in coronaryvascular remodeling,96positive remodeling,74negative remodeling;113fibrous plaquecaused by coronary vascular remodeling,42positive remodeling,71negative remodeling.153due to calcified plaque in coronary reconstruction,36positive remodeling,117negativeremodeling. The different nature of the plaque and its due to coronary remodeling indexdifference was statistically significant (χ~2=36.914, P=0.000<0.05).Conclusions1、The location of the various branches of the SAP two groups ofcoronary distribution difference not statistically significant, but the number of plaques in thebranch vessel distribution differences, the best location of the LAD plaque.2, acute coronarysyndrome (acute coronary syndrome, ACS), unstable angina (stable angina pectoris, SAP) inpatients with plaque constitutes a different soft plaque, fibrous plaque easily lead to theoccurrence of the ACS, and calcification The plaque is generally more stable, mostly inpatients with stable angina pectoris., Eccentric and generally easy to lead to the occurrence ofacute coronary syndrome (acute coronary syndrome, ACS). To the nature of the cardiacplaque stability, and are generally unstable angina (stable angina pectoris, SAP) patients.4,the occurrence of ACS patients in general, severe stenosis in patients with unstable angina ismild stenosis.5, SAP group, vascular remodeling was significantly lower than the ACS group.6the nature of the plaque, plaque morphology, stenosis, coronary remodeling index, softplaque, fibrous plaque is generally eccentric plaque, stenosis, severe coronary artery isreconstruction and more. And calcified plaque is generally concentric plaque, mild stenosis,positive remodeling of coronary vessels less.