A Comparative Study Of Calcified Plaque Stenosis Spectrum CT Coronary Angiography And Coronary Angiography In The Evaluation Of Coronary Artery

Objective:To explore energy spectrum CT in removal of coronary artery calcificationplaques hardening artifacts so as to improve the diagnosis of vascular stenosis degreeanalysis. Further defined energy spectrum CT in coronary artery calcification solutioncontaining the plaque of the function of the degree of luminal stenosis.Materials and methods:Collected at jilin university in china-japan friendship hospital from January2014to October2014clinical patients with suspected or diagnosed coronary heart disease(CHD)50cases, obtain the consent from patients themselves and their families,precious stones energy spectrum CT coronary artery imaging (CTA), and theexamination of the coronary artery angiography (the CAG), with high pressuresyringe after elbow vein injection of80~100ml optimal d show (bayerpharmaceutical company, concentration of370mg/ml), after the scanning, draw acircle on the ascending aorta interested area, get a time-density curve, selection andcalculation of the curve peak time, and increase4~5s on the basis of this, as aformal coronary scanning delay time. Retrospective heart switch control technology isadopted to improve the image restructuring, scanning after the reorganization of the1.25mm thick120KVP image and spectral images. And transmitted to thepost-processing workstation (GE Medical Systems) to deal with all of the images.Application viewer software is analyzed respectively.50cases according to thescanning mode according to the repeated measurement method is divided into120KVP group, V-IVUS (120KVP), energy spectrum image group, the V-IVUS (spectral image), the CAG group, comparing the two vessels containing calcifiedplaque vascular stenosis of the section. By my families, two indications and abovelevel of cardiac imaging doctors evaluate coronary artery stenosis and the number ofcalcified plaque lesions.120KVP, spectral image respectively, V-the CAG andIVUS image image analysis, and several inspection methods are calculatedrespectively and the CAG image difference.Results:On coronary artery120KVP image analysis of50cases of200patients withvascular branch (RCA, LM, LAD, LCX) respectively, on the MIP and CPR imagemeasuring patches of CT values, the vascular branch contains the number of calcifiedplaque results show that the energy spectrum CT coronary CTA showed calcificationplaques with the CAG were223, among them former descending branch lesions in thelargest number. Thus, in the diagnosis of calcified plaque, energy spectrum CT CTAand the diagnosis of the CAG were more accurate.50patients according to each patient’s coronary artery was divided into15segments, in a total of750segments, minus552segments without calcificationplaques and not participate in the evaluation of60segments (including image motionartifact heavy section21,39segmental blood vessel diameter <1.5mm) oranatomical structure is absent, according to138segmental blood vessels can beevaluated.Manual regulation keV value, rises with keV, vascular wall around the beamhardening artifacts to reduce gradually, calcified plaques showed more clear, vascularlumen and the wall also gradually clear display; But as keV, calcified plaque diameterbecame smaller, the surrounding tissue contrast followed decreased.70kev image from120KVP beam hardening artifacts slightly more, calcifiedplaque and vascular wall showed less clear, in80and80kev KVP similar image quality; Within the scope of high keV (100~140keV) image quality. Increased withthe increase of keV, subjective ratings of average. Single factor variance analysisresults of120~140kev score differences within the scope of no statisticalsignificance (p>0.05),80kev image rating with120KVP score difference image hasno statistical significance (p>0.05), more than a single energy levels and120KVPimage subjective score difference had statistical significance (p <0.05).Increased with the increase of keV, subjective scoring average, and within therange of120~140keV score no statistically significant difference (p>0.05),therefore to selective coronary angiography results as the standard, respectively tocalculate the accuracy of precious stones energy spectrum CT120~140keV,compared with the results of the CAG, the highest accuracy of120keV, therefore,that120keV for energy spectrum CT showed best keV value of the coronary artery.Will show138segmental blood vessels made of120kev energy spectrum imagesimulation intravascular ultrasound images (V-IVUS), compared with the CAGimage. Respectively120KVP,120KVP V-the CAG and IVUS image imageanalysis, the analysis results were statistically significant difference (p <0.05);120KVP and120keV analysis result difference was statistically significant (p <0.05);Respectively120keV,120keV-the CAG and IVUS image image analysis, theresults of the analysis differences had no statistical significance (p>0.05).120KVP,V-IVUS (120KVP),120keV, V-IVUS (120keV) compared with CAG images, theaccuracy rate were92%,93.4%,94.9%,95.7%.Conclusion:1Energy spectrum CT coronary angiography (CTA) imaging for diagnosis ofcoronary artery stenosis vessels have higher degree of accuracy, and help to avoidcoronary artery normal or has yet to reach intervention against (no clinical ignificance of coronary artery stenosis) of patients do have a coronary arteryangiography, can meet the requirement of interventional therapy of coronary arterydisease screening.2Spectral CT imaging technology can effectively reduce the single energycoronary artery calcification plaques beam hardening artifacts, including high energylevel (120~140kev) has better effect to remove the beam hardening artifacts,comprehensive image contrast analysis, around this study thinks that120kev energylevel for the ideal reconstruction. Single energy reconstruction technology to a certainextent, reduce the beam hardening artifacts calcified plaque, but cannot completelyeliminate artifacts. Single energy reconstruction technology to a certain extent, reducethe beam hardening artifacts calcified plaque, but cannot completely eliminateartifacts.3V-IVUS can accurate assessment of the degree of vascular stenosis. Helpclinical comprehensive assessment of coronary heart disease (CHD) and choose thetreatment plan.