| Object: To investigate the accuracy of 320 row volumetric CT in diagnosis of coronary artery stenosis compared with coronary angiography and relationship between severe coronary artery stenosis and the risk factors of coronary heart disease according to the density of coronary plaque displayed in 320 row volumetric CT coronary angiography.Materials and Methods: Ninty five(66 male and29 female)patients who received CCA two weeks after CTA were involved in this study.Age ranges from 40 to 82 years old with the average age(63 ± 7 years),?60 years patients are 66.Sixty seven patients have more than one severe stenosis.These severe coronary artery stenosis segments were divided into non-calcified plaque,calcified plaque and mixed plaque according to the density of coronary plaque.The incidence of dyslipidemia plaques in patients was compared between ?60 years and <60 years group.Another group of 56 patients without coronary heart disease was used as control.The following risk fators were compared between the two groups,which included age,history of smoking,hypertension,diabetes,body mass index(BMI)and lipid levels(total cholesterol,triglycerides,high density lipoprotein,low density lipoprotein,apolipoprotein A,apolipoprotein B,lipoprotein;inflammatory factor C-reactive protein).Single factor analysis and multivariate Logistic regression analysis were used to explore the relationship between the risk factors with coronary heart disease.All patients received volumetric CT scanning under the prospective scan mode.To assure image quality patients whose basal heart rate>75/min received 25mg~50mg betamethasone Locke orally or sublingually.All images were transferred into Vitrea Fx 6.1 workstation to perform volume rendering(VR),maximum intensity projection(MIP),multiplanar reconstruction(MPR)and curved planar reconstruction(CPR).? 50% stenosis defined as moderate stenosis;whereas ?75% as severe stenosis.According to the classification guidelines of American Heart Association(AHA),coronary artery is divided into 15 segments and the intermediate branch artery is recorded as the 16 th segment.The sensitivity,specificity,positive predictive value,accuracy,negative predictive value in diagnosing coronary stenosis was calculated based on the glden standard of CCA.Results: The image quality in all 95 patients is high enough to be used to evaluate the degree of stenosis.There are 74 cases of right coronary advantage,6 cases of left coronary advantage and 15 cases of equilibrium in this group.The segmental number demonstrated in CCA(1374)is great higher than those(1180)in CTA.The sensitivity,specificity,accuracy,positive predictive value,negative predictive value of CTA are 87.50%?97.45%?96.78%?71.43%?99.01% in the diagnosis of moderate coronary stenosis and 93.33%?98.66%?97.71%?93.78%?98.56% in severe coronary stenosis.No difference was found between heart rate ?65/min and <65/min group.The incidence of non-calcified plaques in patients <60 years the group with abnormal blood lipid levels is higher than that in patients ?60 years with great significance.Great difference of age,hypertension,diabetes,BMI and inflammatory factor C-reactive protein was found between severe coronary artery stenosis and the normal control group.Multivariate logistic regression suggested that age,blood pressure,blood glucose are independent risk factors for coronary heart disease.Conclusions: Thirty hundred and tweity Row Volumetric CT coronary angiography has the advantage of high image quality,less radiation exposure,high diagnostic accuracy,repeatable and less demanding for heart rate,which is suitable for the patients with angina pectoris or the preferred method for the patients with coronary heart disease.The incidence of non-calcified plaques in younger patients with dyslipidemia is higher than the elder patients,which indicated the younger with dyslipidemia may have higher possibility of acute coronary syndrome.Patients with hypertension,diabetes have higher risk to have coronary heart disease. |
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