The Clinical Application Of Coronary Angiography By Multislice Spiral Computed Tomography With Retrospectively Electrocardiographically Gated In Coronary Artery

Objective: To evaluate the efficacy of multislice spiral computed tomography (MSCT) in the diagnosis of coronary artery disease.Method: A total of 45 patients suspected coronary disease (CAD) were detected by MSCT. All of them were divided into 3 groups: group 1 (n=15) had coronary artery angiography images, group 2 (n=15) had the same CT scanning parameters with group 1; The different scanning parameters were used in group 3 (n=15), but group 2 and 3 had not coronary DSA information. The image datum were reconstructed to demonstrate the coronary artery in some methods such as volume rendering (VR) multiple planar/curve reconstruction (MPR/MPCR), maximum intensity projection (MIP) surface shaded display (SSD).Result: In the group 1 and group 2, patients with heart rate less than 60 BMP, there was no difference to show the main branch of left coronary artery (LMA) and left descending artery compared (LDA) compared with more than 60 BMP. (X2=2.56 5.07, P=0.556 and 0.171, >0.05; Fisher' Exact), and obvious difference in showing left circumflex artery (X2=8.92, P=0.020<0.05, Fisher' Exact) and right coronary artery (RCA) (X2 =13.20, P=0.001<0.05,Fisher' Exact); To the coronary artery in group 2 and group 3, there was no difference to show the three branches (LMA LDA LCA) in the two groups (X2=0.469 0.370 1.761, P=0.894. 1.000 0.811,>0.05, Fisher' Exact), but ROA was not (X2=6i550, P=0.042<0.05). The coronary arteries which were showed successfully (exceeding grade 2) showed best in the heart ≤60 BPM, better in 61~75 BPM and worse in the group of heart >75 BPM, more over, there was no difference to show the four arteries in the different scanning parameters groups (group 1 2 and group 3) (X2=2.091 4.457 3.000 and 3.418, P=0.352 , 0.108 , 0.223 , 0.181>0.05, Fisher' Exact). In all the electrocardiographically phases, LMA LAD and RCA were showed best in 70% phase, LCX in 80% phase, in addition, VR was the best reconstruction way among the other 4 ways, and MSCT image have the advantage over DSA on coronary arteries calcification but not on constriction.Conclusion: Coronary angiography and reconstruction by MSCT are the methods helpful to diagnosis of CAD and re-examination after revascularization.