| Background and significance: The basic pathologic characteristic of coronary artery disease is the formation of coronary artery atherosclerosis plaque. Coronary artery calcification means local calcium deposition at the coronary artery atherosclerosis plaque and is the signal of coronary artery atherosclerosis. The early diagnosis of coronary artery disease has been an important topic of clinical research. Selective coronary angiography can directly show the extent of the coronary artery lumen stenosis and possess unique superiority in the diagnosis and treatment of coronary artery disease. It is still considered the golden standard in the diagnosis of coronary artery disease despite some limitations. But it is an invasive method and can put the patients to some inconvenience and risk. It is not suitable to all patients. The diagnosis of coronary artery disease in practice is mainly by noninvasive methods. Because of its rapid scanning velocity and use of ECG-gated techniques, 64—MSCT have a high temporal and spatial resolution, decreasing the influence of heart beat and respiration , which makes it applicable to detect coronary artery calcification by quantitate and reconstruct the coronary artery segments to show the extent of lumen stenosis.Objective: To evaluate the role of 64—slice spiral computed tomography by detection of coronary artery calcification(CAC) and vascular reconstruction in the diagnosis of coronary artery disease (CAD) compared with selective coronary angiography ( SCA).Method: Seventy-three patients who were suspected of coronary artery disease without percutaneous transluminal coronary angioplasty or surgery with coronary artery bypass grafting, were consecutively investigated using 64-slice spiral computed tomography. 9 patients had heart rates more than 80 beats per minute before MSCT were givenβ-blockers. After the retrospectively ECG-gated axial imaging reconstruction, volume rendering (VR),multiple planar reconstruction(MPR) ,curved MPR and maximum intensity projection (MIP) were used to reconstruct every segment of the coronary artery. By calculating coronary artery calcification scoring and the presentation of vascular stenosis by reconstruction of the coronary artery , we can predict whether a patient had coronary artery disease or not. Selective coronary angiography (SCA) were carried out within 2 weeks after MSCT scanning , we compare the result of MSCT with that of SCA to investigate the value of 64-MSCT in the diagnosis of CAD . Result:1 Patients with CAD have higher calcification scores than patients without CAD with substantial difference .Coronary artery calcification scores elevated in both groups with the process of aging . The majority of calcification happened in the left anterior descending artery (LAD) , and , the more the segment involved in calcification , the higher the CAC scores , in accordance with results of other research of domestic or abroad .2 64 —MSCT have a good temporal and spatial resolution and can reconstruct coronary artery and branches with a diameter ≥1. 5 mm to identify ≥ 50 % obstructive stenosis with acceptable sensitivity and specificity .3 Patients with stable angina pectoris often have intensive coronary artery calcification , while patients with acute coronary syndrome have less calcification and the infarction-related artery often have no or only light calcification, impling a different pathogenesis mechanism .Conclusion : 1 Patients with CAD have higher calcification scores than patients without CAD with substantial difference .2 When the heart rates were less than 80 beats per minute , good coronary imaging quality could be acquired using 64-slice MSCT. It was a reliable noninvasive detection of obstructive coronary artery disease.3 Stable angina pectoris have a higher CAC score than acute coronary syndrome with a substantial difference , impling a different pathogenesis mechanism .
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