Coronary Angiography With 64-slice Spiral CT: A Study Of Technique And Clinical Application

PartⅠThe study of the image quality of coronaryangiography(CTA)with 64-slice spiral computedtomography and the fact that could influence theimage qualityObjective: To evaluate the clinical value and the image quality ofcoronary angiography(CTA) with 64-slice spiral CT and to investigate thefact that could influence the image quality.Materials and Methods: 48 patients with suspected or diagnosedcoronary artery disease underwent plain and contrast-enhanced CTcoronary angiography within a single breath hold. MPR, MIP, VRTreconstruction with enhanced scan images were made in every case. Theimage quality of 15 coronary segments of the AHA classification wereevaluated, and the factors which could influence the image quality wereanalyse.Results: In the evaluation of image quality with VRT image, 634segenmts(95.4%) were in the first class,25 segments(3.7%) were in thesecond class, and 6 segments(0.9%)were in the third class. The imagequality was correlated to heart rate, pulse, breathe,and severe calcificationof the vessle walls. Conclusion: 64-slice spiral Ct coronary angiography is anoninvasive, simple and good method and improves the imagequality.MSCTCA can fulfill the need of primary clinical diagnosis.PartⅡEvaluation the impact of diffrence slice-thick reconstraction for Coronary calcium score.Objective: To evaluation the influence of diffrence slice-thickreconstraction for Coronary calcium score.Materials and Methods: 48 patients with suspected or diagnosedcoronary artery disease underwent plain,27 patients were performed forcalcium quantification. Rescontruction the slice-thick/distance betweenslice for 3.0mm/3.0mm and 1.5mm/1.5mm..Calculation the caldficatonscore and analysis the differents of the two calcium score.Results: every patient's calcification score is different by usingdifferent slice-thick reconstruction. When the slice-thick is 1.5mm, RCA,LM, LAD, LCX and the total calcification scores were 59.3±20.1;27.4±14.8;75.6±34.7; 63.9±27.8; 217.6±54.8. When theslice-thick is 3.0mm, RCA,LM,LAD,LCX and the total calcification scores were47.0±16.5;18.5±9.6; 54.6±21.5;50.4±17.6;184.5±40.3, the 1.5mm higher than the 3.0mm.Conclusion: The slice-thick influence the calcification scores. Indetecting coronary artery calcification, thin-slice reconstrution canprovement the sensitivity and accuracy.PartⅢComparative Study Between 64-slice CT Coronary Angiography and DSAObjective: Comparative between 64-slice CT CoronaryAngiography and DSA, evaluation the sensitivity, specificity andnegative predictive to indentify the medium and significant stenosis ofcoronary artery with 64-slice spiral CTMaterials and Methods: 13 patients underwent both 64-sliceMSCT and CAG, MPR, MIP, VRT reconstruction with enhanced scanimages were made in every case. The image quality of 15 coronarysegments of the AHA classification were evaluated, and results of bothmethods were compared.Results: 152 segemnts can evalue, the sensitivity to identifysignificant stenosis with 64-slice MSCT were 96.4%, medium were83.3%. The specificity to evalue stenosis of coronary artery with 64-slice MSCT were 94.1%, negative predictive were 96.3%.Conclusion: MSCTCAhave a high sensitivity, specificity andnegative predictive.It had great value for CAD diagnosis.can be a methodfor suspected CAD examination.