| ObjectiveIn order to seek a safe and non-invasive imaging modality to evaluate coronary arterial stenosis degree and screen the patients of percutaneous coronary intervention(PCI) , the aim of our study is to assess the diagnostic value and curative effect of 64-row with 128-slice spiral computed tomography in detecting coronary artery disease with coronary artery stenosis and stent restenosis ,which was compared with selective coronary angiography(CAG),using a new retrospectively ECG-gated reconstruction method.MethodsFrom October 2006 to Feburary 2008,81 patients(58 males and 23 females;age range 38-75years;mean age 61士11years) with suspected or final diagnostic coronary heart disease(CHD) were included in our study. All of 81 patients underwent MSCT(64-row with 128-slice spiral computed tomography) and CAG. respectively, 18 of them previously underwent procedure of PCI with stent implantation..According to the suggestion of American Heart Association,the coronary arteries were devided into 13 segments. All of the corornary arteries and its branches with no less than 2mm were assessed.The results of the two methods were analyzed by a group of imageologic and cardiologic experts.Considering CAG as a golden standard,the accuracy of 64-row with 128-slice spiral computed tomography for diagnosis of the marked stenosis of coronary artery and stent was evaluated.Results1.Among the 667 coronary arterial segments of over 2mm diameter in 63 patients, 593(88.91%) segments were evalurable by 64-row with 128-slice spiral computed tomography .2. Based on coronary artery segment,the sensitivity,specificity,positive and negative predictive value,accuracy for 64-row spiral computed tomography to diagnose CHD were 90%,97%,87% , 98% and 96% respectively. 3. Except the unevaluable coronary artery segments,all the segments were compared with CAG..The sensitivity,specificity,positive and negative predictive value to identify stenosis degree≥50% were 90.5%,96.6%,85.9% and 97.8% respectively.The sensitivity,specificity,positive and negative predictive value to identify stenosis degree≥75% were 93.5%,98.9%,87.9% and 99.4% respectively. 4. 25 out of 28(89%) stents implanted in 18 patients were assessed by coronary computed tomography angiography (CTA )because of evaluable image quality. Compared with CAG., the sensitivity,specificity,positive and negative predictive value,accuracy for 64-row with 128-slice spiral computed tomography to diagnose in-stent restenosis were 100%,90%,71% , 100% and 92% respectively.ConclusionsAs a non-invasive method,64-row with 128-slice spiral computed tomography can evaluate the stenosis degree of coronayr arteries and screen the patients with CHD. It can also be used to recheck the patients who underwent PCI such as intracoronary stent implantation.
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