The Image Quality Assessment And Compared Research Of Dual-source Computed Tomography Coronary Angiography

ObjeCTive:Through the the image quality assessment of coronary artery classification and compared with the CAG to explore the clinical application of the dual-source CT(DSCT) coronary angiography in coronary heart disease(CHD).Material and Methods:261 patients with known and suspected of CHD underwent DSCT(Somatom Definition,Siemens)coronary arteriography,men:153,women 108, age range 32 to 85,average was 59.8±11.Average heart rate was 75.7±14.range 52 to 148 bmp.According to AHA classification guidelines for delineation of vascular segments, The image quality of reconstructed coronary artery segements was divided into three grades,and the first and two gradse was defined as evaluable;Classification standards with reference to coronary artery stenosis,30 of all patients were compared by conventional coronary angiography(CAG) within a week.Resualts:1.DSCT coronary arteriography in 261 patients was successful.Coronary artery anatomy structure consist of the coronary artery branchs and part sub-branchs were clearly displayed by DSCT coronary arteriography.94.1%segments of the total 3712 coronary artery segments in 261 patients can be evaluated,which 2915 artery segments in the gread one;579 artery segments in the gread two,and 284 segments in the gread three.there were 97.0%segments of the coronary artery whichs diameter was 1.5mm.2.30 of all patients were compared by conventional coronary angiography (CAG),Stenosis or obstrction of 91 coronary artery segments,85 segments wer cofirmed by CAG.The diagnosis sensitivity of coronary artery stenosis with DSCT was 97.7%, specificity was.97.2%,positive predictive value was 90.4%,negetive prediCTive value was 99.4%,and accuracy was 96.1%。,For the seriously coronary artery stenosis the sensitivity was 98.1%,specificity was 99.2%,positive predictive value was 94.4%, negetive predictive value was 99.4%,accuracy was 99.3%。3.9 of patients with old myocardial infarction in 20 myocardial segments weakened movement,the DSCT characteristics of myocardial infarction is early perfusion deficits.Conclusion:The morphological evaluation of coronary artery with DSCT is very good,indicating the various branches of coronary vascular image quality is better,97.0%of the vascular segments can be used for clinical diagnosis,in which the trunk and proximal segement is far higher than distal and branch vessels.Affect the image quality of the main factors are blood vessels are too small,poor contrast agent filling.fast heart rate,arrhythmia,severe calcifications and respiratory artifacts.DSCT for diagnosis of coronary artery stenosis lesions to the accuracy of 96.1%,close to coronary angiography,Detection of myocardial necrosis in the promising area.DSCT coronary angiography as a noninvasive diagnostic imaging technology,it will be play a higher application value in the diagnosis of coronary heart disease.