The Study Of Atherosclerotic Plaques By 64-slice CT Coronary Artery Angiography

Objection:①To study the imaging features of coronary atherosclerotic plaques;②To evaluate the accuracy of 64 multislice CT coronary angiography(CTA) in diagnosis of coronary artery stenosis caused by coronary atherosclerotic plaques;③To research the relation of coronary artery stenosis caused by atherosclerosis and glucose and blood lipids level.Materials and Methods:Collected 123 cases of CTA imaging data,who were clinically diagnosed or suspected coronary heart disease,and as well as the DSA and clinical materials within one month before or after the CTA examination.Analyzed the materials retrospectively.If atherosclerotic plaques were found in CTA,we divided the patients into the cases group(the coronary atherosclerosis group).Analyzing the CTA imaging characteristics of atherosclerotic plaques of the cases group,we studied the coronary atherosclerotic plaques' distribution,the function of CTA postproeessing methods in showing plaques and the effect of different plaques in different degree of coronary artery stenosis.Compared with DSA,we evaluated the accuracy of 64 multislice CT coronary angiography(CTA) in evaluating of coronary artery stenosis and the superiority of CTA in diagnosing coronary atherosclerosis.Meanwhile,we analyzed the relation of coronary artery stenosis caused by coronary atherosclerotic plaques and glucose,total cholesterol, triglyceride,low density lipoprotein and high density lipoprotein content.Results:①The distribution of atherosclerotic plaques in coronary artery branches was statistical significant(X~2=63.1807,P＜0.01).The left anterior descending artery(LAD) got the most plaques,followed by the right coronary artery(RCA) and the Left Circumflex(LCX).②Thin axial reconstruction imaging(AXI) and curved planar reconstruction(CPR) were better in showing noncalcified plaques than maximum intensity projection(MIP) and volume rendering technology(VRT)(X~2=231.0085, P＜0.001),but there was no difference in displaying calcified plaques of the four.③The plaques that causesⅠ～ⅢandⅣ～Ⅴdegrees' coronary artery stenosis were statistics differences(X~2=4.2250,P＜0.05),68.4%(13/19) ofⅣ～Ⅴdegrees' stenosis(stenosis≥75%) were caused by nocalcified plaques,in which there were 10 cases caused by fatty plaques and mixed plaques with more fatty composition,accounting for 76.9% (10/13).④The accuracy of CTA in evaluating stenosis of coronary artery had no statistics difference with DSA(X~2=0.1000,P＞0.05).Its sensitivity,specificity,positive predictive value,negative predictive value and accuracy of CTA in assessmenting of Medium and severe stenosis caused by atheromatous plaques were 75%,96.8%,66.7 %,97.8%and 90.7%.Meanwhile,CTA could show more and better mild stenosis that could not displayed well in DSA.⑤Coronary artery stenosis caused by atherosclerotic plaques was slightly positive relation with glucose,total cholesterol, triglyceride,low density lipoprotein levels,and slightly negative relation with high density lipoprotein level.Its related coefficient had no statistical significance(P＞0.05).Conclusion:①CTA could nicely show coronary atherosclerotic plaques.Its postprocessing methods could display lesions in three-dimension,so as to show better the atherosclerotic plaques.②The high accuracy in evaluating coronary artery stenosis made CTA a useful method to exclude coronary artery disease.③High level of glucose, hypedipidemia could promote the progress of coronary atherosclerotic plaques,and increase the degree of coronary artery stenosis.