Quantitative Analysis Of Coronary Artery Lesions Used By Virtual Endoscopy Of 64-slice Computed Tomography

PurposeThe purpose of this study was to detect the influences on CTVE(CT virtual endoscopy) and to investigate the potential value of CTVE in the visualization and assessment of coronary lesions whether it can be used in the determination of the strategy for pre-Percutaneous Coronary Intervention (pre-PCI).MethodsCTVE imaging were analyzed retrospectively in 243 patients, including 74 patients by means of both CTVE and coronary angiography(CAG).The Digimizer software was used in quantitative analysis.The 74 patients were comparatively analized by using CAG as a "golden standard". The sensitivity(Se),specificity(Sp), positive predictive value (PPV)and negative predictive value (NPV)were calculated.The agreement test was performed with the use of SAS8.0 software.The bifurcation lesions and chronic total occlusions (CTO)were mainly analyzed in the study.Resultsl.①In all 243 patients,there were 3188 of 3441 coronary sections could be analyzed.602 stenoses were detected.②n 74 patients by means of both CTVE and CAG,there were 901 of 1002 coronary sections could be analyzed.228 of 272 stenoses were correctly diagnosis by using CAG as a "golden standard".③n the 64-MSCT study,the heart rate needed be reduced to 65 beat/min,75 beat/min at least.④The heart rate variety,coronary classification, and coronary artery disease (CAD) risk factors couldn't influence image quality of CTVE.The number of stenosis vessels had effect on image quality of CTVE.2.①In 74 patients by means of both CTVE and CAG,there was statistically significant in patient analysis (X20.0909, P value 0.7630, Kappa 0.7001, Se87.50%, Sp 82.4%, PPV 85.4%, NPV84.8%); there was excellent agreement in vessel analysis (S2 1.6667, P value 0.1967, Kappa 0.8805, Se94.4%, Sp95.0%, PPV89.4%, NPV97.5%).②Lesion's character,the severity of stenosis and the diameter of coronary vessel influence the diagnosis accuracy of CTVE.3.①In 74 patients by means of both CTVE and CAG,there were 89 bifurcation lesions of 368 coronary bifurcations, showing excellent agreement (χ2 0.1818,P value 0.6698,Kappa 0.8382).②CTVE indicated certain diagnosis value in detecting CTO and coronary stents correlated with some other CT 2D or 3D technique.Conclusionsl.In the article, If the patient management and operation were proper, the image quality of CTVE was adequate for imageology diagnosis.2.This was the first study using CTVE to quantitative assess coronary stenosis under the help of Digimizer software, it established the rationale for the coronary quantitative analysis.3. The article show us,CTVE qualitative and quantitative analysis had good diagnosis value in assess the coronary stenosis and the burthen of lesions, it can be used in the determination of the strategy for pre-PCI.4.The bifurcation lesions,CTO,stent restenosis were given emphatic analysis in the study and acquired sufficient clinical application value.