Value Of .16-slice Spiral Ct And Dynamic Ecg Diagnosis Of Coronary Artery Disease And Coronary Stenting Applied Research

Objective To evaluate the diagnostic value of 16-slice spiral CT coronary angiography (16-SCTCA) for coronary artery disease (CAD) and Clinical application of 16-SCT after coronary stent implantation.On the basis of preliminary selection of coronary disease by ambulatory electrocardiography (AECG), 16-SCT is surveyed if it can meet the requirements of the selection of percutaneous coronary intervention and assessment of coronary stents. Methods Fifty patients underwent 16-SCT, AECG before selective coronary angiography(SCA). The findings demonstrated on 16-SCT and AECG were compared with those seen on SCA, the sensitivity ,specificity and accuracy for detection of CAD with AECG and 16-SCT were computed respectively. AECG was performed in another twenty-five patients before and after PTCA and intracoronary stent implantation in one week,three month,six month,one year respectively and they all achieved 16-SCT after coronary stent implantation.In seven patients 16-SCT was compared with coronary angiography. Results With the SCA as the golden standard, Fifty patients were divided into CAD group and control group.The ST-segment depression of the myocardial ischemic during AECG detected CAD with a sensitivity of 65.8% and a specificity of 83.3%.The occurrence rate of ST-segment depression correlated closely with extent of CAD,the incidence of myocardial ischemia in patients with multivessel disease is higher than that with one vessel disease. the sensitivity ,specificity and accuracy for detection of ≥50% stenosis with 16-SCT were 92.2%,90%,91% respectively. The negative and positive prediction value were 81.9% and 96.1% respectively.The incidence of coronary calcium and coronary calcium score by 16-SCT related obviously with extent of coronary stenosis.36 stents of coronary artery of twenty-five patients were all assessable with 16-SCT.The examine results of 6 restenosis patients were similar between 16-SCT and coronary angiography by catheterization in all 7 patients. The frequency, the duration ,the maximal ST-segment depression of the myocardial ischemic and total ischemia burden(TIB) after stents implantation compared with that before stents implantation were significantly decreased in three month,six month and one year (p<0.05),but these indices were not difference between before stents implantation and after stents implantation in one week, between restenosis patients and no- stenosis patients although in three of six restenosis patients,their extent of myocardial ischemic aggravated. Conclusion 1,AECG is a unique method in diagnosing CAD especially silent myocardial ischemia and prinzmetal's variant angina.And it can preliminarily assess coronary stents.2,Because of its high false negative ratio(FN),AECG only as apreliminary tool for diagnosing CAD,but 16-SCT is a new and prespective method in diagnosing CAD,It not only permit high-resolution imaging of the deat heart and the coronary arteries but also allow risk assessment to predict the individual cardiovascular risk and selection of percutaneous coronary intervention and assessment of coronary stents.