| Objective1,To investigate the value of the 320-slice DVCT in evaluation of coronary artery calcification ; 2,To investigate the distribution of coronary artery plaque and to discuss the relationship between coronary artery plaque and the stenosis.MethodsThe experiments were performed in 131 patients suspected coronary artery disease including Male 83 and female 48 cases. The scanning was promoted with Toshiba Aquilion one 320-slice DVCT produced by Siemens. Exclude gradeⅣimages and selectⅠ～Ⅲlevel images into the study. The calculation of the CACS was done automatically by the workstation software.Within two weeks,all the patients were given the coronary angiography (CAG).Taking the result of CAG for the gold standard of evaluating coronary artery stenosis, the subjects were divided into two groups: non-CHD and CHD; then accorrding to the level of the coronary artery stenosis, the subjects were divided into mild,moderate and severe stenosis; according to the number of the coronary artery stenosis, the subjects were divided into one,two and three stenosis; to divide the male and female subjects into three groups : <50-year-old,50～60 years old and≥60 years of age; to evaluate if there were differences of CACS in these different groups.According to the CAG results and clinical symptoms, the subjects were divided into acute coronary syndrome group,stable angina pectoris and non-CAD group;according to the coronary artery branches of these plaques, the subjects were divided into LM group,LAD group,LCX group and RCA group;according to level of the coronary artery stenosis, the subjects were divided into mild,moderate and severe stenosis;then we evaluate if there were differences of the number and nature of Plaque in these different groups.Results1,The value of the 320-slice DVCT in diagnostis of coronary artery calcification1)The comparison of CACS in CAD group and non-CAD group In the LAD group,LCX group and RCA group ,the CACS in CAD group was significantly higher than non-CHD group and difference was statistically significant. In the LM group, the CACS in CAD group was higher than non-CHD group but difference was not statistically significant. In both the CAD group and the non-CHD group,CACS in LAD group and RCA group was significantly higher than others.2)The comparison of CACS in groups with different level of the coronary artery stenosis There is statistically different between the mild group and the moderate and between the mild group and the severe group (P=0.039,P=0.008). However.Difference was not statistically between the moderate group and the severe group(P=0.071).3)The comparison of CACS in groups with different number of the coronary artery stenosis CACS was positively correlated with the number of the coronary artery stenosis (r=0.57, P<0. 01). There is statistically different between the one stenosis group and the two stenosis group(P=0.021).Difference was significant statistically between the one stenosis group and the there stenosis group(P=0.006). However.Difference was not statistically between the two stenosis group and the there stenosis group (P=0.063). 4)The comparison of CACS in groups with different age and different gender Both male subjects and female subjects, calcification rate and the CACS were increasing with age. In the"<50-year-old age"group, the CACS in female subjects was significantly lower than male subjects and the difference was statistically(P=0.008). In the"50～60 age"and"≥60-year-old age"group, the difference was not statistically (P=0.059,P=0.067).2,The value of the 320-slice DVCT in evaluation of coronary artery plaque1)The comparison of distribution between non-calcified plaque and calcified plaque Tn the acute coronary syndrome group,the number of non-calcified plaque is higher than the calcified plaque. Tn the stable angina pectoris group,the number of calcified plaque is higher than the non-calcified plaque.In the non-CAD group,the number of both of the two plaque is small.The difference statistically(χ2=71.011,P<0. 005).2)The comparison of plaque,s distribution in different coronary branches The left anterior descending artery group and the right coronary artery group have the largest number of plaque. The left main stem has the least number of plaque. Most of the non- calcified plaque is in the left anterior descending artery and most of the calcified plaque is in the left anterior descending artery and the right coronary artery.3)The comparison of different levels of the coronary artery stenosis between non calcified plaques and calcified plaques Most of the Non-calcified plaques causes severe stenosis. Most of the calcified plaques causes mild stenosis. Difference is significantly statistically between the two groups(χ2=40.032, P<0.005).Conclusions1,The evaluation of coronary artery calcification and coronary artery plaque made with the 320-slice DVCT is an effective, noninvasive means.It can be used as a screening means before traditional coronary angiography.2,Coronary artery calcium score may reflect the extent of coronary artery disease. The relationship between the two is general relationship, and it is not the clear positive linear correlation.3,The nature of plaque is correlated with risk of coronary heart disease . The severity of coronary artery disease can be estimated by measuring the nature of plaques. |
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