The Display And Analysis About The Distribution And Morphology Of Coronary Atherosclerotic Plaques By Computed Tomographic Coronary Angiography

Objective:Using the multi-detectorspiral computed tomographic coronary angiography post-processing techniques to explore the morphology and distribution of coronary atherosclerotic plaques.Methods and materials:140patients who underwent multislice spiral CT coronary angiography (computed tomographic coronary angiography, CTCA) were randomly selected.There were64male,29female, aged22-86years old, the average(55.59±1.8) years of age. The heart rate of the patients should be controlled below70/pm,if the heart rate>70/pm,the patients should use β-blockers(Betaloc25-50mg) before the examination about20-30min.With GE Light Speed16-slice CT scanning,the scan parameters:tube current of120mA, Tube voltage260kV, pitch1.375:1,Ounaipaike (350mgI/ml)120ml from the LF9000High-pressure syringe injected through the left hand vein puncture injection,the speed of4.0ml/s.in order to reduce the artifacts caused by contrast agents too thick in the superior vena cava,the delay time was determined by bolus tracking or test bolus, the scan range from the tracheal bifurcation1cm to the heart of the phrenic surface.In the AW4.2workstation for image reconstruction.The first,two radiologists compared MPR with CTVE about the abilities of the coronary atherosclerotic plaques’ morphology,and finded one method of MPR、CPR and CTVE,which is the best about the distribution of coronary atherosclerotic plaques.The second, analysed the morphology and distribution of coronary atherosclerotic plaques with MPR and CPR, respectively.Results:1.In the35sections analysis of vascular segments,MPR analysed the morphology of coronary atherosclerotic plaques was better than CTVE,the diagnosis rate was91.43%(32/35), CTVE was60%(21/35), there was significant difference;2. In the diagnosis of the distribution of coronary atherosclerotic plaque with MPR、CPR and VRT,CPR was the most valuable,97.14%(34/35), VRT was the least,31.43%(11/35), there was significant difference;3.As for the684plaques detected by MSCT,119were non-calcified plaques.Plaques were most often seen in the LAD-6segment(41plaques),followed by LAD-7(20plaques),LMA(15plaques),LCX-11(13plaques) and RCA-1(13plaques);4.Coronary arterv stenosis with degrees≥50% were found in78plaques,the result of MPR analysed the morphology of coronary atherosclerotic plaques was73cases the stenosis were found to be eccentric,43of them were found in the medial wall,while others were found in the lateral wall.Only5cases of stenosis were shown to be concentric;5. The result of the distribution of coronary atherosclerotic plaques with CPR, our data show that most of which were focal lesions.followed by tube-like lesions and diffused lesions.Conclusion:1.In many postprocessing technique of multislice CT,MPR vessels cross-section was the best suitable for the morphology of coronary atherosclerotic plaques,CPR was for the distribution.2.The deffirences not only in the plaques’ distribution of the4major coronary branches but also in the different segments of one coronary artery.Incidence rate of atherosclerotic plaques is higher in the left coronary arteries than in the right ones and higher in the proximal segments than in the midpiece and distal segments.3. The most plaques were eccentric shaped, the LAD branch which displays similar plaque distribution in both the medial and the lateral walls,the plaques of LMA、LCX and RCA were the medial wall better than the lateral wall.Concentric plaques are rare. Most plaques are focal or tube-like lesions.4.ACTCA can effectively detect the degree of coronary artery stenosis and the morphology of atherosclerotic plaques.It could be applied in prevention and early diagnostics of coronary heart disease.