Comparative Study Between The Imagine Of Carotid Atherosclerosis Ultrasonography And Coronary CT Imaging Findings

Objective:To analyse the association of disease severity and plaque nature between imagining characteristics of coronary and carotid atherosclerosis, to evaluate the prediction value of carotid atherosclerosis for coronary artery atherosclerosis.Methods:(1)Part One:131subjects who underwent dual source computed tomography(DSCT)were recruited,were grouped as conrtol group and coronary heart disease(CHD) group according to the results of DSCT imaging.All paticents of two groups obtained CT angiography by DSCT scanner.Carotid ultrasound performed in bilateral carotid arteries within three weeks after coronary CT scan.The parameters of the carotid ultrasound imagine measurement,including plaque count,thickness scores, intima-media thickness,were mearsured for all paticents.The range of carotid ultrasound examination obtained common carotid,internal carotid,external carotid. Coronary segmental evaluation was performed according to AHA classification and subdivision of coronary arteries into15segments.Coronary artery luminal stenosis was partitioned into four grades:gradeO (normal coronary artery),grade1≤50%stenosis,50%<grade2≤75%stenosis,grade3>75%stenosis. All subjects were divided into three groups according to mearsuring the highest stenosis rate of segment coronary artery. The quantitative data of carotid atherosclerosis in different groups was recorded using mean±standard deviation.Quantitative data in the different groups and categories were compared using independent t test and one way ANOVA. The correlation between carotid atherosclerosis plaque score and coronary DSCT plaque score was analyzed using Pearson correlation analysis,and compared rate using χ2test. The correlation between coronary stenosis grade and carotid intima-media thickness and plaque score was analyzed using Spearman correlation analysis.(2)Part Two:Coronary plaques those were in the right coronary artery,left main artery,left anterior descending,left circumflex were classified into three types based on CT attenuation value(HU):non-calcified,calcified and mixed plaques,calcified plaque CT attenuation value≥130HU, mixed plaques contain non-calcified and calcified composition.95subjects of coronary heart group were divided into non-calcified plaque group and mixed plaques group groups according to CT plaque type,the plaque type of subjects of the former was nothing but non-calcified plaque,the plaque type of subjects of the latter contain two or more than two CT plaque types.plaque type,Carotid plaque type:(1) echolucency plaque:echo is slighter lower than the surrounding the sterncleidomast, echolucency plaque area/total area≥80%in the plaque maximum longitudinal.(2)Non-echolucency plaquerincluding hyperechoic, strong echo,mixed echo plaque.Echolu-cency plaque area/total plaque area<80%in the plaque maximum longitudeinal is difined as mixed plaque.The correlation between type of coronary plaques and caro tid was evaluated using Logistic regression analysis and compared rate using χ2test.Results:(1)Part One:Carotid atherosclerosis incidence of the CHD group was significantly higher than that of the control group, there were significant differences in carotid intima-media thickness and plaque scores between two groups;coronary stenosis grade had a positive relationship with carotid intima-media thickness,plaque scores.coronary plaque scores had a positive relationship with carotid plaque scores,the correlation coefficient were0.697,0.807,0.902(P<0.05).(1)Part Two:There was no statistitical difference in hypertension,diabetes,smoking, drinking between the non-calcified coronary plaque group and the mixed plaque group(P>0.05), there was statistitical difference in age,gender. the carotid echolucency plaque incidence of non-calcified coronary plaque group was significantly higher than that of mixed plaque group,There was significant correlation between types of coronary plaques and carotid (P<0.05).Conclusion:(1) There were association in lesion severity between the imaging of Carotid atherosclerosis ultrasonography and coronary CT imaging.carotid intima-media thickness,plaque score could predict severity of coronary atherosclerosis to some extent.(2) Echolucency of carotid significantly associates with non-calcified plaque of coronary in the imaging finds,plaque type of carotid atherosclerotic may be a predictor for plaque of coronary.(3)Ultrasound, as an effective screening method for CHD high-risk groups, improve the positive rate of CCTA, reduce unnecessary radiation and the cost of inspection.