New Method Of Coronary Score Evaluation And Its Clinical Application In Assessment Of Coronary Stenosis Combining With CTCA: A Preliminary Study

Part ⅠPRELIMINARY STUDY ON NEW METHOD FOR EVALUATION OFCORONARY ARTERY CALCIFICATION SCORE AND ITS CLINICALAPPLICATIONObjectiveTo investigate the accuracy of calcium score(CS) in CT coronary angiography(CTCA)and its predictive value for significant coronary stenosis to reduce the patient radiationdose.Methods73patients (Female25， male48， the average age is60.27±9.78， the age range is34-82) were enrolled in the prospective study. All patients underwent CTCA using320-rowvolume CT scanner. CS were assessed in traditional method and in CTCA, respectively.The correlation between the two methods was evaluated using Spearman correlationanalysis. With ICA as the reference standard, the capability to predict obvious coronarystenosis was of the two methods was compared using ROC curve.ResultsThe average value of traditional CS and CS in CTCA were365±514and404±572,respectively, which were highly correlated(r=0.977，P<0.01). The area under the AUC fortraditional CS was0.859[95%CI (0.774-0.945)], while the value for CTCA was0.863[95%CI (0.779-0.947)].ConclusionsThe CS in CTCA is correlated with that with traditional CS, which may skips theadditional CS scanning and reduce the total radiation dose further. Part ⅡNEW QUANTIFICATION OF CORONARY ARTERY CALCIFICATIONCOMBINED WITH CT CORONARY ANGIOGRAPHY FOR THE DIAGNOSISOF CORONARY ARTERY DISEASEObjectiveTo explore the ability to assess the coronary stenosis of the combination of newcalcium score and coronary CT angiography (CT coronary angiography, CTCA), and tofurther reduce the patient radiation dose by skipping pure calcium score scan.Methods73patients((Female25， male48， the average age is60.27±9.78， the age rangeis34-82) received examination with320-rows volume CT to assess the quantification ofcoronary artery calcification and coronary artery disease in CTCA. With ICA as thereference standard, ROC curve was applied to asses the diagnosis capacity of combinationof the new CS and CTCA in coronary artery diseases.ResultsIn predicting the coronary artery stenosis using the new CS, sensitivity was84.6%and specificity was100%. Positive Predictive Value was100%and negative predictivevalue was71.4%. In assessing the coronary artery stenosis with CTCA, sensitivity was96.1%%and specificity was77.3%; positive Predictive Value was90.7%and negativepredictive value was89.1%. For assessment of coronary artery disease with thecombination of CS and CTCA, sensitivity was96.1%%and specificity was100%, positivePredictive Value was100%and negative predictive value was91.7%。ConclusionA significant accuracy was present in assessment of CAD using the new CS andCTCA, which would further decline the patients’ radiation dose at the same time.