The Diagnostic Value Of DSCT Coronary Vulnerable Plaques

Objective:By comparison with the CAG, evaluate the diagnostic value of dual-source CT coronary angiography (CTA) for coronary vulnerable plaques.Methods:June2013to November5Fifth Affiliated Hospital of Xinjiang Medical University,46cases (clinically suspected or confirmed coronary artery disease), all patients underwent dual-source CT coronary CT examination, using dual-energy scanning mode, then selective coronary angiography (CAG) examined by two experienced interventional cardiologists joint analysis of angiographic results, diagnostic results and DSCT comparison, the patch number, location and severity of the DSCT measured analyzed. Finally, the detection of different types of single-energy spectrum analysis of plaque and plaque depicting the spectrum curve.Results:46of138patients, respectively, major coronary arteries and dual source CT CAG examination,(1) to CAG as a standard, dual-source CT positive predictive value97%, negative predictive value82%, sensitivity90%, specificity93%6%of false positive and false negative10%. Dual-source CT to detect lesions count compliance rates were RCA80%, LAD93%, LCX96%,(2) to CAG as the standard, DSCT total plaque detection rate of80%; various branches near the middle of the plaque the detection rates were RCA81%,77%; LAD93%,81%; LCX83%,92%; RCA plaque detection rate is lower than the LAD and LCX.(3) dual-source CT detected98plaque, soft plaque (23.5%); calcified plaques27.6%; mixed plaque,50%; non-fibrous plaque.(4) soft plaque and adipose tissue changes in CT value range is different, but the trend curve to take shape roughly consistent with calcified plaque CT values ranging from bone tissue is different, but generally the trend is also taking shape curves consistent. Mixed plaque curve has fluctuated within a certain range.Conclusion:(1) DSCT coronary angiography for coronary artery stenosis and plaque quantitative diagnosis with high accuracy.(2) DSCT can make noninvasive evaluation of coronary plaque morphology and composition. (3) mild stenosis mostly soft plaque lesions, severe stenosis lesions mostly mixed plaques.(4) dual-energy spectroscopy can identify some special ingredients for the analysis of plaque composition can provide some valuable information.