Diagnostic Value Of Dual-source CT Coronary Angiography In Coronary Artery Stenosis And Detecting Coronary-stent Restenosis

Objective:With invasive coronary angiography (CAG) as the gold standard to evalution the diagnosis of coronary artery stenosis and detecting coronary-stent restenosis,explor dual-source CT(DSCT)in the diagnosis of coronary artery stenosis and the sensitivity and specificity of stent restenosis. Methods:Retrospective analysis of92cases of Urumqi General Hospital of Lanzhou Military Region,Department of Cardiology suspected coronary heart disease on Jume2012to Jume2013,patients underwent dual-source CT coronary angiography and coronary angiography,and at intervals of not more than two weeks,of which98were inplangted stents and stent diameter greater than3.00mm,stent patient within one to three months after coronary angiography in the diagnosis of in-stent restenosis15.Conventional coronary angiography was taken as gold standard for calculation of diagnostic accuracy. The sensitivity, specificity, positive predictive value.and negative predictive value of DSCT were evaluated respectively for detection of coronary artery stenosis.All statistical tests were calculated using SPSS17.0software. Two-related χ2test was calculated to evaluate the relationship between the DSCT and CAG in discovering the coronary artery stenosis and the stent restenosis, and Cohen’s kappa was also calculated to quantify inter-rater agreement between DSCT and CAC.Results:The sensitivity,specificity,positive predictive value and negative predictive value of the DSCT in detecting coronary artery stenosis on a per-segment basis were83.18%(178/214),72.08%(111/154),80.54%(178/221),75.51%(111/147).The accuracy rate of DSCT in detecting coronary artery stenosis was73.7%. The sensitivity,specificity,positive predictive value and negative predictive value of the DSCT in detecting coronary artery the stent restenosis on a per-segment basis were93.33% (14/15,95.18%(79/83),77.78%(14/18),98.75%(79/80). Statistical analysis using a two-related x2test showed no obvious difference in the discovery of coronary artery stenosis and the stent restenosis between DSCT and CAG. Also, kappa index (k=0.568、0.832) indicated excellent agreement between DSCT and CAG. Conclusion:Dual-source CT coronary artery stenosis and stent stenosis diagnosis accuracy is close to selective coronary angiography,check method is an accurate and reliable.