The Value Of Multi-slice CT Angiography In Assessment Of Left Coronary Artery Bifurcation Lesions By Measuring The Bifurcation Angle

Objective:To evaluate the value of multi-slice coronary CT angiography in assessment of bifurcation lesions by measuring the left coronary artery bifurcation angle.Methods: Within the patients who experienced coronary artery CTA and coronary angiography in our hospital, 80 cases of patients with left coronary artery bifurcation plaque were selected, using multi-slice CTA to diagnose the extent of lumen stenosis and to measure the left anterior descending and circumflex artery bifurcation angle, and using coronary angiography to assess luminal stenosis. Then taken the coronary angiography results as the golden standard, 1. Evaluating the coronary artery CTA diagnostic accuracy.2. The correlation between left coronary artery bifurcation and bifurcation lesions was assessed by receiver operating characteristic curve(ROC), and the diagnostic thresholds were obtained;3.Combining the measurement of the diameter of the coronary artery and the bifurcation angle, and compare with the results of the measurement of lumen diameter.Results:Coronary artery CTA by direct measurement of luminal stenosis degree method in the diagnosis of left coronary bifurcation lesions of the sensitivity, specificity, PPV and NPV respectively: 0.89, 0.76 and 0.75 and 0.90,Youden index 0.65.2. ROC curves were used to describe the correlation between bifurcation angles and bifurcation lesions, area under the ROC curve relationship with lesion was 0.757, 95% confidence interval for the 0.650-0.864.The diagnostic threshold of 90 o and corresponding diagnosis of left coronary bifurcation lesions of the sensitivity, specificity, positive predictive value(PPV),and negative predictive value(NPV) were 0.75 and 0.73, 0.70 and 0.78. 3.Combing the lumen measurement and bifurcation angle,the sensitivity,specificity, PPV and NPV were:0.63、0.91、0.85、0.75,Coronary CTA by bifurcation angle measurement shows great improvements in the specificity and positive predictive value.Conclusion: Left coronary artery bifurcation angle can be used as an index to assess bifurcation lesions, which can significantly improve the diagnostic specificity and positive predictive value.