Study On The Predictive Value Of Revolution CT In Vulnerable Plaque

Objective: To study the imaging characteristics of coronary plaque of CTA in patients with acute coronary syndrome,and to evaluate the predictive value and role of Revolution CT in the diagnosis of vulnerable plaque.Methods: 1.From January 2016 to December 2018,50 patients who have undergone coronary CTA examination with acute coronary syndrome diagnosed in cardiology department of the Affiliated Zhoupu Hospital of Shanghai University of Medicine&Health Sciences were collected as the study group and 50 patients with stable angina as the control group.The differences in plaque characteristics between the two groups were compared,including spotty calcification,positive reconstruction,napkin ring syndrome,CT value of non-calcified plaque and perivascular fat stranding.2.58 patients suspected of acute coronary syndrome who underwent Revolution CT and intravascular ultrasound from January 2018 to July 2019 in The Affiliated Zhoupu Hospital of Shanghai University of Medicine&Health Sciences were enrolled.Among them,28 were male and 30 were female.The average age was(69.32 ± 9.16)years.The consistency between Revolution CT and intravascular ultrasound in plaque quantitative detection,including lumen diameter stenosis rate,area stenosis rate,external elastic membrane cross-sectional area(EEM-CSA),minimum lumen area(MLA),minimum lumen diameter(MLD),plaque area(PA),plaque burden(PB)and remolding index(RI),was checked,and the sensitivity,specificity,positive predictive value and negative predictive value of Revolution CTA in the diagnosis of vulnerable plaque were calculated.Results: 1.Compared with the patients with stable angina pectoris,the plaque of patients with acute coronary syndrome had higher proportion of spotty calcification,positive remodeling,perivascular fat stranding and napkin ring sign,and the CT value of non-calcified plaque was lower than that of the control group,the difference was statistically significant(?2value was 17.834,9.561,4.440,9.927,t value was 10.716,P < 0.05);2.With intravascular ultrasound as the gold standard,GE revolution CT had no significant difference in the critical lesion plaque measurement results of lumen diameter stenosis rate,area stenosis rate,MLA,MLD,EEM-CSA,PA,PB and RI of critical lesions(t value was 1.468,1.761,1.086,1.909,1.214,0.829,0.264,1.383,P value > 0.05),and there were good consistency and correlation(correlation coefficient r value was 0.634,0.732,0.719,0.813,0.732,0.69,0.658,0.732 respectively);The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of Revolution CT in diagnosing vulnerable plaque were 73.81%,70.27%,73.17%,68.42% and 70.89%,respectively.Conclusion: 1.The main features of plaque in patients with acute coronary syndromes on CTA are spotty calcification,positive remodeling,napkin ring sign,low CT value of non-calcified plaques,and perivascular fat stranding,and perivascular fat stranding is a new sign of plaque in patients with acute coronary syndromes on CTA.2.There is a good consistency between Revolution CT and intravascular ultrasound in plaque quantitative detection.Revolution CT has a good prediction rate for vulnerable plaque.