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Comparative of Coronary Heart Disease Dectecting Coronary Arterial Calcification and Stenosis between 16-MSCT and Coronary Angiography

Author: LiuWenMin
Tutor: ZhouXuChen
School: Dalian Medical University
Course: Internal Medicine
Keywords: Multislice CT Coronary CT angiography Coronary angiography Coronary artery calcification
CLC: R541.4
Type: Master's thesis
Year: 2008
Downloads: 126
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Abstract


Objective: The pathophysiological basis of coronary heart disease (CHD) is caused by coronary plaque of coronary stenosis, coronary artery calcification (CAC) is part of the process of coronary sclerosis, reflects the amount of plaque load. The purpose of this study observed the detection of coronary CT angiography (CTA) and selective coronary angiography (CAG) are two methods for the CAC, according to CTA plaque classification, compare calcified plaque and noncalcified plaque in the coronary artery lumen narrow; explore the CTA, maximum intensity projection (MIP) and / or multi-planar reconstruction (MPR) images on a specific simplex calcified plaque parameters with coronary stenosis correlation observed calcified plaque morphological characteristics and the degree of stenosis The relationship; CTA diagnosis of calcified and non-calcified plaque CAG consistency. Methods: 38 cases of patients with coronary artery disease underwent 16-MSCT and CAG checks and records the analysis of clinical data of patients with coronary heart disease. Coronary angiography via the femoral or radial artery intubation, double-blind study the MSCT results with the results of coronary angiography. Coronary vascular tree is divided into 12 segment. Record the CTA examination results record: calcification, purely calcified plaque and mixed plaque distribution; according to the semi-quantitative method for the evaluation of coronary calcification, records the CAG show calcification; CTA detect different plaque components plaque divided into non-calcified plaque (soft plaque and plaque based mixed noncalcified plaque) and calcified plaque (simple calcified plaque and calcification mainly mixed plaque) groups. Is divided into significant coronary stenosis (gt; 50%) and non-significant stenosis (lt; 50%); at the CTA MIP and MPR images, observed specific purely calcified plaque diameter, plaque diameter and the corresponding normal vascular diameter ratio, length, record MIP images purely calcified plaque size and morphology. X 2 test, the test of significance of the difference between the samples, using Kappa test consistency analysis of the results of the CTA and CAG, Pearson product-moment correlation analysis correlation and Spearman rank correlation, P lt; 0.05 as a statistical test standard. Results: 1.CTA detect calcified plaque: 38 patients without CAC 6 cases, accounting for 15.8%, the CAC 32 cases, accounting for 84.2%. 38 patients with a total of 456 vessel segments found 30 soft plaque, calcification 32 simple calcified plaque, 78, 25 mixed calcified plaque. Calcified plaque the previous the descending branch sixth (28/38, 73.7%) gt; the right coronary Sec (15/38, 39.5%) gt; proximal segment of the circumflex artery (8/38, 21.1%). 2 CTA detected calcified plaque as the standard application of X 2 calcified plaque number and the presence or absence of diabetes, high blood pressure, high cholesterol, smoking and age differences (P = gt; 0.05). 3. CTA and CAG calcification detected a good correlation. 4. Coronary artery calcified plaque fast group and calcified plaque group differences stenosis probability significantly difference (X 2 = 8.188, p = 0.004), the soft plaque and mixed plaque based non-calcified A block is the the narrow main reason leading to angiogenesis significant. 5. MPR images, the ratio of the diameter of the calcified plaque and plaque diameter / normal vessel diameter and coronary stenosis no correlation; MIP images, calcified plaque diameter and the the plaque diameter / normal vessel diameter ratio coronary stenosis correlation (0.01 lt; P value lt; 0.05); MPR and MIP reconstructed image length with coronary stenosis weak correlation (0.01 lt; P value lt; 0.05); calcified coronary stenosis area no correlation. 6.CTA better than calcified plaques for the evaluation of non-calcified plaque, two types of plaque and CAG has a good consistency (Kapp values ??of 0.805 and 0.687, respectively). Conclusion: CTA or CAG can better check out the calcified lesions is the Clinical most commonly found two methods of CAC. Since non-calcified plaque is caused by coronary artery significant stenosis (gt; 50%) mainly due to non-calcified lesions mainly observed in the analysis of CTA. Underwent coronary CTA observed calcium plaque, the main reason for the cause of coronary artery stenosis, mostly moderate to severe; simple calcified plaques cause blood vessels to narrow, mostly mild to moderate major analysis of mixed plaque, mixed plaque. MPR images, mainly observed plaque composition, some of the specific parameters can be observed purely calcified plaque in the MIP image reaction of coronary stenosis, calcified plaque area not reflect coronary stenosis.

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CLC: > Medicine, health > Internal Medicine > Heart, blood vessels ( circulatory ) disease > Heart disease > Coronary arteries ( atherosclerosis ),heart disease (CHD)
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