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Application of 64-Detector Computed Tomography Coronary Angiography in Eldly Patients with CHD and DM

Author: JinXiaoDong
Tutor: LiJiFu
School: Shandong University
Course: Cardiology
Keywords: 64 -slice spiral CT Coronary heart disease Diabetes Angiocardiography
CLC: R587.1
Type: Master's thesis
Year: 2010
Downloads: 57
Quote: 0
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Abstract

[Research background and significance] coronary heart disease, diabetes is a serious hazard to human health are the clinical disease, common diseases, such as diabetes, coronary heart disease risk is also considered disease, coronary heart disease and diabetes more severe atherosclerosis, coronary more extensive lesions, especially in elderly patients. Currently, selective coronary angiography in the diagnosis of coronary heart disease is still the \and the high cost of the evaluation of coronary artery disease is also flawed. Has been reported that in 1995 about one million European patients underwent selective coronary angiography, which is not suitable for normal coronary artery disease or interventional treatment of patients accounted for 72%. The clinically most patients, especially elderly patients, the diagnosis means demand is non-invasive, accurate and secure. In recent years, along with multi-slice CT widely used in clinical and CT technology and the rapid development and progress, especially 64-slice spiral CT, because of its fast scanning speed, combined with ECG gating technology and advanced image processing technology, the basic rule heart beat and respiration impact, with high temporal and spatial resolution, determine disease have a higher sensitivity and specificity, and relatively non-invasive, inexpensive, convenient and low risk; while these are optional coronary angiography, echocardiography, exercise treadmill test, Holter monitoring and other means of inspection can not be both a. 64-slice spiral CT coronary heart disease and diabetes in the clinical application are also increasingly concerned about the medical profession. [Objective] The 64-row spiral CT coronary heart disease patients with diabetes mellitus and coronary artery disease extent of coronary lesions and explore its application in such patients value and limitations. [Methods] 52 cases of clinically diagnosed coronary heart disease in diabetic patients underwent 64-slice spiral CT coronary angiography and selective coronary angiography. All enhanced scan axial images for multi-planar reconstruction (multiplanar reconstuction, MPR), volume rendering (volume rendering, VR), maximum intensity projection (maximum intensity projection, MIP), surface reconstruction (curved planar reconstuction, CPR), vascular simulation Endoscopy (vitual endoscopy, VE) and other post-processing, evaluation of all coronary luminal stenosis and plaque in nature. All patients were enrolled within two weeks of selective coronary angiography, according to the results to determine MSCT angiography for coronary heart disease in diabetic coronary artery disease predictive value. [Results] 1.52 cases of patients with conventional coronary angiography in all patients of the actual analysis of 676 coronary segments, which found 174 segments with ≥ 50% stenosis, only four cases of 52 patients with mild disease, the rest are in severe lesions; including occlusive disease 11 (6.3%); long lesions 26, accounting for 14.9%; single-vessel disease patients, 19.2% (10/52), double vessel disease accounted for 38.5% (20/52), three vessel disease accounted for 42.3% (22/52). In conventional angiography found 174 segments with ≥ 50% stenosis in the segment, CT coronary angiography correctly detected 155. 64-slice spiral CT coronary angiography diagnosis of coronary artery stenosis with a sensitivity of 89.1% (155/174) and a specificity of 92.8% (466/502), the accuracy was 91.9% (621/676), positive predictive value of 81.2% ( 155/191), negative predictive value of 96.1% (466/485). 2 diabetic patients with coronary heart coronary atherosclerotic plaques in soft plaque and mixed plaque common, some with calcification, simply less calcified plaque. [Conclusion] 1.64 slice spiral CT coronary angiography can clearly show the various main coronary artery and its branches, right coronary artery stenosis with high diagnostic value. 2 diabetic patients with multivessel coronary heart disease incidence of coronary atherosclerotic plaques in soft plaque and mixed plaque common, some with calcification; occlusive lesions and long lesions common. 3.64-slice spiral CT although due to motion, calcification and other effects, there is a certain proportion of blood vessels can not be accurately assessed, but can be used as diabetic patients with coronary heart disease risk stratification, prognosis and guide treatment, an effective secondary prevention means of checking.

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