Abstract:Aim To evaluate whether the value of 64-detector spiral computed tomography coronary angiography （64-DSCTCA） is identical between female and male in diagnosis of patients with coronary artery stenosis. Methods 75 female and 75 male patients with coronary artery disease （CAD） or suspected CAD were chosen, who had been examined with not only 64-DSCTCA but also coronary angiography （CAG）. The result of CAG was regarded as the gold standard. The sensitivities, specificities, positive prediction values and negative prediction values of 64-DSCTCA were respectively calculated in diagnosis of female and male patients with CAD （coronary artery stenosis≥50%）, coronary artery moderate stenosis （stenosis 50%～75%）, severe stenosis and occlusion （stenosis 76%～100%）. The aforementioned results were analyzed by statistical method, and contrasted between female and male. Results For the sensitivity, specificity, and negative prediction value of 64-DSCTCA in diagnosis of CAD, the differences were not statistically significant （P>0.05）, but positive prediction value was lower in female than that in male （P<0.05）. For the sensitivity, specificity, positive prediction value, and negative prediction value of 64-DSCTCA in diagnosis of coronary artery moderate stenosis, the differences were not statistically significant between female and male （P>0.05）. For the sensitivity, specificity, and negative prediction value of 64-DSCTCA in diagnosis of coronary artery severe stenosis and occlusion, the differences were not statistically significant （P>0.05）, but positive prediction value was lower in female than that in male （P<0.05）. Conclusions Diagnostic value of 64-DSCTCA is different in female and male. Positive prediction value of 64-DSCTCA is lower in female than that in male for diagnosis of CAD, coronary artery severe stenosis and occlusion.

Abstract:Aim To compare the coronary stent implantation between different types of coronary plaque by retrospectively investigating patients who received 64-slice spiral computed tomography coronary angiography before coronary stent implantation. Methods 86 patients who received 64-slice spiral computed tomography angiography before stent implantation from 2007 to 2009 were selected. 137 stents were implanted. Those coronary atherosclerotic plaques were divided into calcified plaque group and noncalcified plaque group based on average computed tomography value of plaque. Clinical character,ballon size,balloon predilation pressure,stent size,stent release pressure in two groups were compared. Results The age of patients in noncalcified plaque group was relatively younger than that in calcified plaque group. The low-density lipoprotein in noncalcified plaque group was higher than that in calcified plaque group. The proportion of 1-vessel disease in noncalcified plaque group was higher than that in calcified plaque group. The size of ballon and stent were similar in those two groups. The balloon predilation pressure in calcified plaque group was higher than that in noncalcified plaque group(898.93±159.67 kPa vs 810.22±112.61 kPa,P><0.01). Stent release pressure in calcified plaque group was higher than that in noncalcified plaque group(1 403.90±273.12 kPa vs 1 243.79±254.12 kPa,P><0.01). Conclusion Compared with noncalcified plaque,calcified plaque was stiffer,and had higher resistance to balloon predilation and stent angioplasty. Identifying the type of plaque before coronary stent implantation was significant.

Abstract:Aim To analyze factors that affected the coronary stent image quality of 64-slice spiral computed tomograghy. Methods 116 patients who received 64-slice spiral computed tomograghy after coronary drug-eluting metal stent implantation from 2007 to 2010 were selected.Those stents image were assessed by semi-quantitive method.Whether stent diameter,stent length,stent material,stent number and calcification status affected the stent image quality were analyzed. Results The sensitivity,specificity,positive predictive value,negative predictive value of 64-slice spiral computed tomograghy to detect significant in-stent restenosis were 85.7%,90.2%,60.0%,97.4%,respectively.Image quality of stents with diameters of >2.75 mm was better than stents with diameter of < or =2.75 mm(P><0.001).Image quality of stents which located on noncalcified plaque were better than stents which located on calcified plaque(P><0.05).Stent length,stent material,stent number did not affect the stent image quality of computed tomograghy. Conclusion 64-slice spiral computed tomograghy had ability to assess the cornary stent after implantation.64-slice spiral computed tomograghy was more suitable for assessing stents with diameters of > 2.75 mm and stents which located on noncalcified plaque.