The clinical application of multi-slice spiral CT coronary angiography in patients with coronary heart disease

Objective: To assess the value of multi-slice spiral computed tomography (MSCT) coronary angiography in patients with coronary heart disease. Methods: Forty patients of coronary heart disease with sinus rhythm were studied by contrast-enhanced, electrocardiographically-gated MSCT, and CT findings were compared with those of conventional angiography. Results: Compared with conventional angiography, MSCT angiography correctly determined the absence of coronary artery disease in 4 patients. Of the total 124 coronary arteries (left main, left anterior descending, left circumflex, and right coronary artery) in 31 cases, the proximal and severe lesions of coronary artery (≥50% stenosis) could be detected (sensitivity=81.8%, specificity=90.1%), as well as the stenosis extent resulted from the coronary plaques. Plaque morphology could be clearly differentiated and classified by MSCT. Calcified plaque, especially the extensively calcified, caused mild lumen diameter stenosis (<50% stenosis). However, non-calcified plaque caused significant stenosis (≥50% stenosis). In the segments with coronary stents and bypass graft, the position and distal blood flow were well showed. Conclusion: MSCT coronary angiography is a reliable diagnostic method for coronary heart disease. It is valuable in demonstrating coronary lumen stenosis and coronary atherosclerotic plaque. MSCT coronary angiography can replace conventional angiography for detecting rupture-prone soft coronary plaque as a noninvasive method. (authors)