Application of CCTA in the Diagnosis of Coronary Heart Disease and Assessment of Plaque Properties
Objective To evaluate the application value of coronary computed tomography angiography(CCTA)in the diagnosis of coronary heart disease and assessment of coronary atherosclerotic plaque properties.Methods The clinical data of 83 patients who were suspected of coronary heart disease and admitted to the hospital from September 2022 to January 2024 were analyzed retrospectively.All patients underwent coronary angiography(CAG),intravascular ultrasound(IVUS),and CCTA.With CAG and IVUS results as the gold standard,the application value of CCTA in the diagnosis of coronary heart disease and assessment of plaque properties was analyzed.Results A total of 552 coronary segments in the 83 patients were examined by CAG,and 305 segments were diagnosed with stenosis,including 82 mild stenoses(26.89％),146 moderate stenoses(47.87％)and 77 severe stenoses(25.25％).241 plaques were detected by IVUS,including 80 non-calcified plaques(33.20％),109 calcified plaques(45.23％),and 52 mixed plaques(21.58％).Compared with CAG,the sensitivity,specificity and accuracy of CCTA for diagnosing coronary artery stenosis were 91.80％,97.17％and 94.20％,showing high consistency with the diagnostic results of CAG(Kappa value=0.884).Its diagnostic coincidence rates for mild,moderate,and severe coronary artery stenosis were 90.30％,89.25％,and 85.11％,respectively.Compared with IVUS,the sensitivity,specificity and accuracy of CCTA for diagnosing coronary atherosclerotic plaque were 94.19％,84.76％and 90.37％,showing high consistency with the diagnosis results of IVUS(Kappa value=0.798).Its diagnostic coincidence rates for non-calcified plaque,calcified plaque,and mixed plaque were 76.25％,91.74％,and 90.38％,respectively.In the diagnosis of coronary atherosclerotic plaque property,the area under the ROC curve(AUC)of CCTA for diagnosing calcified plaque was the highest(0.942),followed by mixed plaque(0.939)and non-calcified plaque(0.830),showing high diagnostic value(P＜0.01).Conclusion CCTA is of high value in the diagnosis of coronary heart disease and the differentiation of coronary atherosclerotic plaque property,with high consistency with the gold standard.
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