[Differential judgment of coronary stenosis by 320-slice dynamic volume computed tomography and coronary angiography]

To compare the characteristics of lesions with consistent and inconsistent judgments of coronary stenosis on 320-slice dynamic volume computed tomography (DVCT) versus coronary angiography (CAG).

Ninety-two patients (265 lesions) with CAG and DVCT within 2 weeks from January 2011 to May 2012 were enrolled. According to the matching degree of stenotic judgment, all lesions were divided into consistent and inconsistent groups. The position of lesions, degree of bending, plaque morphology and calcification proportion were analyzed.

There were 236 lesions in consistent group versus 29 lesions in inconsistent group.In inconsistent group, there were more left circumflex artery, distal, ostial and tortuous lesions than that in consistent group (P < 0.05). At the same time, the proportion of nubbly type plaque, calcified plaque, nubbly and nodular type calcification in the main plaque in inconsistent group was higher than those in consistent group (P < 0.05).Segmental coronary calcium score (250 ± 210 vs 82 ± 66, P < 0.05), number of calcifications and calcification proportion in main plaque (55% ± 28% vs 43% ± 30%, P < 0.05) in inconsistent group were higher than those in consistent group (P < 0.05).

When coronary lesion occurs in ostial, distal or tortuous position or its main plaque is of nubbly type with a heavy calcification load, the judgment of stenosis by CTA and CAG is more likely to be inconsistent.