320排CT冠状动脉减影对冠脉钙化斑块狭窄程度诊断价值及图像质量影响因素分析OACSTPCD

Objective:To investigate the diagnostic value of 320-slice CT coronary subtraction on stenosis degree of calcified plaque and the influencing factors of image quality.Methods:A total of 193 patients with 320-row CT coronary subtraction(Sub-CCTA)in our hospital from September 2021 to November 2023 were selected as study subjects,and 236 narrow calcified plaque segments were detected in these patients.Using the results of digital subtraction angiography(DSA)as the gold standard,the diagnostic results of Sub-CCTA and DSA on the degree and rate of coronary stenosis were compared,and the diagnostic efficacy of Sub-CCTA on different degrees of coronary stenosis was analyzed.Logistic regression was used to analyze the influencing factors of Sub-CCTA image quality,and the correlation intensity between the influencing factors and image quality was analyzed by restricted cubic spline model.Results:Sub-CCTA and DSA showed a high degree of consistency in the diagnosis of coronary stenosis degree and stenosis rate(Kappa=0.912,interclass correlation coefficients were 0.983 and 0.972,respectively).Sub-CCTA has high accuracy in the diagnosis of coronary artery stenosis,especially in the sensitivity of grade Ⅳ stenosis and the specificity of grade Ⅱ stenosis.Multivariate Logistic regression analysis showed that BMI was an independent protective factor and heart rate was an independent risk factor for Sub-CCTA image quality(P＜0.05).The correlation strength of BMI,heart rate and image quality was nonlinear dose-response relationship(nonlinear detection,P＜0.001).Conclusion:Sub-CCTA has high diagnostic accuracy for coronary arteries with different stenosis degrees,and is highly consistent with DSA diagnosis results.BMI is an independent protective factor for Sub-CCTA image quality,while heart rate is an independent risk factor,both of which have a nonlinear relationship with image quality.