中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (43): 8163-8167.doi: 10.3969/j.issn.2095-4344.2012.43.036

• 生物材料临床实践 clinical practice of biomaterials • 上一篇    下一篇

双源CT冠状动脉成像对冠状动脉支架内再狭窄的评价

胡钢峰1，鲍 健1，钱萍艳1，钱 斌1，胡晓华2，吴晶涛2   

  1. 1南京医科大学附属无锡人民医院医学影像科，江苏省无锡市 214023
    2扬州大学临床医学院医学影像科，江苏省扬州市 225001
  • 收稿日期:2012-03-15 修回日期:2012-05-28 出版日期:2012-10-21 发布日期:2012-10-21
  • 作者简介:胡钢峰，男，1977年生，江苏省无锡市人，汉族，1997年浙江大学医学院毕业，主管技师，主要从事医学影像技术研究。 1067019959@qq.com

Diagnostic value of dual-source CT coronary angiography in detecting coronary-stent restenosis

Hu Gang-feng1, Bao Jian1, Qian Ping-yan1, Qian Bin1, Hu Xiao-hua2, Wu Jing-tao2   

  1. 1Department of Radiology, Wuxi People’s Hospital of Nanjing Medical University, Wuxi 214023, Jiangsu Province, China
    2Department of Radiology, Clinical Medical College of Yangzhou University, Yangzhou 225001, Jiangsu Province, China
  • Received:2012-03-15 Revised:2012-05-28 Online:2012-10-21 Published:2012-10-21
  • About author:Hu Gang-feng, Technician in-charge, Department of Radiology, Wuxi People’s Hospital of Nanjing Medical University, Wuxi 214023, Jiangsu Province, China 1067019959@qq.com

PDF

357

被引次数

3

摘要：

背景：传统的CT在冠心病介入治疗后随访中难以普及，寻找无创、有效的检查方法对支架内再狭窄的评价就成了影像科医生非常关心的课题。
目的：通过在不控制心率下双源CT冠状动脉成像与选择性冠状动脉造影对支架评估的对比，探讨双源CT冠状动脉成像对冠状动脉支架内再狭窄的诊断价值。
方法：收集53例患者共75枚支架在不控制心率情况下同期行双源CT冠状动脉成像及冠状动脉造影检查的患者影像资料，分析双源CT冠状动脉成像诊断支架内再狭窄的敏感性等各项指标。
结果与结论：①双源CT冠状动脉成像能清楚显示全部支架，96%（72/75）支架图像达到良好以上。②双源CT冠状动脉成像对支架内再狭窄诊断的敏感性、特异性、阳性预测值、阴性预测值及准确性，与冠状动脉造影结果比较差异无显著性意义(P > 0.05)。③双源CT冠状动脉成像分别对心率< 70次/min和≥70次/min的患者支架再狭窄检测的敏感性、特异性、阳性预测值、阴性预测值、准确性比较差异无显著性意义 (P > 0. 05 )。④双源CT冠状动脉成像对直径< 3.0 mm支架再狭窄检测的敏感性、特异性、阳性预测值、阴性预测值、准确性低于≥3.0 mm的支架再狭窄(P < 0. 05 )。结果说明，双源CT冠状动脉成像对诊断冠状动脉支架内再狭窄具有较高的应用价值，且不受心率的影响，可作为大直径支架通畅情况的评估方式及小直径支架的初步筛查方法。

关键词: 体层摄影术, X射线计算机, 支架内再狭窄, 冠状动脉造影成像, 双源CT冠状动脉成像

Abstract:

BACKGROUND: The traditional CT is hard to be popularized in follow-up after the treatment of coronary heart disease with interventional stents, looking for noninvasive and effective method to evaluate the stent restenosis has became the hot spot.
OBJECTIVE: To investigate the diagnosis value of dual-source CT coronary angiography in detecting coronary-stent restenosis through the comparing the evaluative effect of dual-source CT coronary angiography and selective coronary angiography without heart rate control.
METHODS: The 53 cases with a total of 75 stents were performed with dual-source CT coronary angiography and coronary angiography to evaluate image quality and analyze sensitivity of coronary-stent restenosis.
RESULTS AND CONCLUSION: ①All stents were considered assessable for diagnosis with dual-source CT angiography. Images quality of 96% (72/75) of the stents was good. ②There was no significant difference in sensitivity, specificity, positive and negative predictive value and the accuracy between dual-source CT angiography diagnose in-stent restenosis and coronary angiography diagnose in-stent restenosis (P > 0.05). ③There was no significant difference in sensitivity, specificity, positive and negative predictive value and the accuracy between the patients with the heart rate < 70 beats/min and ≥ 70 beats/min receiving dual-source CT angiography diagnosis for in-stent restenosis (P > 0.05). ④The dual-source CT angiography had lower sensitivity, specificity, positive and negative predictive value and accuracy to detect < 3.0 mm in-stent restenosis than to detect ≥ 3.0 mm in-stent restenosis (P < 0.05). The dual-source CT is helpful for the evaluation of coronary in-stent restenosis without heart rate control, and it can be used as the large-diameter stent patency assessment method and small-diameter stent preliminary screening method.

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