中国组织工程研究与临床康复
中國組織工程研究與臨床康複
중국조직공정연구여림상강복
JOURNAL OF CLINICAL REHABILITATIVE TISSUE ENGINEERING RESEARCH
2009年
52期
10297-10301
,共5页
付鑫%吴桂平%张彦红%孙兆清%邹德玲
付鑫%吳桂平%張彥紅%孫兆清%鄒德玲
부흠%오계평%장언홍%손조청%추덕령
冠状动脉狭窄%多层螺旋CT%支架材料%支架壁/直径%随访%支架置入
冠狀動脈狹窄%多層螺鏇CT%支架材料%支架壁/直徑%隨訪%支架置入
관상동맥협착%다층라선CT%지가재료%지가벽/직경%수방%지가치입
背景:由于金属材料对多层螺旋CT图像有伪影干扰作用,支架结构中金属管壁厚度和管腔内径也可明显影响多层螺旋CT靶血管支架内纵轴成像质量,但目前仅有少量报道涉及到这方面的问题.目的:观察不同材料的冠状动脉支架及其结构对多层螺旋CT评价靶血管通畅性图像质量的影响,希望实验数据能为改进和完善支架技术提供参考.设计、时间及地点:对比观察,于2006-01/2008-12在沈阳医学院沈洲医院及中国医科大学附属盛京医院完成.对象:纳入接受支架置入的冠状动脉粥样硬化性心脏病患者139例,共置入支架227枚,按置入支架材料和结构分组.不锈钢支架92枚,镍钛合金支架135枚:薄金属壁支架(<140 μm)85枚,厚金属壁支架(≥140 μm)142枚;小直径支架(<3 mm)71枚,大直径支架(≥3 mm)156枚.方法:随访期间采用64层螺旋CT机进行冠状动脉扫描,并做常规冠状动脉造影检查,比较不同组别靶血管通畅性图像质量的差异.主要观察指标:采取4分制进行多层螺旋CT图像质量评分,评价多层螺旋CT的敏感度、异度、准确度、阳性预期值与阴性预期值.结果:139例患者共置入支架227枚,按支架材料分组后,不锈钢支架组CT图像质量较差处明显多于镍钛合金组,前者的平均CT图像质量评分、敏感性、特异性、阳性和阴性预测值均明显低于镍钛合金组(P均<0,05).按支架厚度分组后,厚会属壁支架组CT图像质量较差处明显多于薄金属壁支架组,前者的平均CT图像质量评分、敏感性、特异性、阳性和阴性预测值均明显低于薄金属壁支架组(P均<0.05).按支架直径分组后,小直径支架组CT图像质量较差处明显多于大直径支架组,前者的平均CT图像质量评分敏感性、特异性、阳性和阴性预测值均明显低于大直径支架组(P均<0.05).结论:冠状动脉支架金属材料、金属壁厚度和管腔直径均可能影响多层螺旋CT靶血管成像质量.
揹景:由于金屬材料對多層螺鏇CT圖像有偽影榦擾作用,支架結構中金屬管壁厚度和管腔內徑也可明顯影響多層螺鏇CT靶血管支架內縱軸成像質量,但目前僅有少量報道涉及到這方麵的問題.目的:觀察不同材料的冠狀動脈支架及其結構對多層螺鏇CT評價靶血管通暢性圖像質量的影響,希望實驗數據能為改進和完善支架技術提供參攷.設計、時間及地點:對比觀察,于2006-01/2008-12在瀋暘醫學院瀋洲醫院及中國醫科大學附屬盛京醫院完成.對象:納入接受支架置入的冠狀動脈粥樣硬化性心髒病患者139例,共置入支架227枚,按置入支架材料和結構分組.不鏽鋼支架92枚,鎳鈦閤金支架135枚:薄金屬壁支架(<140 μm)85枚,厚金屬壁支架(≥140 μm)142枚;小直徑支架(<3 mm)71枚,大直徑支架(≥3 mm)156枚.方法:隨訪期間採用64層螺鏇CT機進行冠狀動脈掃描,併做常規冠狀動脈造影檢查,比較不同組彆靶血管通暢性圖像質量的差異.主要觀察指標:採取4分製進行多層螺鏇CT圖像質量評分,評價多層螺鏇CT的敏感度、異度、準確度、暘性預期值與陰性預期值.結果:139例患者共置入支架227枚,按支架材料分組後,不鏽鋼支架組CT圖像質量較差處明顯多于鎳鈦閤金組,前者的平均CT圖像質量評分、敏感性、特異性、暘性和陰性預測值均明顯低于鎳鈦閤金組(P均<0,05).按支架厚度分組後,厚會屬壁支架組CT圖像質量較差處明顯多于薄金屬壁支架組,前者的平均CT圖像質量評分、敏感性、特異性、暘性和陰性預測值均明顯低于薄金屬壁支架組(P均<0.05).按支架直徑分組後,小直徑支架組CT圖像質量較差處明顯多于大直徑支架組,前者的平均CT圖像質量評分敏感性、特異性、暘性和陰性預測值均明顯低于大直徑支架組(P均<0.05).結論:冠狀動脈支架金屬材料、金屬壁厚度和管腔直徑均可能影響多層螺鏇CT靶血管成像質量.
배경:유우금속재료대다층라선CT도상유위영간우작용,지가결구중금속관벽후도화관강내경야가명현영향다층라선CT파혈관지가내종축성상질량,단목전부유소량보도섭급도저방면적문제.목적:관찰불동재료적관상동맥지가급기결구대다층라선CT평개파혈관통창성도상질량적영향,희망실험수거능위개진화완선지가기술제공삼고.설계、시간급지점:대비관찰,우2006-01/2008-12재침양의학원침주의원급중국의과대학부속성경의원완성.대상:납입접수지가치입적관상동맥죽양경화성심장병환자139례,공치입지가227매,안치입지가재료화결구분조.불수강지가92매,얼태합금지가135매:박금속벽지가(<140 μm)85매,후금속벽지가(≥140 μm)142매;소직경지가(<3 mm)71매,대직경지가(≥3 mm)156매.방법:수방기간채용64층라선CT궤진행관상동맥소묘,병주상규관상동맥조영검사,비교불동조별파혈관통창성도상질량적차이.주요관찰지표:채취4분제진행다층라선CT도상질량평분,평개다층라선CT적민감도、이도、준학도、양성예기치여음성예기치.결과:139례환자공치입지가227매,안지가재료분조후,불수강지가조CT도상질량교차처명현다우얼태합금조,전자적평균CT도상질량평분、민감성、특이성、양성화음성예측치균명현저우얼태합금조(P균<0,05).안지가후도분조후,후회속벽지가조CT도상질량교차처명현다우박금속벽지가조,전자적평균CT도상질량평분、민감성、특이성、양성화음성예측치균명현저우박금속벽지가조(P균<0.05).안지가직경분조후,소직경지가조CT도상질량교차처명현다우대직경지가조,전자적평균CT도상질량평분민감성、특이성、양성화음성예측치균명현저우대직경지가조(P균<0.05).결론:관상동맥지가금속재료、금속벽후도화관강직경균가능영향다층라선CT파혈관성상질량.
BACKGROUND:Mental material has shadow intervention effects on multi-slice helical CT (MDCT).Mental wall thickness and lumens inner diameter in stent structure can significantly affect longitudinal axis imaging quality of MDCT target vessel stent.However.there are few studies involved in this aspect.OBJECTIVE:To analyze the effect of various coronary stent materials and structures on patency images of target vessel by MDCT evaluation,and to provide clinical evidences for improving stent technique.DESIGN,TIME AND SETTING:The comparison observation was conducted at the Shenzhou Hospital,Shenyang Medical College.and Shengjing Hospital,China Medical University from January 2006 to December 2008.PARTICIPANTS:A total of 139 patients with coronary heart disease who were treated with stent implantation were divided into material and construct groups (227 stents were implanted).There were 92 stainless steel stents,135 nick-eltitanium alloy stents,85 thin mental wall stents (<140μm).142 thick mental wall stents (≥140μm).71 small diameter stents (<3 mm),and 156 big diameter stents (≥3mm).METHODS:During following up,patients were checked using 64-slice helical CT and routine coronary arteriongraphy to compare patency images of target vessels in the two groups.MAIN OUTCOME MEASURES:MDCT was scored by four-mark standard to evaluate sensitivity,specificity,accuracy,positive and negative predictive values of MDCT.RESULTS:A total of 227 stents were implanted into 139 patients.CT images of stainless steel stent group were poorer than nickel-titanium alloy group,and the indicators including image score,sensitivity,specificity,positive and negative predictive values of the stainless steel stent group were significantly less than nickel-titanium alloy group (P<0.05).CT images of thick-wall stent were poorer than thin-wall stent,while the indicators including image score,sensitivity,specificity,positive and negative predictive values of the thick-wall stent were significantly less than thin-wall stent (P<0.05).CT images of small-diameter stent were poorer than large-diameter stent,while the indicators including image score,sensitivity,specificity,positive and negative predictive values of the small-diameter stent were significantly less than large-diameter stent (P<0.05).CONCLUSION:Materials,wall thickness and diameter of coronary stent may influence images of target vessels via MDCT evaluation.
