CAJ | 학술논문

目的：研究双源 CT（DSCT）和冠状动脉造影（CAG）评估冠状动脉支架内再狭窄的一致性及前者取代后者的可行性。方法137例患者193枚支架均行 CAG 检查及 DSCT 检查判断是否存在支架内再狭窄（ISR），以 CAG 结果为金标准，比较 DSCT 评估支架狭窄的敏感性、特异性、阳性预测值、阴性预测值、准确性。结果137例患者193枚支架，CAG 评估为 ISR 共计61枚，DSCT 正确判断57枚，其敏感性89．4％、特异性88．5％、阳性预测值80．3％、阴性预测值96．7％、准确性90．7％；在 P ＜0．05水准上检验得 Kappa 值为0．5463，DSCT 评估与 CAG 评估 ISR 有较好的一致性；146枚直径≥3．0 mm 支架，CAG 判断46枚 ISR，DSCT 准确判断44枚，其敏感性95．6％、特异性90％、阳性预测值81．5％、阴性预测值97．8％、准确性91．8％；直径＜3．0 mm 的47枚支架，CAG 判断15枚 ISR，DSCT 正确判断13枚，其敏感性86．7％、特异性87．5％、阳性预测值76．5％、阴性预测值93．3％、准确性87．2％。结论DSCT评估 ISR 与 CAG 相比有很好的一致性，但受支架置入部位及大小影响判断，易出现误判及判断 ISR 程度较重，但在大寸径的支架通畅情况的评估基本可以取代 CAG。
목적：연구쌍원 CT（DSCT）화관상동맥조영（CAG）평고관상동맥지가내재협착적일치성급전자취대후자적가행성。방법137례환자193매지가균행 CAG 검사급 DSCT 검사판단시부존재지가내재협착（ISR），이 CAG 결과위금표준，비교 DSCT 평고지가협착적민감성、특이성、양성예측치、음성예측치、준학성。결과137례환자193매지가，CAG 평고위 ISR 공계61매，DSCT 정학판단57매，기민감성89．4％、특이성88．5％、양성예측치80．3％、음성예측치96．7％、준학성90．7％；재 P ＜0．05수준상검험득 Kappa 치위0．5463，DSCT 평고여 CAG 평고 ISR 유교호적일치성；146매직경≥3．0 mm 지가，CAG 판단46매 ISR，DSCT 준학판단44매，기민감성95．6％、특이성90％、양성예측치81．5％、음성예측치97．8％、준학성91．8％；직경＜3．0 mm 적47매지가，CAG 판단15매 ISR，DSCT 정학판단13매，기민감성86．7％、특이성87．5％、양성예측치76．5％、음성예측치93．3％、준학성87．2％。결론DSCT평고 ISR 여 CAG 상비유흔호적일치성，단수지가치입부위급대소영향판단，역출현오판급판단 ISR 정도교중，단재대촌경적지가통창정황적평고기본가이취대 CAG。
Objective To study of dual source CT (DSCT)and coronary angiography (CAG)of dual source CT cor-onary artery restenosis of stent (DSCT)and coronary angiography (CAG)in diagnosis of coronary artery in stent rest-enosis consistency and former feasibility.Methods 137 cases underwent CAG examination of in stent restenosis (ISR) patients received DSCT examination again in the informed consent,evaluating a total of 193 stents in two kinds of in-spection methods of the degree of stenosis.Comparison of DSCT evaluation of stent stenosis sensitivity,specificity,pos-itive predictive value,and negative predictive value,accuracy.Results CAG was evaluated in 137 patients with 193 stents,to determine the ISR a total of 61 medals,DSCT assessment correctly judge the 57 pieces,4 pieces of missed di-agnosis,misdiagnosis 14 pieces,DSCT sensitivity of 89.4%,specificity of 88.5%,positive predictive value of 80.3%, negative predictive value of 96.7%,accuracy of 90.7%;DSCT evaluation and CAG evaluation of ISR are in good agree-ment at the P <0.05 level test,Kappa value was 0.5463;146 pieces of diameter ≥ 3.0mm scaffolds,CAG display 46 stents restenosis,DSCT accurately showed 44 pieces,2 pieces of missed diagnosis,misdiagnosis 10 pieces,DSCT sensi-tivity of 95.6%,specificity of 90%,positive predictive value of 81.5%,negative predictive value of 97.8%,accuracy 91.8%;diameter < 47 3.0mm stents,CAG display 15 pieces of restenosis,DSCT display 13 restenosis,missed 2,mis-diagnosed in 4 pieces,DSCT sensitivity of 86.7%,specificity of 87.5%,positive predictive value of 76.5%,negative predictive value of 93.3%,accuracy of 87.2%.Conclusion Compared DSCT assessment of ISR and CAG have good consistency,sensitivity,satisfactory accuracy,especially in the big inch diameter to assess the patency of stent can re-place the CAG.