CAJ | 학술논문

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.
배경:전통적 CT 재관심병개입치료후수방중난이보급,심조무창、유효적검사방법대지가내재협착적평개취성료영상과의생비상관심적과제.목적:통과재불공제심솔하쌍원CT관상동맥성상여선택성관상동맥조영대지가평고적대비,탐토쌍원CT관상동맥성상대관상동맥지가내재협착적진단개치.방법:수집53례환자공75매지가재불공제심솔정황하동기행쌍원CT관상동맥성상급관상동맥조영검사적환자영상자료,분석쌍원CT관상동맥성상진단지가내재협착적민감성등각항지표.결과여결론:①쌍원CT관상동맥성상능청초현시전부지가,96%(72/75)지가도상체도량호이상.②쌍원CT관상동맥성상대지가내재협착진단적민감성、특이성、양성예측치、음성예측치급준학성,여관상동맥조영결과비교차이무현저성의의(P>0.05).③쌍원CT관상동맥성상분별대심솔<70차/min화≥70차/min적환자지가재협착검측적민감성、특이성、양성예측치、음성예측치、준학성비교차이무현저성의의(P>0.05).④쌍원CT관상동맥성상대직경<3.0 mm지가재협착검측적민감성、특이성、양성예측치、음성예측치、준학성저우≥3.0 mm적지가재협착(P<0.05).결과설명,쌍원CT관상동맥성상대진단관상동맥지가내재협착구유교고적응용개치,차불수심솔적영향,가작위대직경지가통창정황적평고방식급소직경지가적초보사사방법.
BACKGROUND:The traditional CT is hard to be popularized in fol ow-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: ①Al 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 smal-diameter stent preliminary screening method.