CAJ | 학술논문

目的：探讨双低冠状动脉CT血管造影术(CCTA)在经皮冠状动脉介入治疗(PCI)术后随访中的临床应用价值。方法选取行PCI的128例(143枚可评估支架)冠心病患者为研究对象，均予以常规冠状动脉造影(CAG)检查；根据随机数字表法将受试患者分为A、B两组，各64例；A组患者接受双低CCTA检查(100kv电压+270mgI/mL碘对比剂)，B组接受常规CCTA检查(120kv电压+350mgI/mL碘对比剂)。详细记录检查结果，以CAG为“金标准”评估双低CCTA检查对支架再狭窄(ISR)的特异性、敏感性、准确性差异；记录双低CCTA检查及常规CCTA检查方案图像质量主观评分、辐射剂量(ED)、碘用量差异。结果①此次受试的A组患者72枚可评估支架中经CAG诊断为ISR共9枚(12.5%)，非ISR共63枚(87.5%)；其中双低CCTA正确诊断ISR8枚，正确诊断非ISR57枚，对ISR诊断的准确性、特异性、敏感性分别为90.3%(65/72)、90.5%(57/63)和88.9%(8/9)；②双低CCTA及常规CCTA检查在图像质量主观评分对比上均无统计学意义(P>0.05)；双低CCTA检查ED及碘用量均显著低于常规CCTA检查，差异具有统计学意义(P<0.05)。结论双低CCTA检查可作为PCI患者术后随访复诊的首选检查方案，对ISR诊断准确性较高，具有图像清晰、碘摄入量少、辐射剂量低等优势，值得临床推广。
목적：탐토쌍저관상동맥CT혈관조영술(CCTA)재경피관상동맥개입치료(PCI)술후수방중적림상응용개치。방법선취행PCI적128례(143매가평고지가)관심병환자위연구대상，균여이상규관상동맥조영(CAG)검사；근거수궤수자표법장수시환자분위A、B량조，각64례；A조환자접수쌍저CCTA검사(100kv전압+270mgI/mL전대비제)，B조접수상규CCTA검사(120kv전압+350mgI/mL전대비제)。상세기록검사결과，이CAG위“금표준”평고쌍저CCTA검사대지가재협착(ISR)적특이성、민감성、준학성차이；기록쌍저CCTA검사급상규CCTA검사방안도상질량주관평분、복사제량(ED)、전용량차이。결과①차차수시적A조환자72매가평고지가중경CAG진단위ISR공9매(12.5%)，비ISR공63매(87.5%)；기중쌍저CCTA정학진단ISR8매，정학진단비ISR57매，대ISR진단적준학성、특이성、민감성분별위90.3%(65/72)、90.5%(57/63)화88.9%(8/9)；②쌍저CCTA급상규CCTA검사재도상질량주관평분대비상균무통계학의의(P>0.05)；쌍저CCTA검사ED급전용량균현저저우상규CCTA검사，차이구유통계학의의(P<0.05)。결론쌍저CCTA검사가작위PCI환자술후수방복진적수선검사방안，대ISR진단준학성교고，구유도상청석、전섭입량소、복사제량저등우세，치득림상추엄。
Objective To investigate the clinical application value of double low coronary CT angiography (CCTA) in the follow-up after percutaneous coronary intervention (PCI).Methods 128 patients (143 measurable stents) with coronary heart disease who underwent PCI were selected as the research subjects. All the patients were given cinventional coronary arteriography (CAG) examination. According to the random number table method, the objects were divided into A, B of two groups with 64 cases in each group. Group A received double low CCTA examination (100kv voltage and 270mgI/mL iodinated contrast agent) while group B received routine CCTA examination (120kv voltage and 350mgI/mL iodinated contrast agent). The results were recorded in detail. CAG was taken as the golden standard to evaluate the specificity, sensitivity and accuracy differences of the double low CCTA in the examination of in-stent restenosis (ISR). The differences in subjective score of image quality, the radiation dose (ED) and the dosage of iodide between double low CCTA and routine CCTA were recorded. Results ①Among the 72 measurable stents in group A, there were 9 stents (12.5%) with ISR and 63 stents (87.5%) without diagnosed by CAG. 8 stents with ISR and 57 cases without were correctly diagnosed by double low CCTA. The accuracy, specificity and sensitivity in the diagnosis of ISR were 90.3% (65/72), 90.5% (57/63) and 88.9% (8/9), respectively. ②The comparison of subjective score of image quality between double low CCTA and routine CCTA was not statistically significant (P>0.05). ED and dosage of iodide in double low CCTA were significantly lower than routine CCTA and the differences were statistically significant (P<0.05).Conclusion Double low CCTA can be used as preferred examination scheme for follow-up and subsequent visit of patients after PCI. The accuracy in the diagnosis of ISR is higher, with clear image, low intake of iodine and low radiation dose, etc. which is worthy of clinical promotion.