320排CT评价冠状动脉支架通畅性及再狭窄的初步探讨

Initial evaluation of coronary stent patency and restenosis with 320-slice CT coronary angiography

目的初步探讨320排CT冠状动脉成像评价支架通畅性及再狭窄的临床价值及优势。方法对32例冠状动脉支架植入术后患者的48枚支架行320排CT冠状动脉成像及常规冠状动脉造影;应用3分法评价320排CT冠状动脉支架的图像质量;以常规冠状动脉造影为参照,评价320排CT诊断支架通畅性及再狭窄的准确性。结果所有48枚支架及支架内管腔均可以显示并满足诊断要求。以常规X线冠状动脉造影为标准,320排CT冠状动脉成像诊断支架内再狭窄的敏感度、特异度、阳性预测值、阴性预测值及准确度分别为92.31%(12/13)、97.14%(34/35)、92.31%(12/13)、97.14%(34/35)及95.83%(46/48)。结论 320排CT冠状动脉成像在支架再狭窄评价方面有较高的准确度及应用价值,可以作为冠状动脉支架植入术后常规随访的首选影像学方法。

Objective To explore the clinical value of 320-slice computed tomography(CT)for the assessment of coronary stent patency and restenosis,by using conventional coronary angiography as the reference standard.Methods 320-slice CT coronary angiography and conventional coronary angiography were perfomed in 32 patients with 48 coronary stents.Image quality of the stents were evaluated on a 3-point scale.In-stent restenosis was defined as more than 50% narrowing of the lumen.Sensitivity,specificity,positive and negative predictive values were calculated.Results All stents were considered assessavle for diagnosis with 320-slice CT.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 92.31%(12/13),97.14%(34/35),92.31%(12/13),97.14%(34/35),and 95.83%(46/48)respectively.Conclusions 320-slice CT has a high accuracy for the detection of in-stent restenosis and may be a valuable modality for the follow-up of coronary artery stent patency.