64层螺旋CT冠状动脉支架成像效果的影响因素

Influential Factors of Coronary Stent Image Quality of 64-Slice Spiral Computed Tomograghy

目的探讨64层螺旋CT冠状动脉支架成像效果的影响因素。方法选取冠状动脉药物涂层金属支架植入术后行64层螺旋CT检查的病例116例,对支架部位图像质量采取半定量评价,分析支架直径、支架长度、支架材质、支架个数和钙化情况对支架部位CT图像质量的影响。结果 64层螺旋CT检出有意义支架内再狭窄的敏感度、特异度、阳性预测值、阴性预测值分别为85.7%、90.2%、60.0%、97.4%。直径2.75 mm以上支架的CT图像质量优于直径2.75 mm及以下的支架(P<0.001),非钙化病变的支架术后CT图像质量优于钙化病变(P<0.05)。支架长度、支架材质和是否多支架对支架部位CT图像质量无影响。结论 64层螺旋CT能胜任冠状动脉支架术后复查。直径2.75 mm以上支架和非钙化病变的支架病例更适合用64层螺旋CT进行复查。

Aim To analyze factors that affected the coronary stent image quality of 64-slice spiral computed tomograghy. Methods 116 patients who received 64-slice spiral computed tomograghy after coronary drug-eluting metal stent implantation from 2007 to 2010 were selected.Those stents image were assessed by semi-quantitive method.Whether stent diameter,stent length,stent material,stent number and calcification status affected the stent image quality were analyzed. Results The sensitivity,specificity,positive predictive value,negative predictive value of 64-slice spiral computed tomograghy to detect significant in-stent restenosis were 85.7%,90.2%,60.0%,97.4%,respectively.Image quality of stents with diameters of 2.75 mm was better than stents with diameter of or =2.75 mm（P0.001）.Image quality of stents which located on noncalcified plaque were better than stents which located on calcified plaque（P0.05）.Stent length,stent material,stent number did not affect the stent image quality of computed tomograghy. Conclusion 64-slice spiral computed tomograghy had ability to assess the cornary stent after implantation.64-slice spiral computed tomograghy was more suitable for assessing stents with diameters of 2.75 mm and stents which located on noncalcified plaque.