能谱CT对冠状动脉支架内再狭窄的诊断价值

目的研究宝石能谱CT冠状动脉成像(CTCA)对冠状动脉支架内再狭窄(ISR)的诊断价值。方法对经皮冠状动脉介入(PCI)术后行宝石能谱CT冠状动脉成像的79例患者进行分析,支架内管腔狭窄≥50%以上诊断为支架内再狭窄,以冠状动脉造影为标准,计算诊断ISR的敏感性、特异性、阳性预测值和阴性预测值。结果宝石能谱CT诊断冠状动脉支架腔内≥50%狭窄的敏感性和特异度分别为90.0%和98.1%,阳性预测值为81.8%,阴性预测值为99.0%。结论宝石能谱CT冠状动脉成像对ISR具有较高的诊断价值。

Objective To evaluate the diagnostic accuracy of coronary in-stem restenosis （ISR） with angiography using computed tomography coronary angiography（CTCA）. Methods Computed tomography coronary angiography was performed on 79 patients with previous coronary stent implantation. An in-stent luminal diameter that was narrowed by 50% or more （up to in-stent occlusion） was defined as significant restenosis. Sensitivity, specificity, positive and negative predictive values for the detection using conventional angiography in combination with quantitative coronary angiography as the gold standard, were calculated. Results Accordingly, sensitivity, specficity, and positive and negative predictive value to identify in-stent restenosis that was narrowed by 50% or more （up to in-stent occlusion） in interpretable stents were 90.8%, 98.1%, 81.8%, 99.0%. Conclusion In-stent restenosis can be evaluated with computed tomography coronary angiography with high diagnostic value.