64层螺旋CT冠脉动脉支架成像与冠脉造影诊断再狭窄的价值分析

Analysis on Value of 64-slice Spiral CT Coronary Angiography and Coronary Angiogram Diagnosis Restenosis

目的研究64层螺旋CT冠脉动脉成像与冠脉造影在冠脉支架术后再狭窄的诊断价值,为今后临床实践提供参考和借鉴,提高对冠脉支架植入后再狭窄的诊断水平。方法选择我院收治的68例行冠脉支架植入术的冠心病患者为研究对象,对其进行64层螺旋CT冠脉成像检查,并与传统的冠状动脉造影检查结果进行比较,分析64层螺旋CT冠脉动脉成像对冠脉支架植入术后的诊断价值。结果 CTA与CAG对照评价支架通畅性的敏感性为80.0%、特异性为86.8%,CTA诊断为阳性预测值、阴性预测值分别为82.8%、84.6%,采用Kappa分析评价两种方法的一致性,Kappa=0.562,说明两者的的一致性比较好。结论 64层螺旋CT冠脉成像对冠脉支架再狭窄的敏感性和准确性比较高,其影像具有一定的特征性,对狭窄的诊断能力比较强,具有无创检查的优势,可以作为冠状动脉支架植入术后患者随访检查的一种理想检查方式,值得在临床实践中广泛推广。

Objective This paper is to investigate clinical value of 64-slice spiral CT coronary angiography and coronary artery image in diagnosis after the restenosis of coronary stenting, to provide the reference for clinical practices in the future and to improve the diagnosis level after the restenosis of coronary stenting.Methods Sxity eight patients undergoing intracoronary stent implantation admitted by the Hospital were selected as research subjects, and they were subject to 64-slice spiral CT coronary angiography examination, which was compared to conventional coronary angiography results, and diagnostic value of 64-slice spiral CT coronary angiography in diagnosis of coronary heart disease （CHD） was analyzed.Results The sensitivity of CTA and CAG comparative evaluation on the patency of the stent hit 80.0%, and the specificity was 86.8%, positive and negative predictive value of CTA diagnosis were 82.8% and 84.6% respectively, Kappa analysis was applied to evaluate the consistency of the two methods, Kappa = 0.562 showed the consistency between them was better.Conclusions 64-slice spiral CT coronary angiography delivers important high sensibility and accuracy in the diagnosis of the restenosis of coronary stent, its images show certain characteristics, its diagnosis ability on the stenosis is powerful, posing non-invasive examination advantage, and it becomes an ideal examination method in the diagnosis of coronary heart disease, delivering high value of clinical services.