256层螺旋CT评价冠状动脉支架再狭窄的应用价值

Research on the application value of 256 slices spiral CT in the evaluation of coronary artery stent restenosis

目的:探讨256层螺旋CT在评估冠状动脉支架再狭窄的临床应用价值。方法:采用飞利浦256层螺旋CT机对84例患者行经皮冠状动脉介入治疗(PCI)支架植入术(98枚),且于近期进行冠状动脉造影(CAG)检查的患者进行冠状动脉CT血管造影(CTA)检查,对CTA图像质量进行评分,以CAG为参考标准,计算CTA的诊断灵敏度、特异度、阳性预测值、阴性预测值和诊断准确率。结果:84例受检者的CTA图像质量评分均达到了临床诊断要求;对98枚支架进行分析,诊断支架腔内通畅:CAG为79枚、CTA为80枚;诊断支架腔内再狭窄:CAG为19枚、CTA为18枚;CTA诊断支架腔内再狭窄的灵敏度为94.7%,特异度为100%,阳性预测值为100%,阴性预测值为98.8%,诊断准确率为98.9%。结论:256层螺旋CT冠状动脉造影是一种可靠的评价PCI术后支架再狭窄的检查方法,可清晰显示支架腔内情况,对PCI支架植入术后随访有非常重要的临床应用价值,已成为目前评估冠状动脉支架再狭窄的首选方式。

Objective： To investigate the 256 slices spiral CT in the evaluation of stent restenosis after coronary stent implantation in the clinical application value. Methods： Use philips 256 slices spiral CT examine 84 cases of PCI after stent implantation who also take coronary angiography（CAG） recently, take CTA image quality evaluation, use CAG diagnosis as reference standard, calculation of CTA diagnostic sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy. Results： Eight-four cases of client CTA images score all meet the requirements of the clinical diagnosis; 98 stents were analyzed, diagnosis of stent patency of the cavity： CAG is 79, for CTA is 80, diagnosis of stent restenosis cavity： CAG is 19, for CTA is 18; CTA in the diagnosis of the sensitivity of the stent lumen stenosis was 94.7%, specificity of 100%, positive predictive value was 100%, negative predictive value of 98.8%. Conclusion： Two hundred and fifty six slices spiral CT coronary angiography is a reliable evaluation of stent restenosis after PCI, can be clear display stent lumen, for follow-up after PCI stent implantation has very important clinical value, and has now become the preferred way of coronary artery stent restenosis after stent implantation in evaluating.