多层螺旋CT冠状动脉成像对冠脉支架血管再狭窄的诊断价值

The diagnostic value of coronary stents vascular restenosis with Multislice CT coronary artery imaging

目的探讨多层螺旋CT冠状动脉成像对冠状动脉支架再狭窄的应用价值,及其与选择性冠脉造影(selective coronary angiography,SCA)诊断冠状动脉支架血管再狭窄的一致性。方法回顾性分析同时行冠状动脉CTA和DSA检查的冠脉支架置入术后患者25例,并分析其影像学资料,评价CT冠状动脉成像对冠状动脉支架再狭窄诊断的准确率、敏感性,及于SCA检查的一致性。结果 25例患者清晰显示45枚支架,多层螺旋冠状动脉CTA诊断冠状动脉支架血管再狭窄的准确率、敏感度、特异度、阳性预测值、阴性预测值、假阳性率及假阴性率分别为95.30%、89.12%、96.21%、85.13%、97.03%、2.11%、10.06%,与SCA检查诊断冠状动脉支架血管再狭窄比较无统计差异(P>0.05),具有良好的一致性,Kappa值为0.817。结论多层螺旋CT血管造影成像诊断冠状动脉支架术后血管再狭窄准确率较高,并具有较好的可行性,可作为冠脉支架血管再狭窄筛选的首选方法。

Objective Explore the application value of multi-slice spiral CT coronary artery imaging of coronary artery stent restenosis and the consistency with selective coronary angiography in diagnosis of coronary artery stent restenosis.Methods Review and analyse the imaging data about 25 patients after coronary stenting in coronary artery CTA and DSA at the same time,and to evaluate the value of CT coronary artery imaging of coronary artery stent restenosis diagnostic accuracy,sensitivity,and with SCA check consistency.Results There were 45 stents clear displayed about 25 cases of patients,multi-slice spiral CT coronary angiography in diagnosing coronary artery stent restenosis of the accuracy,sensitivity,specificity,positive predictive value,negative predictive value,false positive rate and false negative rate were 95.30%and 89.12%and 96.21%,away,97.03%,2.11%and 10.06%,and SCA examination in diagnosis of coronary artery stent restenosis had no statistical difference（P〉0.05）,has a good consistency,kappa=0.817.Conclusion Multi slice spiral CT angiography in the diagnosis of coronary artery stent restenosis has high accuracy and good feasibility,and can be used as the preferred method for the selection of coronary stent restenosis.