MSCT在冠心病诊断及冠心病PCI术后支架内再狭窄的预测价值

Value of MSCT in Diagnosing Coronary Heart Disease and Predicting in-stent Restenosis after PCI

目的探究多层螺旋CT(MSCT)在冠心病诊断及冠心病经皮冠状动脉介入治疗(PCI)术后支架内再狭窄的预测价值。方法选择2015年7月至2017年1月于我院收治的94例冠心病患者作为研究对象,所有患者行MSCT冠状动脉检查,并于2周内行冠状动脉造影(CAG)检查;接受PCI治疗的38例患者在支架置入术后6个月时行MSCT冠状动脉检查及CAG检查。以CAG诊断结果为金标准,计算MSCT诊断冠心病及PCI术后支架再狭窄的灵敏度、特异度、阳性预测值、阴性预测值及准确率。结果 MSCT评估冠脉狭窄的灵敏度、特异度、阳性预测值、阴性预测值及准确率分别为86.30%、97.23%、90.00%、96.09%、94.78%,MSCT评估PCI术后支架再狭窄的灵敏度、特异度、阳性预测值、阴性预测值及准确率为80.00%、94.73%、88.89%、90.00%、89.65%;MSCT与CAG在冠脉狭窄及PCI术后支架再狭窄的诊断上具有较好的一致性。结论 MSCT能较好的显示出冠状动脉狭窄情况,也可对冠脉PCI术后支架再狭窄情况进行诊断,在临床上可用于冠心病的筛查及冠脉PCI术后常规检查。

Objective To explore the value of multi-slice spiral CT（MSCT） in diagnosing coronary heart disease（CHD） and predicting in-stent restenosis after percutaneous coronary intervention（PCI）. Methods 94 patients with CHD admitted to the hospital from July 2015 to January 2017 were selected as the study subjects. All patients underwent MSCT coronary artery examination and underwent coronary angiography（CAG） within 2 weeks. 38 cases treated with PCI were examined with MSCT and CAG at 6 months after stent implantation. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate of MSCT in diagnosing CHD and in-stent restenosis after PCI were calculated with the diagnostic results of CAG as the golden standard. Results The sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate of MSCT in evaluating coronary artery stenosis were 86.30%, 97.23%, 90.00%, 96.09% and 94.78% respectively, while those in evaluating in-stent restenosis after PCI were 80.00%, 94.73%, 88.89%, 90.00% and 89.65% respectively. The consistency of MSCT and CAG was good in the diagnosis of coronary artery stenosis and in-stent restenosis after PCI. Conclusion MSCT can well display coronary artery stenosis, and it can also be used for the diagnosis of in-stent restenosis after PCI. It can be used for screening CHD and routine examination after PCI.