SSF技术对冠脉CT血管成像的优化及PCI术后再狭窄患者的评估价值探讨

Further Improving Image Quality of Coronary CT Angiography and Evaluation Value of Restenosis Patients after PCI with Snap Shot Freeze Technique

目的 探讨冠状动脉追踪冻结技术(SSF)在提高PCI术后CCTA图像质量中的作用并研究其在评估支架内再狭窄中的效能。方法 纳入2020年5月至2022年10月在我院行冠状动脉支架植入术后复查的127名(179支支架)患者。按照心率的高低分为高心率组(心率>70次/分)和低心率组(心率≤70次/分),均行常规技术重建及SSF技术重建,其中71名患者(共106支支架)在术后1年内行冠脉造影。对比两种技术重建的冠状动脉支架CTA图像质量在主观评分上的差异。将冠脉造影检查作为“金标准”,比较常规技术重建和SSF技术重建在评估冠脉狭窄方面的一致性及诊断效能。结果 高心率组常规技术重建冠状动脉支架CTA图像质量平均评分为(3.23±0.427),SSF技术为(3.81±0.467)。低心率组常规技术重建图像质量平均评分为(3.98±0.458),SSF技术为(4.38±0.490)。以冠脉造影结果为标淮,常规技术组灵敏度为80.56%,特异度为97.14%,阳性预测值为93.54%,阴性预测值为90.67%,准确率为91..51%;SSF技术组灵敏度为88.24%,特异度为98.61%,阳性预测值为96.77%,阴性预测值为94.67%准确率为95.28%。结论 SSF技术可以降低冠状动脉支架术后患者运动伪影及支架伪影,并且较好的应用于支架术后患者的随访评估。

Objective To explore the role of coronary artery snap shot freeze technique(SSF) in improving the image quality of CCTA after PCI and its efficacy in evaluating in-stent restenosis.Methods A total of127 patients,who had 179 stents implanted as part of a coronary stent placement procedure at our hospital between May 2020 and October 2022,were incorporated into the subsequent follow-up assessment.According to the heart rate,it is divided into high heart rate group(heart rate>70 beats/min) and low heart rate group(hea rt rate ≤70 beats/min)conventional and SSF techniques were both performed.Among them,71 patients(106 stents in total) underwent coronary angiography within3 months after operation.To compare the subjective scores of CTA image quality of coronary artery stent reconstructed by the two reconstruction techniques.Using coronary angiography as the "gold standard" to compa re the consistency and diagnostic efficacy of conventional and SSF reconstruction techniques in evaluating co ronary stenosis.Results The average image quality sco re of coronary stents reconstructed by conventional technique in high heart rate group was(3.38±0.75),SSF technique was(3.810.467).The average image quality score of coronary stents reconstructed by conventional technique in low hea rt rate group was(3.980.458),SSF technique was(4.380.490).Based on the results of coronary angiography,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of conventional technique group were 80.56%,97.14%,93.54%,90.67% and 91.51%respectively.The sensitivity of SSF technology group was 88.24%,the specificity was 98.61%,the positive predictive value was 96.77%,the negative predictive value was 94.67%,and the accuracy was 95.28%.Conclusion SSF can reduce the motion artifacts and stent artifacts of patients after coronary artery stenting,and it is better applied to the follow-up evaluation of patients after stenting.