摘要
目的评价多层CT(MSCT)诊断邻近支架冠状动脉血管段狭窄的价值。方法对2003年8月至2006年12月首都医科大学附属北京朝阳医院心脏中心62例成功经皮冠状动脉介入治疗(PCI)术后(共植入80枚支架)的患者,于随访期同时行MSCT冠状动脉成像和冠状动脉造影(CAG)检查,把两种成像技术对临近支架的冠状动脉血管段狭窄程度的测量结果进行对比。结果80个邻近支架冠状动脉血管段有57段(71.25%)可供研究;不能评价的主要原因是移动伪影(13/23,57%)和严重钙化(8/23,35%)。直径的测量结果,MSCT和CAG比较差异有统计学意义[(2.52±0.7)mm比(2.79±0.73)mm,配对差均值(0.28±0.64)mm,P<0.05]。MSCT正确诊断5个狭窄节段,漏诊1例,其评价邻近支架冠状动脉狭窄的敏感性、特异性、准确度、阳性预测值、阴性预测值分别为83%、93%、93%、56%、98%。结论MSCT诊断邻近支架节段冠状动脉狭窄具有很高的准确度。影响MSCT诊断特性的主要因素是运动伪影和冠状动脉弥漫性钙化。
Objective To evaluate the accuracy of multslice computed tomography （MSCT） in detection of coronary stenosis in the proximal or distal to stents. Methods 62 consecutive patients who have experienced percutaneous coronary intervention （Implanted 80 stents） were studied with MSCT and coronary artery angiography（CAG）. The results （with The coronary stenoses in the proximal and/or distal to the stents） from the two angiographic techniques were compared. Results In the 80 coronary artery segments with stents,57 （71.25%） were judged to be evaluable by MSCT. Misinterpretations were mainly the results of motive artifacts（ 13/23,57% ） and severe calification（8/23,35% ）. The coronary artery diameters in the proximal and/or distal to stents were compared between MSCT and CAG. The mean coronary artery diameter in MSCT was （2. 52 ± 0. 71 ） mm, （2. 79 ± 0. 73 ） mm in CAG, the mean absolute difference between the MSCT and CAG measurement was （0. 28 ±0. 64） mm. There was signification difference in diameters measurement between MSCT and CAG（P 〈 0. 05 ）. CAG showed significanty lesions in 6 coronary artery segments（2 lesions ≥70% ） in the proximal and/or distal to the stents. 5 coronary stenosis were correctly diagnosed by MSCT, 1 severe lesion was lost. These values correspond to a sensitivity of 83% ,specificity of 93% ,positive predictive value of 56% ,and negative predictive value of 98% for the detection of stenoses in stents by MSCT. Conclusion （ 1 ） The detection of MSCT on the coronary stenoses is more accurate in the proximal or distal to the stents. （2）The factors that influence the quality of coronary artery with stents were mainly motive artification and severe calcification.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2008年第9期767-769,共3页
Chinese Journal of Practical Internal Medicine
