摘要
目的：探讨炫速双源CT在诊断冠状动脉支架内再狭窄（ISR）中的应用。方法对101例患者植入的167枚冠脉支架行炫速双源CT血管显像复查，测量支架段各部位的CT值评价支架内再狭窄，并与随后60d内所做的选择性冠状动脉造影结果对比，计算炫速双源CT诊断ISR的准确程度及诊断ISR的CT临界值。结果炫速双源CT显示151枚（90.5%）支架的影像质量适于诊断，支架直径是主要影响因素。炫速双源CT评价冠状动脉ISR的敏感度、特异度、阳性预测值、阴性预测值和符合率分别为83.8%、82.8%、77.0%、88.2%和83.2%。诊断ISR的主动脉根部与支架近端5-10mm、支架近端、支架内、支架远端、支架远端5-10mm的CT值差值的临界值分别为：7.5、16.0、42.5、47.5和56.0Hu。结论炫速双源CT能清晰地对冠状动脉支架内血管进行显像，对于ISR的诊断具有较高的准确性。
Objective To investigate the value of flash dual- source computed tomography （CT） angiography in the evaluation of coronary artery instent restenosis （ISR）. Methods 101 patients with 167 coronary stents underwent dual- source CT angiography for re- examination. CT values of different segments of vessels with stents were measured for evaluation of ISR and compared with the results of elective coronary angiography performed during fol owing 60 days. The accuracy and cut- off value of dual- source CT in the diagnosis of ISR were calculated. Results The CT image quality of 151 stents （90.5%） was suitable for evaluation. The diameter of stent was a main factor influencing CT image quality. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of dual- source CT for the diagnosis of ISR were 83.8%, 82.8%, 77.0%, 88.2%and 83.2%, respectively. The cutoff points of a difference in CT value from aortic root to the vessel 5-10mm proximal to the stent, proximal end of the stent, in- stent lumen, distal end of the stent, and the vessel 5-10mm distal to the stent for diagnosing ISR were 7.5Hu, 16.0Hu, 42.5Hu, 47.5Hu and 56.0Hu, respectively. Conclusion The in- stent lumen of coronary artery can be imaged clearly by dual- source CT, which could provide higher diagnostic accuracy of ISR.
出处
《心电与循环》
2016年第2期84-89,共6页
Journal of Electrocardiology and Circulation
关键词
冠状动脉
支架内再狭窄
炫速双源CT
Coronary artery
In-stent restenosis
Flash dual-source computed tomography
