摘要
目的探讨光子双源CT血管成像在下肢动脉支架植入术后随访中的应用价值。方法回顾性分析2013年5月~2018年12月咸宁市中心医院行下肢动脉支架植入术及CT血管成像随访的90例患者资料,采用多种后处理技术进行血管及支架重建,由两名高级职称医师独立进行图像质量评价,比较光子双源CT与普通螺旋CT的图像质量、辐射剂量及检查时间,并结合DSA检查结果,评价光子双源CT诊断支架再狭窄的敏感性、特异性及准确性。结果两名医师对103枚支架重建图像独立评分为(4.59±0.57)分、(4.62±0.54)分,评分具有较好的一致性(ICC=0.886);与普通螺旋CT比较,光子双源CT的图像质量评分无明显差异(P>0.05),但辐射剂量及检查时间优势明显(均P<0.05);光子双源CT随访的58例患者(69枚支架)与DSA造影结果比较,二者结果具有较好的一致性(Kappa=0.83),且光子双源CT诊断支架再狭窄的敏感性为96.15%,特异性94.12%,阳性预测值98.04%,阴性预测值88.89%,准确性95.65%。结论光子双源CT血管成像技术安全、无创,能清晰地对下肢动脉血管及支架进行显像,对支架再狭窄的诊断有较高的敏感性、特异性及准确性,且能显著降低患者辐射剂量,缩短检查时间,具有较好的临床应用价值。
Objective To discuss the application of dual-source CT angiography with Stellar photon detector in the postoperative re-examination of lower limb artery stent implantation.Methods Retrospective analysis was performed on patients underwent stent implantation of lower limb artery and follow-up of CT angiography in xianning central hospital from May 2013 to December 2018. Multiple post-processing techniques were used for vascular and stent reconstruction. Two doctors with senior professional titles independently evaluated the image quality. Compared the image quality, radiation dose and inspection time of the ordinary spiral CT and the dual-source CT with Stellar photon detector. Combined with DSA, the sensitivity, specificity, and accuracy of the dual-source CT with Stellar photon detector in the diagnosis of stent restenosis were evaluated.Results The independent scores of 103 stent reconstruction images by the two doctors were(4.59±0.57、4.62±0.54), with good consistency(ICC=0.886). Compared with ordinary spiral CT, the image quality score of photon dual-source CT showed no significant statistical difference(P>0.05), but the radiation dose and inspection time had obvious advantages(4262.35 mGy/cm vs. 2341.81 mGy/cm, 31.85 s vs. 18.91 s). Compared with DSA, the results of the 58 patients(69 stents) showed good consistency(Kappa=0.83), and the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of photon dual-source CT in diagnosis of stent restenosis were 96.15%, 94.12%, 98.04%, 88.89%, and 95.65%. Conclusion The dual-source CT angiography with Stellar photon detector is safe, non-invasive, and can clearly show the image of lower limb arteries and stents. It has high sensitivity, specificity, and accuracy in the diagnosis of stent restenosis, and can reduce the radiation dose of patients and shorten the examination time, which has good clinical application value.
作者
李顺珍
田红岸
余开湖
袁劲松
贾弯弯
LI Shunzhen;TIAN Hongan;YU Kaihu;YUAN Jinsong;JIA Wanwan(Department of Radiology,Xianning Central Hospital,The First Affiliated Hospital of Hubei University of Science and Technology,Xianning 437100,Hubei,China)
出处
《西部医学》
2020年第4期593-597,601,共6页
Medical Journal of West China
基金
湖北省自然科学基金项目(2012FFB06201)
咸宁市中心医院科研项目(2016XYA004)。
关键词
双源CT
光子探测器
血管成像
下肢动脉
支架
Dual-source CT
Stellar photon detector
Angiography Lower extremity artery
Stent
