摘要
目的探究冠状动脉CT血管成像(CCTA)下腔内密度校正差(DCCO)在诊断冠心病(CAD)患者介入治疗后支架内再狭窄(ISR)中的应用价值。方法回顾性分析2021年6月至2024年12月于北京中医医院顺义医院接受介入治疗的325例CAD患者病历资料。以冠状动脉造影(ICA)作为评估标准,判断各支血管是否存在ISR,评估CCTA经验性诊断结果与ICA对ISR诊断的一致性,对比两类患者DCCO;采用受试者工作特征(ROC)曲线分析CCTA经验性诊断结果、DCCO以及2项联合对ISR的诊断价值。结果一致性检验显示,CCTA诊断结果与ICA对ISR诊断的一致性分析Kappa值为0.675,ICA检查阴性患者DCCO显著低于阳性患者(0.37±0.06与0.44±0.09,t=-6.441,P<0.001),CCTA、DCCO下单独评估ISR的曲线下面积(AUC)分别为0.817、0.756,联合检测的AUC为0.897。结论CCTA下DCCO在诊断CAD患者介入治疗后ISR中具有较高的临床应用价值,联合CCTA经验性诊断与DCCO可以显著提高ISR的诊断准确度,为临床决策提供有力支持。
Objective To explore the application value of difinition of corrected coronary opacification(DCCO)under coronary artery computed tomography angiography(CCTA)in the diagnosis of in-stent restenosis(ISR)after interventional therapy in patients with coronary artery disease(CAD).Methods The medical records of 325 patients with CAD who received interventional therapy in the Shunyi Hospital,Beijing Traditional Chinese Medicine Hospital from June 2021 to December 2024 were retrospectively analyzed.Intracoronary angiography(ICA)was used as the evaluation standard to determine whether there was ISR in each vessel,and the consistency between the empirical diagnosis result of CCTA and the diagnosis of ISR by ICA was evaluated.DCCO was compared between the two kinds of patients.The diagnostic value of CCTA empirical diagnostic result,DCCO and the combinations of the two on ISR was explored by ROC curve.Results Consistency test revealed that the Kappa value of consistency analysis between CCTA diagnostic result and ICA for ISR diagnosis was 0.675.The DCCO in ICA negative patients was significantly lower than that in positive patients(0.37±0.06 vs.0.44±0.09,t=-6.441,P<0.001).The areas under the curves(AUC)of CCTA and DCCO in evaluating ISR were 0.817 and 0.756 respectively.The AUC of combined detection was 0.897.Conclusion CCTA under DCCO coronary angiography has high clinical application value in the diagnosis of ISR in CAD patients after interventional therapy.The combination of CCTA empirical diagnosis and DCCO can significantly enhance the diagnostic accuracy of ISR and provide strong support for clinical decision-making.
作者
邹婷婷
Zou Tingting(Department of Radiology,Shunyi Hospital,Beijing Traditional Chinese Medicine Hospital,Beijing 101300,China)
出处
《实用医技杂志》
2025年第8期584-587,I0001,共5页
Journal of Practical Medical Techniques
