摘要
【目的】评价多层CT(MSCT)诊断冠状动脉支架段血管狭窄的价值。【方法】对62例成功经皮冠状动脉介入治疗术后患者,于随访期同时行MSCT冠状动脉成像和冠状动脉造影(CAG)检查。对其中的33例患者进行了MSCT和CAG的对照研究。【结果】80枚支架的MSCT重建图像中,57枚支架CT图像可评价(占71.25%)。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%)。CAG显示33例患者的42个支架段血管,重度狭窄5例,中度狭窄3例。MSCT显示重度狭窄为11例,中度狭窄为14例。MSCT诊断重度支架内狭窄及中重度支架内狭窄的敏感度100%、100%;特异度84%、50%;准确度86%、60%;阳性预测值45%、32%;阴性预测值100%、100%。42个支架段冠状动脉直径的测量结果,MSCT和CAG比较差异有显著性(1.33±0.74 mm vs 2.28±1.05 mm,P<0.05)。【结论】①MSCT冠状动脉成像有助于排除支架内狭窄。②如果图像质量满意,MSCT诊断支架内重度狭窄有较高的准确度。③影响MSCT诊断支架段冠状动脉狭窄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 multislice computed tomography（MSCT） in detection of coronary stenosis with stents.【Methods】Sixty two consecutive patients with percutaneous coronary intervention were studied with MSCT and coronary artery angiography.The results were compared with quantitative coronary angiography in 33 patients.【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%）.Among the 33 patients with 42 intracoronary stents,CAG and MSCT showed severe lesions in 5 stents and 11 stents,moderate lesions in 3 stents and 14 stents,respectively.In assessable coronary segments with stents,these values corresponded to a sensitivity of 100% and 100%,specificity of 84% and 50%,positive predictive value of 45% and 32%,negative predictive value of 100% and 100% for the detection of high degree stenoses（≥70%） and moderate stenoses with stents by MSCT.The mean coronary artery diameter in MSCT was（1.33±0.74）mm,（2.28±1.05）mm in CAG,There was significant difference in diameters measurement between MSCT and CAG（P〈0.05）.【Conclusion】①The values correspond to negative predictive value of 100% for the detection of restenosis with stents by MSCT.②MSCT permits the detection of coronary artery severe stenoses with stents in high accuracy if image quality is sufficient.③The factors that influence the quality of coronary artery with stents are mainly motive artification and severe calcification.
出处
《医学临床研究》
CAS
2007年第6期895-897,901,共4页
Journal of Clinical Research
