双源CT Flash模式冠状动脉CT血管成像在PCI术后随访中的应用价值  

Value of CCTA by dual source CT Flash mode for follow-up after percutaneous coronary intervention

作　　者：石向明[1] 王辉[2] 何淼[3] 许雅芳[1] 贺亚男 王成健[1] SHI Xiang-ming;WANG Hui;HE Miao;XU Ya-fang;HE Ya-nan;WANG Cheng-jian(Department of Radiology,CNPC Central Hospital,Langfang 065000,Hebei Province,China;Department of Cardiology,CNPC Central Hospital,Langfang 065000,Hebei Province,China;Emergency Department,CNPC Central Hospital,Langfang 065000,Hebei Province,China)

机构地区：[1]中国石油天然气集团公司中心医院影像科,河北廊坊065000 [2]中国石油天然气集团公司中心医院心内科,河北廊坊065000 [3]中国石油天然气集团公司中心医院急诊科,河北廊坊065000

出　　处：《医疗卫生装备》2018年第10期50-53,共4页Chinese Medical Equipment Journal

基　　金：廊坊市科学技术研究与发展计划课题(2014013020)

摘　　要：目的:探讨双源CT Flash模式冠状动脉CT血管成像(coronary CT angiography,CCTA)在经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后随访中的应用价值,以对患者PCI术后情况作出准确判断。方法:选取PCI术后患者106例,可评价支架147枚。随机分为A、B 2组,A组行Flash模式扫描,B组行常规回顾性心电门控扫描。以冠状动脉造影(coronary angiography,CAG)为金标准评价Flash模式CCTA对支架内再狭窄(in-stent restenosis,ISR)的敏感性、特异性、阳性预测值和阴性预测值。对比A、B 2组检查方案在图像质量、辐射剂量、造影剂用量方面的差异。应用SPSS 19.0进行统计分析。结果:双源CT Flash模式CCTA ISR诊断的敏感性、特异性、阳性预测值、阴性预测值分别为85.7%、95.1%、80.0%和96.7%。A组与B组在图像质量方面差异无统计学意义(P>0.05),A组在造影剂用量、辐射剂量方面均显著低于B组,差异有统计学意义(P<0.05)。结论:双源CT Flash模式CCTA在PCI术后随访中的ISR诊断准确率高,与常规回顾性心电门控扫描相比患者所受辐射剂量小、造影剂用量少,可以作为排除PCI术后ISR的可靠检查方法。Objective To discuss the value of CCTA by dual source CT Flash mode for the follow-up after percutaneous coronary intervention （PCI）. Methods Totally 106 PCI patients （147 evaluable stents） with coronary heart disease were divided into A and B groups randomly. Flash mode scan was executed in A group, and retrospective ECG gated scan was carried out in B group. The results by coronary angiography （CAG） were used as the golden standard to evaluate the sensitivity, specificity, positive predictive value and negative predictive value of CCTA when used to detect in-stent restenosis （ISR）. A and B groups were compared in image quality, radiation dose and contrast dose, and statistical analysis was implentented with SPSS 19.0 software. Results CCTA by dual source CT Flash mode had its sensitivity, specificity, positive predictive value and negative predictive value being 85.7%, 95.1%, 80.0% and 96.7% respectively. A group had no significant difterences with B group in image quality （P〉0.05）, while statistically lower contrast dose and radiation dose than those in B group （P〈0.05）. Conclusion CCTA by dual source CT Flash mode gains high ISR diagnosis accuracy while low radiation dose and contrast dose when compared with retrospective ECG gated scan, and thus can be a tool for eliminating ISR after PCI.

关 键 词：双源CT CCTA Flash模式 冠心病 PCI ISR CAG 

分 类 号：R318[医药卫生—生物医学工程] R814.42[医药卫生—基础医学]