64排螺旋CT冠脉造影与DSA冠脉造影评定冠心病PCI术后支架内再狭窄的对照研究  

Controlled Study of 64-slice CTCA and DSA in the Diagnosis of In-stent Restenosis after PCI

作　　者：张劭彦 ZHANG Shaoyan(The First People’s Hospital of Huizhou City,Huizhou 516001,China)

机构地区：[1]广东省惠州市第一人民医院

出　　处：《中国医学创新》2019年第15期106-109,共4页Medical Innovation of China

基　　金：惠州市科技计划项目(2018Y071)

摘　　要：目的:研究64排螺旋CT冠脉造影(computed tomography coronary angiography,CTCA)及DSA冠脉造影(digital subtraction angiography,DSA)用于评定冠心病经皮冠状动脉介入治疗(PCI)后支架内再狭窄的临床意义与价值。方法:选取本院心血管内科50例行PCI术的患者作为研究对象。术后对所有患者进行64排CTCA检查和DSA冠脉造影检查,观察患者应用不同影像学方式检查后支架腔内通畅性、狭窄程度等指标。结果:50例患者104枚支架中,CTCA评价冠脉支架内再狭窄20枚,未狭窄84枚。以DSA为标准,出现再狭窄22枚,未狭窄82枚。以DSA为金标准,64排螺旋CT呈现诊断支架内再狭窄灵敏度为86.3%(19/22),特异度为98.7%(81/82),阳性预测值95.0%(19/20),阴性预测值96.4%(81/84)。结论:64排螺旋CT冠脉造影可获得与DSA冠脉造影相近的检查结果,有助于更好地对支架内再狭窄发生情况进行预测并发挥辅助作用,临床应用时可结合两种方法有助于为临床判断冠脉支架腔内通畅性及狭窄程度提供更加有效的科学依据,并可作为冠心病筛查及支架植入术后随访的手段。Objective:To discuss the clinical significance and value of 64-slice computed tomography coronary angiography(CTCA)and digital subtraction angiography(DSA)in the diagnosis of in-stent restenosis(ISR)after the percutaneous coronary intervention(PCI).Method:50 patients underwent PCI in our vasculocardiology department were selected.Postoperative 64-slice CTCA and DSA were performed for all the patients.The in-stent patency and stenosis degree based on different imaging methods were observed.Result:A total of 104 stents were installed.CTCA examination results showed 20 ISR cases and 84 non-stenosis cases.DSA examination results showed 22 ISR cases and 82 non-stenosis cases.Based on the golden standard of DSA,the diagnosis sensitivity,specificity,positive predictive value and negative predictive value were86.3%(19/22),98.7%(81/82),95.0%(19/20)and 96.4%(81/84).Conclusion:64-slice CTCA can obtain similar results to DSA,which can play an auxiliary role in the occurrence of ISR.In clinical practice,the combination of two methods can provide more effective scientific basis for clinical judgment of the in-stent patency and stenosis degree.Thus it can be used as a screening method for coronary heart disease after stent implantation.

关 键 词：64排螺旋CT冠脉造影 DSA冠脉造影 经皮冠状动脉介入治疗 支架内再狭窄 

分 类 号：R541.4[医药卫生—心血管疾病]