320排动态容积CT动脉造影评价冠状动脉支架内再狭窄的价值  

Diagnostic accuracy of 320-slice dynamic volume CT in assessment of coronary artery in-stent restenosis

作　　者：刘雪莲[1] 郝宝顺[2] 刘定辉[2] 陈秀珍[3] 周彬[2] 余舒杰[2] Liu Xuelian;Hao Baoshun;Liu Dinghui;Chen Xiuzhen;Zhou Bin;Yu Shujie(Interventional Operation Room,the Third Affiliated Hospital of Sun Yat-sen University,Guangdong Guangzhou 510630,China;Department of Cardiologythe Third Affiliated Hospital of Sun Yat-sen University,Guangdong Guangzhou 510630,China;Department of Radiology,the Third Affiliated Hospital of Sun Yat-sen University,Guangdong Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院介入手术室,广东广州510630 [2]中山大学附属第三医院心内科,广东广州510630 [3]中山大学附属第三医院放射科,广东广州510630

出　　处：《中华介入放射学电子杂志》2020年第2期166-169,共4页Chinese Journal of Interventional Radiology：electronic edition

摘　　要：目的评价320排动态容积CT(320-slice dynamic volume CT,320-DVCT)动脉造影诊断冠状动脉支架内部再狭窄的准确性。方法 208例怀疑发生支架内再狭窄的冠状动脉支架植入患者,进行320-DVCT动脉造影检查,之后2~7 d内行冠状动脉造影检查。结果 320-DVCT动脉造影可获得较好的图像质量,可用于诊断冠状动脉支架内再狭窄。对于直径≥3.0 mm的支架,其图像优级率和成功率明显高于直径<3.0 mm的支架。320-DVCT诊断冠状动脉支架内再狭窄的敏感性91.30%,特异性95.21%,阳性预测值86.3%,阴性预测值97.07%,准确率94.24%;诊断左前降支支架内再狭窄的敏感性89.29%,特异性96.77%,阳性预测值89.29%,阴性预测值96.77%,准确率95.04%;诊断左回旋支支架内再狭窄的敏感性88.89%,特异性92.73%,阳性预测值80.00%,阴性预测值96.23%,准确率91.78%;诊断右冠状动脉支架内再狭窄的敏感性88.00%,特异性94.92%,阳性预测值88.00%,阴性预测值94.92%,准确率92.86%。结论 320-DVCT动脉造影是目前较新的一种安全无创、有效诊断冠状动脉支架内再狭窄的检查方法。Objective To evaluate the diagnostic accuracy of coronary artery in-stent restenosis with 320 dynamic volume computed tomography in comparison of selective coronary angiography.Methods Two hundred and eight patients with suspected coronary artery in-stent restenosis underwent 320-DVCT coronary angiography,and selective coronary angiography was performed within 2 to 7 days subsequently.Results The images acquired from 320-DVCT were excellent and sufficient enough to be used to evaluate coronary in-stent restenosis.For the stents with diameter of more than 3.0 mm,the image of optimization rate and success rate are significantly higher than those with a diameter of<3.0 mm.The sensitivity,specificity,positive and negative predictive value,rate of accuracy of 320-DVCT for detecting in-stent restenosis were 91.30%,95.21%,86.3%,97.07%and 94.24%,respectively.The sensitivity,specificity,positive and negative predictive value,rate of accuracy of in-stent restenosis in the left anterior descending stent were 89.29%,96.77%,89.29%,96.77%and 95.04%,respectively.The sensitivity,specificity,positive and negative predictive value,rate of accuracy of in-stent restenosis in the left circumflex stent were 88.89%,92.73%,80.00%,96.23%and 91.78%,respectively.The sensitivity,specificity,positive and negative predictive value,rate of accuracy rate of in-stent restenosis in the right coronary artery stent were 88.00%,94.92%,88.00%,94.92%and 92.86%,respectively.Conclusions 320-DVCT angiography is a safe,noninvasive and effective method for the diagnosis of coronary in-stent restenosis at present.

关 键 词：320排动态容积CT 冠状动脉 冠状动脉造影 

分 类 号：R541.4[医药卫生—心血管疾病] R816.2[医药卫生—内科学]