支架精显技术在冠状动脉支架植入术中的应用  

Application of enhanced stent visualization technology in coronary artery stent implantation

作　　者：刘伟丽 廉哲勋[2] 李大成[3] 张岩[1] 徐美玲[1] 孟真[1] 綦俊辉[1] 杨红[1] 谭好飞 李燕超 付军桦[1] LIU Weili;LIAN Zhexun;LI Dacheng;ZHANG Yan;XU Meiling;MENG Zhen;QI Junhui;YANG Hong;TAN Haofei;LI Yanchao;FU Junhua(Interventional Operation Room,Affiliated Hospital of Qingdao University,Qingdao,Shandong Province 266003,China)

机构地区：[1]青岛大学附属医院介入手术室,山东266003 [2]青岛大学附属医院心血管内科 [3]青岛大学附属医院PET/CT中心

出　　处：《介入放射学杂志》2020年第7期659-663,共5页Journal of Interventional Radiology

摘　　要：目的探讨冠状动脉造影定量分析(QCA)、支架精显(StentViz)和血管内超声(IVUS)在经皮冠状动脉介入术(PCI)中评价支架可视性和膨胀性的应用。方法收集2016年5月至2018年11月同时接受StentViz和IVUS检查的PCI患者30例。分别在QCA、StentViz和IVUS图像中对植入的33枚支架最小直径、最大直径进行测量,计算支架偏心指数,并进行不同方法间比较分析。对33枚支架共143幅StentViz影像作支架可视性分级评价。结果QCA测量的支架最小直径、最大直径均显著大于StentViz、IVUS测量(P<0.05),支架偏心指数均显著低于StentViz、IVUS测量(P<0.05);StentViz测量的上述指标与IVUS测量比较,差异无统计学意义(P>0.05)。StentViz与IVUS测量的支架最小直径相关性(r=0.956)优于QCA与IVUS测量的相关性(r=0.776)。StentViz测量的支架最小直径与QCA测量相比,同IVUS测量具有更好的一致性。143幅StentViz图像中支架可视性评价显示,支架显示优82.1%(评分4分),良15.3%(2~3分),差2.6%(0~1分)。结论StentViz可显著提高冠状动脉内支架可视性,与QCA相比在测量支架直径方面同IVUS具有更好的相关性和一致性。Objective To discuss the application of quantitative coronary angiography(QCA),enhanced stent visualization technology(StentViz)and intravascular ultrasound(IVUS)in evaluating the visibility and expansibility of stent during the performance of percutaneous coronary intervention(PCI).Methods A total of 30 admitted patients,who received both StentViz and IVUS checks during PCI procedure,were enrolled in this study.The minimum diameter and the maximum diameter of the 33 implanted stents were measured on the QCA,StentViz and IVUS images respectively.The eccentricity index of the stent was calculated.The comparative analysis was conducted by using different methods.A total of 143 StentViz images of 33 stents were used to evaluate the visibility rating of the stents.Results The minimum stent diameter and maximum stent diameter measured by QCA were significantly higher than those measured by StentViz or by IVUS(both P<0.05),while the eccentricity index of the stent measured by QCA was remarkably lower than that measured by StentViz or by IVUS(both P<0.05).No statistically significant differences in the minimum stent diameter,maximum stent diameter and stent eccentricity index existed between StentViz mensuration and IVUS mensuration(P>0.05).The correlation of stent minimum diameter between StentViz mensuration and IVUS mensuration(r=0.956)was better than that between QCA mensuration and IVUS mensuration(r=0.776).The StentViz mensuration and IVUS mensuration had better consistency in estimating the stent minimum diameter when compared with QCA mensuration.The evaluation of stent visualization degree of clarity of 33 stents displayed on the 143 StentViz images showed that excellent visualization was obtained in 82.1%of 33 stents(scoring of 4 points),fine visualization in 15.3%of 33 stents(scoring of 2-3 points)and poor visualization in 2.6%of 33 stents(scoring of 0-1 point).Conclusion StentViz can strikingly improve the visualization of stent in the coronary arteries.Compared with QCA mensuration,the StentViz mensuration

关 键 词：冠状动脉造影定量分析 支架精显技术 血管内超声 经皮冠状动脉介入术 

分 类 号：R541.4[医药卫生—心血管疾病]