双源CTA在急性心肌梗死诊断及介入治疗后支架再狭窄评估中的应用  

Application of dual-source CTA in the diagnosis of acute myocardial infarction and evaluation of stent restenosis after interventional therapy

作　　者：沈衍富[1] 李添[1] 林生发 Shen Yanfu;Li Tian;Lin Shengfa(Department of Radiology,Fujian Medical University Provincial School of Clinical Medicine,Fujian Provincial Hospital,Fuzhou 350001,China)

机构地区：[1]福建医科大学省立临床医学院福建省立医院放射科,福州350001

出　　处：《国际医药卫生导报》2020年第23期3560-3563,共4页International Medicine and Health Guidance News

基　　金：2017年福建省卫生计生青年科研课题(2017/1/7)。

摘　　要：目的探讨双源CT冠状动脉血管成像(DSCTA)诊断急性心肌梗死(AMI)及评估介入治疗后支架再狭窄的价值。方法回顾性分析2018年2月至2019年3月本院收治的154例疑似AMI患者的临床资料,均行DSCTA及冠状动脉造影(CAG),以CAG为金标准,评价DSCTA对AMI的诊断价值,同时比较两种检查方法在评估确诊为AMI患者介入治疗后的支架再狭窄的效果。结果CAG检查结果显示85例患者未诊断为AMI,69例患者诊断为AMI;DSCTA检查结果显示87例患者未诊断为AMI,67例患者诊断为AMI。DSCTA与CAG在诊断AMI方面具有较强一致性(Kappa=0.842)。69例AMI患者中有41例患者行介入治疗,随访共评价分析604节段血管,DSCTA与CAG在诊断介入治疗后支架再狭窄方面具有较强一致性(Kappa=0.916)。两种检查方法图像质量评分比较差异无统计学意义(P>0.05),DSCTA的造影剂用量及辐射剂量均明显低于CAG(均P<0.05)。结论DSCTA在AMI诊断及介入治疗后支架再狭窄评估中均具有良好应用价值。Objective To investigate the value of dual-source CT coronary angiography(DSCTA)in the diagnosis of acute myocardial infarction(AMI)and evaluation of stent restenosis after interventional therapy.Methods The clinical data of 154 patients with suspected AMI admitted to our hospital from February 2018 to March 2019 were retrospectively analyzed.DSCTA and coronary angiography(CAG)were performed.With CAG as the gold standard,the diagnostic value of DSCTA on AMI was evaluated.The effects of the two examination methods were compared in evaluating stent restenosis in patients with AMI after interventional therapy.Results CAG examination results showed that 85 patients were not diagnosed as AMI and 69 patients were diagnosed as AMI.DSCTA examination results showed that 87 patients were not diagnosed as AMI and 67 patients were diagnosed as AMI.DSCTA and CAG had a high consistency in the diagnosis of AMI(Kappa=0.842).Among 69 patients with AMI,41 patients underwent interventional therapy.Follow-up evaluation and analysis of 604 segments of blood vessels showed that DSCTA and CAG had a high consistency in the evaluation of stent restenosis after interventional therapy(Kappa=0.916).There was no statistically significant difference in the image quality score between the two examination methods(P>0.05),and the contrast agent dosage and radiation dosage of DSCTA were significantly lower(both P<0.05).Conclusion DSCTA has a good application value in the diagnosis of AMI and the evaluation of stent restenosis after interventional therapy.

关 键 词：X线计算机 冠状动脉血管成像 急性心肌梗死 支架 再狭窄 

分 类 号：R542.22[医药卫生—心血管疾病]