单扇区联合锐利重建算法CT冠状动脉造影对冠状动脉支架再狭窄的诊断价值  

The diagnostic value of the coronary artery stent restenosis by the filter function 56 algorithm and half cycle reconstruction in coronary artery CT angiography

作　　者：郑葵葵[1] 满意[1] 王镇章[1] 曹国全[1] ZHENG Kuikui;MAN Yi;WANG Zhenzhang;CAO Guoquan(Department of Radiology,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325015,China)

机构地区：[1]温州医科大学附属第一医院放射影像中心,浙江温州325015

出　　处：《温州医科大学学报》2020年第12期990-993,共4页Journal of Wenzhou Medical University

摘　　要：目的:探讨单扇区联合锐利重建技术(FHR)对冠状动脉支架再狭窄(ISR)的诊断效能。方法:回顾性分析温州医科大学附属第一医院冠脉支架植入(PCI)患者在320排CT上行冠状动脉CT造影(CCTA)随访的的影像资料,以常规的冠状动脉造影(ICA)为金标准,对比FHR及常规重建(RR)在诊断冠状动脉支架内狭窄的差异性。结果:纳入患者共99例,植入支架共190枚,以ICA为金标准,发生再狭窄或者闭塞的支架共63枚,FHR及RR图像上的结果差异具有统计学意义(P<0.05)。对比ICA结果,RR图像诊断冠状动脉支架病变的敏感度为76.1%,特异度为78.7%,阳性预测值为64.0%,阴性预测值为86.9%;FHR图像上诊断冠脉支架在狭窄的敏感度为98.4%,特异度为96.8%,阳性预测值为93.9%,阴性预测值为99.1%。FHR与ICA的一致性较高(Kappa>0.8);RR与ICA的一致性较差(Kappa<0.4)。结论:320排CT下FHR图像重建技术可以有效提高对冠脉支架内病变诊断的准确性。Objective:To compare the diagnostic efficacy between the filter function 56 algorithm and half cycle reconstruction(FHR)and routine reconstruction(RR)in the diagnosis of coronary stent restenosis by 320-slice CT coronary angiography(CCTA).Methods:The CCTA data of the patients with history of coronary stent implantation in the First Affiliated Hospital of Wenzhou Medical University was analyzed retrospectively.Conventional coronary angiography(ICA)was used as the gold standard in comparison of the differences between FHR and RR imaging in the diagnosis of coronary stent stenosis.Results:A total of 99 patients or 190 implanted stents were included in this experiment.With ICA as the gold standard,63 stents were restenosis or occlusion.There was statistical difference between FHR and RR images(P<0.05).Compared with ICA,the sensitivity,specificity,positive predictive value and negative predictive value of RR images were 76.1%,78.7%,64.0%and 86.9%;FHR imaging showed sensitivity of 98.4%,specificity of 96.8%,positive predictive value of 93.9%,and negative predictive value of 99.1%,respectively.Furthermore,FHR had a high consistency with ICA(Kappa>0.8),while RR had a poor consistency with ICA(Kappa<0.4).Conclusion:FHR reconstruction under 320-slice CT can effectively improve the diagnostic performance of the coronary stent restenosis.

关 键 词：冠状动脉支架置入术 冠状动脉造影 重建技术 单扇区 锐利算法 

分 类 号：R445.4[医药卫生—影像医学与核医学]