多层螺旋CT和冠状动脉造影评估冠心病诊断及经皮冠状动脉介入治疗术后评估支架内再狭窄研究  

Application values of MSCT and coronary angiography in the CHD diagnosis and postoperative assessment of PCI treatment on in-stent restenosis

作　　者：赵童童 李涛[1] 尚进伟 陈雷[1] ZHAO Tong-tong;LI Tao;SHANG Jin-wei(Department of Radiology,NO.2 People's Hospital of Fuyang City,Fuyang 236015,China;不详)

机构地区：[1]阜阳市第二人民医院放射科,安徽阜阳236015

出　　处：《中国医学装备》2022年第1期77-81,共5页China Medical Equipment

摘　　要：目的:分析多层螺旋CT(MSCT)在冠心病(CHD)诊断及经皮冠状动脉介入治疗(PCI)术后随访中评估支架内再狭窄的应用价值。方法:选取医院心内科收治的156例疑似CHD患者,所有患者均行MSCT检查,以冠状动脉造影(CAG)检查结果为金标准,对其中行PCI治疗的72例患者在支架置入术后6个月时再行MSCT和CAG检查(其余84例未行PCI治疗)。分析MSCT和CAG检查诊断的疾病类型及斑块定量测量值;对MSCT和CAG检查冠状动脉的各动脉血管狭窄情况进行评价;计算MSCT诊断血管狭窄及PIC术后支架再狭窄灵敏度、特异度、阳性预测值及阴性预测值。结果:在156例疑似CHD患者中经CAG确诊CHD100例,其中心绞痛41例,心肌梗死44例,无症状心肌缺血型15例;经MSCT确诊为97例,其中心绞痛40例,心肌梗死43例,无症状心肌缺血14例,诊断正确率为97.00%(97/100)。MSCT检查诊断血管狭窄的灵敏度为92.86%,特异度为97.75%,阳性预测值为89.31%,阴性预测值为98.84%。行冠状动脉支架术的72例患者共植入支架100枚,以CAG诊断结果为标准,MSCT评估PCI术后支架再狭窄的灵敏度为80.56%,特异度为96.88%,阳性预测值为93.55%,阴性预测值为89.86%。结论:MSCT可比较准确的显示出冠状动脉管腔的狭窄及冠状动脉PCI术后支架狭窄的情况,可作为PCI术后效果随访观察的重要手段,对CHD的诊断和治疗具有价值。Objective:To analyze the application value of multi-slice spiral computed tomography(MSCT)in the diagnosis of coronary heart disease(CHD)and the assessment of in-stent restenosis postoperative follow-up of percutaneous coronary intervention(PCI)treatment.Methods:156 patients with suspected CHD who admitted to hospital were selected as the study objects.All patients were examined by MSCT,and the results of coronary arteriography examination were used as gold standard.72 patients of them,who were treated by PCI,underwent the examinations of MSCT and coronary angiography at the 6 th months after stent implantation(other 84 cases didn’t underwent PCI treatment).The disease type and the quantitatively measurement values of plaques were diagnosed by MSCT and coronary arteriography were analyzed.The stenosis conditions of each artery blood vessel of coronary artery which were detected by the examinations of MSCT and coronary angiography were evaluated.The sensitivity,specificity,positive predictive value and negative predictive value that MSCT diagnosed the stenosis of blood vessel and restenosis of stent after PIC surgery were calculated.Results:In 156 suspected patients,100 cases were confirmed by coronary angiography as CHD,and 41 cases of them were angina,and 44 cases of them were myocardial infarction and 15 cases of them were asymptomatic myocardial ischemia.And 97 cases were confirmed by MSCT as CHD,and 40 cases of them were angina,and 43 cases of them were myocardial infarction and 14 cases of them were asymptomatic myocardial ischemia,and the diagnostically correct rate of MSCT was 97.00%(97/100).The sensitivity,specificity,positive predictive value and negative predictive value of MSCT were 92.86%,97.75%,89.31% and 98.84% in diagnosing the stenosis of blood vessel,respectively.The total of 100 stents were implanted in 72 patients who underwent the surgery of coronary stent.The diagnostic result of coronary angiography was used as standard,and then,the sensitivity,specificity,positive predictive value and neg

关 键 词：多层螺旋CT(MSCT) 冠状动脉造影(CAG) 冠心病(CHD) 经皮冠状动脉介入治疗(PCI) 术后随访 

分 类 号：R816.2[医药卫生—放射医学]