论著-头颈部
MSCT在冠心病诊断及冠心病PCI术后支架内再狭窄的预测价值
作者:周 喆1 刘长柱2 刘 玥2 屠志伟2
所属单位:1.北京市第六医院CCU病区(北京 100007) 2.北京市第六医院CT室(北京 100007)
PDF摘要
目的探究多层螺旋CT(MSCT)在 冠心病诊断及冠心病经皮冠状动脉介入治 疗(PCI)术后支架内再狭窄的预测价值。 方法 选择2015年7月至2017年1月于我院 收治的94例冠心病患者作为研究对象, 所有患者行MSCT冠状动脉检查,并于2周 内行冠状动脉造影(CAG)检查;接受PCI 治疗的38例患者在支架置入术后6个月时 行MSCT冠状动脉检查及CAG检查。以CAG 诊断结果为金标准,计算MSCT诊断冠心 病及PCI术后支架再狭窄的灵敏度、特异 度、阳性预测值、阴性预测值及准确率。 结果 MSCT评估冠脉狭窄的灵敏度、特异 度、阳性预测值、阴性预测值及准确率分 别为86.30%、97.23%、90.00%、96.09%、 94.78%,MSCT评估PCI术后支架再狭窄的 灵敏度、特异度、阳性预测值、阴性预测 值及准确率为80.00%、94.73%、88.89%、 90.00%、89.65%;MSCT与CAG在冠脉狭窄 及PCI术后支架再狭窄的诊断上具有较好 的一致性。结论 MSCT能较好的显示出冠 状动脉狭窄情况,也可对冠脉PCI术后支 架再狭窄情况进行诊断,在临床上可用于 冠心病的筛查及冠脉PCI术后常规检查。
Objective To explore the value of multi-slice spiral CT (MSCT) in diagnosing coronary heart disease (CHD) and predicting in-stent restenosis after percutaneous coronary intervention (PCI). Methods 94 patients with CHD admitted to the hospital from July 2015 to January 2017 were selected as the study subjects. All patients underwent MSCT coronary artery examination and underwent coronary angiography (CAG) within 2 weeks. 38 cases treated with PCI were examined with MSCT and CAG at 6 months after stent implantation. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate of MSCT in diagnosing CHD and in-stent restenosis after PCI were calculated with the diagnostic results of CAG as the golden standard. Results The sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate of MSCT in evaluating coronary artery stenosis were 86.30%, 97.23%, 90.00%, 96.09% and 94.78% respectively, while those in evaluating in-stent restenosis after PCI were 80.00%, 94.73%, 88.89%, 90.00% and 89.65% respectively. The consistency of MSCT and CAG was good in the diagnosis of coronary artery stenosis and in-stent restenosis after PCI. Conclusion MSCT can well display coronary artery stenosis, and it can also be used for the diagnosis of in-stent restenosis after PCI. It can be used for screening CHD and routine examination after PCI.
【关键词】多层螺旋CT;冠心病;支架内再狭窄
【中图分类号】R543.3;R445.3
【文献标识码】A
【DOI】10.3969/j.issn.1672-5131.2018.08.023
前言
经皮冠状动脉介入治疗(Percutaneous coronary interventions, PCI)是治疗冠心病的重要手段,冠状动脉支架内再狭窄是术后并发症 之一[1]。目前对于冠心病及PCI术后支架内再狭窄诊断的金标准仍是冠 状动脉造影(CAG),常规CAG检查创伤大,价格昂贵,有一定并发症发 生风险,对于一些无明显症状仅需进行常规筛查的患者并不适用[2]。 随着多层螺旋CT(MSCT)技术的发展,MSCT在时间空间分辨率上较以往 有了较大的提高,对常规诊断及PCI术后评价的价值也逐渐被大家所接 受[3-4]。本研究探究了64层螺旋CT对冠心病及PCI术后支架内再狭窄的 诊断价值,现报道如下。
中国CT和MRI杂志
第16卷, 第 8 期
2018年08月
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