摘要
目的 探讨多排螺旋CT血管成像(MSCT computed tomography angiography,CTA)及数字减影(digital subtraction angiography,DSA)对冠状动脉支架植入术后腔内再狭窄的不同诊断价值。方法 回顾性分析我院31例冠脉支架植入 术后患者的64排冠脉CTA的后处理图像与DSA冠脉造影图像进行比较,观察两者在支架腔内的通畅性、狭窄程度、支 架远端血管的显示情况。结果 经冠脉CTA 发现支架植入术后再狭窄8例,经DSA检查证实支架腔内再狭窄10例。CTA 对支架腔内再狭窄的敏感度为83%,特异度90%,阳性预测值为71%。与DSA比较无统计学差异。结论 MSCT冠脉成 像可获得与DSA相近的检查结果,对了解支架内再狭窄的预测有重要的辅助作用,将二者结合能更加准确的判断和 了解冠脉支架腔内的通畅性与狭窄的程度。
Objective To explore the different diagnostic value of MSCT angiography (computed tomography angiography, CTA) and digital subtraction angiography(DSA) in the patients with restenosis after coronary stent implantation. Methods Retrospective analysis of 31 cases of coronary stent implantation in patients with CTA postprocessing images were compared with DSA images, observate the stent patency, stenosis and distal vascular. Results 8 cases with restenosis after stent implantation were been found by CTA, 10 cases were confirmed by DSA.The sensitivity was 83%, the specificity was 90%, the positive predictive value was 71% of the CTA examination.There was no significant difference between the CTA and DSA. Conclusion MSCT coronary artery imaging can obtain similar results with DSA.It is important to understand the prediction of in-stent restenosis. The combination of the two examination can be accurately determine and understand the patency of coronary stent and the degree of stenosis.
【关键词】支架;支架内再狭窄;体层摄影术;X线计算机;冠脉;血管造影术
【中图分类号】R322.1+2
【文献标识码】A
【DOI】10.3969/j.issn.1009-3257.2017.05.005
前言
冠状动脉内支架置入术后再狭窄的发生率较高, 有文献报道约21%~28%[1],如何尽早发现并解决这一 问题尤为重要。多层螺旋CT图像采用VR重建,并调 整阈值,可多角度,多方位观察,获得真正的三维图 像,使血管立体成像成为现实[2],能清楚显示冠脉内 支架、支架近端及远端血管的情况,对支架置入所造 成的管腔再狭窄具有一定的评估能力。本文应用64排 螺CT血管造影血管探针技术,重点观察支架植入术后 支架腔内的通畅情况,与DSA进行比较,探讨其在冠 状动脉支架置入术后再狭窄的诊断中的指导意义。
罕少疾病杂志
第24卷, 第 5 期
2019年11月
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