引用本文:严 立,程 琦.CCTA诊断冠状动脉支架内再狭窄的价值及再狭窄相关因素分析[J].中国临床新医学,2019,12(6):646-649.
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CCTA诊断冠状动脉支架内再狭窄的价值及再狭窄相关因素分析
严 立,程 琦
230001 合肥,安徽医科大学附属省立医院影像科
摘要:
[摘要] 目的 评价冠状动脉CT血管造影(CCTA)在诊断冠状动脉支架植入术后支架内再狭窄的价值,并对再狭窄支架方面的相关因素进行分析。方法 对106例冠状动脉支架植入术后患者,分别行CCTA及冠状动脉造影(CAG)检查,将CAG的诊断结果作为金标准,评估CCTA诊断支架内再狭窄的灵敏度、特异度,并分析支架内再狭窄是否与支架部位、直径、长度及类型有关。结果 (1)CCTA对106例患者的174枚支架内再狭窄的诊断特异度、灵敏度、阴性预测值、阳性预测值分别是97.3%、91.7%、98.6%、84.6%,与CAG的诊断一致性较高(Kappa=0.860)。(2)支架内再狭窄与支架直径、狭窄性病变是否处于血管分叉处有关,与支架长度、支架所在冠脉节段、支架类型无关。结论 CCTA对冠状动脉支架内再狭窄的诊断结果与CAG的诊断结果存在较高的一致性。支架内再狭窄的形成与支架直径及狭窄性病变是否处于血管分叉处有关。
关键词:  冠状动脉支架  支架内再狭窄  冠状动脉CT血管造影  冠状动脉造影
DOI:10.3969/j.issn.1674-3806.2019.06.17
分类号:R 445
基金项目:
Diagnostic value of CCTA in in-stent restenosis and its related factors
YAN Li, CHENG Qi
Department of Radiology, Affiliated Provincial Hospital of Anhui Medical University, Hefei 230001, China
Abstract:
[Abstract] Objective To evaluate the value of coronary computed tomography angiography(CCTA) in diagnosis of in-stent restenosis(ISR) after coronary stent implantation, and to analyze the related factors of ISR. Methods One hundred and six patients who had been performed coronary stenting were examined by CCTA and coronary angiography(CAG) for evaluating ISR. The diagnostic results of CAG were taken as the golden standard to evaluate the sensitivity and specificity of CCTA in the diagnosis of ISR after coronary stent implantation and to analyze whether the restenosis was related to the position, diameter, length and type of stents. Results (1)The diagnostic specificity, sensitivity, negative predictive value and positive predictive value of 174 stent restenosis in 106 patients with CCTA were 97.3%, 91.7%, 98.6% and 84.6%, respectively. The diagnostic consistency with CAG was high(Kappa=0.860). (2)ISR was related to the diameter of stents and whether stenosis was located at a vascular bifurcation, but was not related to the length of stents, the type of stents and the segment of the coronary artery in which the stents were located. Conclusion The diagnostic results of CCTA for restenosis are in good agreement with those of CAG. In addition, the formation of stent restenosis is related to stent diameter and stenotic lesion at the vascular bifurcation.
Key words:  Coronary stent  In-stent restenosis(ISR)  Coronary computed tomography angiography(CCTA)  Coronary angiography(CAG)