64层螺旋CT冠状动脉支架成像效果的影响因素

目的 探讨64层螺旋CT冠状动脉支架成像效果的影响因素.方法选取冠状动脉药物涂层金属支架植入术后行64层螺旋CT检查的病例116例,对支架部位图像质量采取半定量评价,分析支架直径、支架长度、支架材质、支架个数和钙化情况对支架部位CT图像质量的影响.结果 64层螺旋CT检出有意义支架内再狭窄的敏感度、特异度、阳性预测值、阴性预测值分别为85.7%、90.2%、60.0%、97.4%.直径2.75 mm以上支架的CT图像质量优于直径2.75 mm及以下的支架(P<0.001),非钙化病变的支架术后CT图像质量优于钙化病变(P<0.05).支架长度、支架材质和是否多支架对支架部位CT图像质量无影响.结论 64层螺旋CT能胜任冠状动脉支架术后复查.直径2.75 mm以上支架和非钙化病变的支架病例更适合用64层螺旋CT进行复查.

Influential Factors of Coronary Stent Image Quality of 64-Slice Spiral Computed Tomograghy

Aim To analyze factors that affected the coronary stent image quality of 64-slice spiral computed tomograghy. Methods 116 patients who received 64-slice spiral computed tomograghy after coronary drug-eluting metal stent implantation from 2007 to 2010 were selected.Those stents image were assessed by semi-quantitive method.Whether stent diameter,stent length,stent material,stent number and calcification status affected the stent image quality were analyzed. Results The sensitivity,specificity,positive predictive value,negative predictive value of 64-slice spiral computed tomograghy to detect significant in-stent restenosis were 85.7%,90.2%,60.0%,97.4%,respectively.Image quality of stents with diameters of >2.75 mm was better than stents with diameter of < or =2.75 mm(P><0.001).Image quality of stents which located on noncalcified plaque were better than stents which located on calcified plaque(P><0.05).Stent length,stent material,stent number did not affect the stent image quality of computed tomograghy. Conclusion 64-slice spiral computed tomograghy had ability to assess the cornary stent after implantation.64-slice spiral computed tomograghy was more suitable for assessing stents with diameters of > 2.75 mm and stents which located on noncalcified plaque.