MSCT冠状动脉成像在冠状动脉支架置入术后的应用

目的 探讨64排螺旋CT （MSCT）冠状动脉成像在冠状动脉支架置入后的应用价值.方法 分析行冠状动脉支架置入术后于我院2011年9月至2013年8月期间行64排MSCT冠状动脉成像的患者47例.用评分的方法客观评估多层螺旋CT血管造影（MSCTA）对冠状动脉支架的显示情况,并对支架管腔狭窄情况进行评估测量.对于中重度狭窄的患者进一步行DSA检查,并分析其与MSCTA评估结果的相关性.结果 47例患者共置入89枚冠状动脉支架,其中评为3分的支架为39枚,评为2分的支架为41枚,评为1分的支架为9枚.39枚支架没有发现狭窄,24枚支架轻度狭窄,15枚支架中度狭窄,11枚支架重度狭窄.DSA与MSCTA对中、重度狭窄的评估呈高度正相关,相关系数为r=0.804.伴钙化支架组MSCTA中、重度狭窄评估结果与DSA评估结果呈中度相关,相关系数为r=0.603.结论 MSCT冠状动脉成像能够很好地显示冠状动脉支架及其管腔狭窄,具有重要的临床价值.支架局部的钙化是影响评估准确性的因素之一.

Evaluation of MSCT coronary angiography in diagnosing coronary in-stent restenosis

Objective To investigate the diagnostic value of 64-slice computed tomography angiography （CTA）in diagnosing coronary in-stent restenosis.Methods Forty-seven patients underwent CTA after coronary stent implantation between September,2011 and August,2013.The display of stent on MSCTA was assessed with graded,and lumen of in-stent restenosis was measured.For moderate to severe stenosis were further examined by DSA.The correlation between DSA and MSCTA was analyzed.Results A total of 47 patients with 89 coronary artery stent,which named 3 points for 39 medal,2 points for 41,1 point for 9.It showed 39 stents with no stenosis,24 stents with mild stenosis,15 stents with moderate stenosis,11 stents with severe stenosis.A highly positive correlation between CTA and DSA was achieved （r=0.804）,and it showed a moderate correlation in the mainly calcified plaques （r=0.603）.Conclusion MSCT coronary angiography had a reliable way of displaying stent and in-stent restenosis,and it had an important clinical value.But calcification may be an influential factor of diagnosing coronary artery in-stent restenosis accurately.