双源CT对冠状动脉支架靶血管再狭窄的诊断价值

目的:探讨双源CT（DSCT）对冠状动脉支架置入靶血管再狭窄的诊断价值。方法:对我院69例冠状动脉支架置入患者（共111枚支架）进行DSCT,评价支架图像质量得分与靶血管级别的相关性;并对部分患者同期进行冠状动脉造影（CAG）检查,对比分析DSCT对冠状动脉支架置入靶血管病变的真实性。结果:DSCT支架图像质量得分与靶血管级别正相关;DSCT对支架靶血管再狭窄诊断的灵敏度82%、特异度98%、和准确度95%;DSCT与CAG对不同直径支架的靶血管再狭窄检出率差异无统计学意义,但DSCT对直径≥3.0 mm支架靶血管再狭窄检出的特异度和准确度明显高于直径＜3.0 mm支架靶血管的相应指标（均P＜0.05）,而灵敏度的差异未达到显著水平。结论:DSCT可清晰的显示冠状动脉支架靶血管的病变情况,能较准确地评价冠状动脉支架靶血管再狭窄的发生,具有临床应用价值。

Clinical value of dual-source computed tomography for target vessel of coronary stent

AIM:To evaluate the clinical value of dual-source computed tomography(DSCT) for the target vessel of coronary stent.METHODS:Sixty patients with coronary stent implantation(96 stents) were tested by DSCT to study the correlation of image quality scores and target vessel levels.Some patients were tested at the same time by coronary angiography(CAG).Results of DSCT and CAG were compared for sensitivity,specificity and accuracy of DSCT for diagnosis of coronary stent implantation target vessel disease.RESULTS:Correlative analysis showed that there was a positive correlation between the image quality score and the target vessel levels from DSCT.Sensitivity,specificity,positive predictive value,negative predictive value and accuracy of DSCT diagnosis in-stent restenosis were 77.8%,97.6%,87.5%,95.2% and 94%,respectively.No significant difference was observed between DSCT and CAG in the diagnosis of in-stent restenosis,but DSCT had a higher detection rate of positive predictive value,specificity and sensitivity of in-stent restenosis in diameter of ≥3.0 mm stents compared with those in diameter of <3.0 mm stents.CONCLUSION:DSCT can more accurately show the target vessel coronary stent lesions and target vessel coronary artery stent restenosis.DSCT is of high clinical value in diagnosis of in-stent restenosis.