摘要
目的研究CT血管造影(CTA)在评价冠状动脉支架术后支架内再狭窄中的应用价值。方法40例冠状动脉支架术后患者(共82枚支架),分别接受16排CTA和常规冠状动脉造影(CAG)检查,并由两位有经验的医师独立对冠状动脉支架开通或再狭窄进行评估。结果CTA方法能评价所有82枚支架中的68枚(83%),其中支架直径≥3.0 mm者53枚(78%),支架壁厚度<140μm者51枚(75%);CAG显示有7枚支架发生再狭窄,CTA发现其中5枚;CAG和CTA对其余61枚支架均显示无再狭窄。在CTA不可评价的14枚支架中,支架直径<3.0 mm者13枚(93%),支架壁厚度≥140μm者13枚(93%)。CTA对冠状动脉支架术后再狭窄诊断的敏感性、特异性、阳性预测值和阴性预测值分别为71%、100%、97%和100%。结论16排CTA能较准确地评价冠状动脉支架术后支架内再狭窄的发生,尤其对大直径、薄金属壁支架的评估价值较高。
Objective To evaluate the clinical value of computed tomographic angiography （CTA） in the evaluation of in-stent restenosis （ISR） after coronary stenting. Methods Forty consecutive patients who had been performed coronary stenting with 82 stents were included in the study. All the patients were examined by 16-row CTA and conventional invasive coronary angiography （CAG） for evaluating ISR after coronary stenting. The patency and ISR after coronary stenting were evaluated by two experienced doctors independently. Results Of all the 82 stents, 68 （83%） could be assessed by CTA. Of all the 68 assessable stents, there were 53 （78%） whose diameters were no shorter than 3.0 mm and 51 （75%） whose thickness was less than 140 μm. Of the 7 stents with ISR indicated by CAG, 5 could be detected by CTA. The other 61 stents were not found to have ISR either by CAG or CTA. Of the 14 uninterpretable stents, there were 13 （93%） whose diameters were shorter than 3.0 mm and 13（93% ） whose thickness was no less than 140 μm. These findings resulted in a sensitivity of 71% , specificity of 100% , positive predictive value of 97% and negative predictive value of 100%. Conclusion 16-row CTA can accurately evaluate ISR, especially for longer diameter and thinner struts of stents after coronary stenting.
出处
《上海交通大学学报（医学版）》
CAS
CSCD
北大核心
2006年第10期1172-1175,共4页
Journal of Shanghai Jiao tong University:Medical Science
