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中华介入放射学电子杂志

中华介入放射学电子杂志 ›› 2020, Vol. 08 ›› Issue (02) : 166 -169. doi: 10.3877/cma.j.issn.2095-5782.2020.02.013

所属专题： 专题评论； 文献；

影像诊断

320排动态容积CT动脉造影评价冠状动脉支架内再狭窄的价值
刘雪莲1, 郝宝顺2,†(), 刘定辉2, 陈秀珍3, 周彬2, 余舒杰2   
  1. 1. 510630　广东广州，中山大学附属第三医院介入手术室
    2. 510630　广东广州，中山大学附属第三医院心内科
    3. 510630　广东广州，中山大学附属第三医院放射科
  • 收稿日期:2020-02-13 出版日期:2020-05-25
  • 通信作者: 郝宝顺

Diagnostic accuracy of 320-slice dynamic volume CT in assessment of coronary artery in-stent restenosis

Xuelian Liu1, Baoshun Hao2,†(), Dinghui Liu2, Xiuzhen Chen3, Bin Zhou2, Shujie Yu2   

  1. 1. Interventional Operation Room, the Third Affiliated Hospital of Sun Yat-sen University, Guangdong Guangzhou 510630, China
    2. Department of Cardiology, the Third Affiliated Hospital of Sun Yat-sen University, Guangdong Guangzhou 510630, China
    3. Department of Radiology, the Third Affiliated Hospital of Sun Yat-sen University, Guangdong Guangzhou 510630, China
  • Received:2020-02-13 Published:2020-05-25
  • Corresponding author: Baoshun Hao
  • About author:
    Corresponding author: Hao Baoshun, Email:
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刘雪莲, 郝宝顺, 刘定辉, 陈秀珍, 周彬, 余舒杰. 320排动态容积CT动脉造影评价冠状动脉支架内再狭窄的价值[J/OL]. 中华介入放射学电子杂志, 2020, 08(02): 166-169.

Xuelian Liu, Baoshun Hao, Dinghui Liu, Xiuzhen Chen, Bin Zhou, Shujie Yu. Diagnostic accuracy of 320-slice dynamic volume CT in assessment of coronary artery in-stent restenosis[J/OL]. Chinese Journal of Interventional Radiology(Electronic Edition), 2020, 08(02): 166-169.

目的

评价320排动态容积CT（320-slice dynamic volume CT，320-DVCT）动脉造影诊断冠状动脉支架内部再狭窄的准确性。

方法

208例怀疑发生支架内再狭窄的冠状动脉支架植入患者，进行320-DVCT动脉造影检查，之后2～7 d内行冠状动脉造影检查。

结果

320-DVCT动脉造影可获得较好的图像质量，可用于诊断冠状动脉支架内再狭窄。对于直径≥3.0 mm的支架，其图像优级率和成功率明显高于直径<3.0 mm的支架。320-DVCT诊断冠状动脉支架内再狭窄的敏感性91.30％，特异性95.21％，阳性预测值86.3％，阴性预测值97.07％，准确率94.24%；诊断左前降支支架内再狭窄的敏感性89.29％，特异性96.77％，阳性预测值89.29％，阴性预测值96.77％，准确率95.04%；诊断左回旋支支架内再狭窄的敏感性88.89％，特异性92.73％，阳性预测值80.00％，阴性预测值96.23％，准确率91.78％；诊断右冠状动脉支架内再狭窄的敏感性88.00％，特异性94.92％，阳性预测值88.00％，阴性预测值94.92％，准确率92.86%。

结论

320-DVCT动脉造影是目前较新的一种安全无创、有效诊断冠状动脉支架内再狭窄的检查方法。

关键词: 320排动态容积CT, 冠状动脉, 冠状动脉造影
Objective

To evaluate the diagnostic accuracy of coronary artery in-stent restenosis with 320 dynamic volume computed tomography in comparison of selective coronary angiography.

Methods

Two hundred and eight patients with suspected coronary artery in-stent restenosis underwent 320-DVCT coronary angiography, and selective coronary angiography was performed within 2 to 7 days subsequently.

Results

The images acquired from 320-DVCT were excellent and sufficient enough to be used to evaluate coronary in -stent restenosis. For the stents with diameter of more than 3.0 mm, the image of optimization rate and success rate are significantly higher than those with a diameter of <3.0 mm. The sensitivity, specificity, positive and negative predictive value, rate of accuracy of 320-DVCT for detecting in-stent restenosis were 91.30%, 95.21%, 86.3%, 97.07% and 94.24%, respectively. The sensitivity, specificity, positive and negative predictive value, rate of accuracy of in-stent restenosis in the left anterior descending stent were 89.29%, 96.77%, 89.29%, 96.77% and 95.04%, respectively. The sensitivity, specificity, positive and negative predictive value, rate of accuracy of in-stent restenosis in the left circumflex stent were 88.89%, 92.73% , 80.00%, 96.23% and 91.78%, respectively. The sensitivity, specificity, positive and negative predictive value, rate of accuracy rate of in-stent restenosis in the right coronary artery stent were 88.00%, 94.92%, 88.00%, 94.92% and 92.86%, respectively.

Conclusions

320-DVCT angiography is a safe, noninvasive and effective method for the diagnosis of coronary in-stent restenosis at present.

Key words: 320-Slice dynamic volume computed tomography, Coronary artery, Coronary angiography
表1 320-DVCT动脉造影图像质量评价
支架直径 优 良 中 差 成功率
A组：≥3 mm 68 63 30 11 160
172枚 39.53% 36.63% 17.44% 6.40% 93.60%
B组：<3 mm 28 32 25 21 85
106枚 26.42% 30.19% 23.58% 19.81% 80.19%
表2 208例患者320-DVCT和CAG检查显示冠脉支架内狭窄统计学分析
320-DVCT CAG 合计 敏感性 特异性 阳性预测值 阴性预测值 准确率
阳性 阴性
阳性 63 10 73 91.30% 95.21% 86.3% 97.07% 94.24%
阴性 6 199 205 ? ? ? ? ?
合计 69 209 278 ? ? ? ? ?
表3 208例患者320-DVCT和CAG检查显示不同冠状动脉支架内狭窄统计学分析
支架部位 支架数目 320-DVCT CAG 敏感性 特异性 阳性预测值 阴性预测值 准确率
阳性 阴性
LAD 121 阳性 25 3 89.29% 96.77% 89.29% 96.77% 95.04%
? ? 阴性 3 90 ? ? ? ? ?
LCX 73 阳性 16 4 88.89% 92.73% 80.00% 96.23% 91.78%
? ? 阴性 2 51 ? ? ? ? ?
RCA 84 阳性 22 3 88.00% 94.92% 88.00% 94.92% 92.86%
? ? 阴性 3 56 ? ? ? ? ?
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