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目的对比64层与320层螺旋CT显示冠状动脉及诊断冠状动脉支架植入术后再狭窄的价值。方法回顾性分析62例冠脉支架植入术后患者的64层(64层CT组,20例共38枚支架)和320层螺旋CT冠状动脉成像(320层CT组,42例共64枚支架)资料,对比两组图像质量、患者心率、有效辐射剂量(ED),并以CAG为“金标准”评价64层及320层螺旋CT对冠状动脉支架植入术后再狭窄的诊断能力。结果两组间图像质量评分差异无统计学意义(P>0.05);患者心率、ED差异均有统计学意义(P均<0.05)。64层螺旋CT诊断冠状动脉支架植入术后再狭窄的敏感度、特异度、阳性预测值、阴性预测值及准确率分别为100%(5/5)、92.31%(24/26)、71.43%(5/7)、100%(24/24)及93.55%(29/31);320层螺旋CT分别为100%(11/11)、95.65%(44/46)、84.62%(11/13)、100%(44/44)及96.49%(55/57),差异均无统计学意义(P均>0.05)。结论 64层及320层螺旋CT均可应用于冠状动脉支架植入术后随访,320层螺旋CT对患者心率的要求更低,患者接受的辐射剂量更少。
Objective To compare the value of 64-slice and 320-slice spiral CT in the diagnosis of coronary artery and the diagnosis of restenosis after coronary stent implantation. Methods Sixty-two patients undergoing coronary stent implantation were retrospectively analyzed. Sixty-four patients (64-slice CT group, 20-slice total 38 stents) and 320-slice spiral CT coronary angiography ) Were used to compare the image quality, heart rate and effective radiation dose (ED) between two groups and to evaluate the diagnosis of restenosis after coronary stent implantation with 64-slice and 320-slice spiral CT with CAG as the “gold standard” ability. Results There was no significant difference in image quality scores between the two groups (P> 0.05). There was significant difference in heart rate and ED between the two groups (all P <0.05). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 64-slice spiral CT in the diagnosis of restenosis after coronary stenting were 100% (5/5), 92.31% (24/26), 71.43 100% (24/24) and 93.55% (29/31) respectively. The CT scan of 320-slice spiral CT was 100% (11/11), 95.65% (44/46) and 84.62% 13), 100% (44/44) and 96.49% (55/57), respectively, with no significant difference (all P> 0.05). Conclusion Both 64-slice and 320-slice spiral CT can be used for follow-up after coronary stent implantation. The 320-slice spiral CT requires less heart rate and receives less radiation dose.