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目的:探讨320排CT冠状动脉成像对冠状动脉支架术后再狭窄的应用价值。方法:回顾性分析110例冠状动脉支架术后患者的320排CT资料及冠状动脉造影资料,以常规冠状动脉造影结果作为“金标准”进行对比分析。统计学方法采用Kappa评价方法。结果:200枚支架均显示优良,320排CT能够对支架置入术后的通畅情况、术后血栓形成等情况进行观察及评估。冠状动脉造影示冠状动脉支架内中度以上再狭窄62枚,320排CTA二维、三维图像及仿真内镜正确诊断50枚,漏诊2枚,误诊10枚,320排CTA诊断支架内再狭窄的敏感性96.87%、特异性95.83%、准确度78.50%、阳性预测值91.18%、阴性预测值98.57%,Kappa值的u检验中得到:u=16.2494,存在一致性,Kappa值=0.6920,参照评价原则,320排CTA和冠状动脉造影对支架内狭窄程度评估一致性极好。结论:320排CTA二维、三维图像能很好显示冠状动脉支架术后管腔,对再狭窄部位、性质、程度能够进行准确全面的观察,而且无创、重复性好,对支架术后疗效观察和随访有较高的临床应用价值。
Objective: To explore the value of 320-slice CT coronary angiography in the treatment of restenosis after coronary stenting. Methods: A retrospective analysis of 320 cases of coronary artery stent in patients with 320 row CT data and coronary angiography data, conventional coronary angiography as a “gold standard” for comparative analysis. Statistical methods using Kappa evaluation method. Results: All the 200 stents showed good results. The 320-row CT was able to observe the status of postoperative stent thrombosis and postoperative thrombosis. Coronary angiography showed 62 cases of restenosis within the coronary stent, 320 rows of CTA two-dimensional, three-dimensional images and simulated endoscopy correct diagnosis of 50, missed 2, misdiagnosed 10, 320 row CTA diagnosis of stent restenosis Sensitivity 96.87%, specificity 95.83%, accuracy 78.50%, positive predictive value 91.18%, negative predictive value 98.57%, Kappa value u test obtained: u = 16.2494, there is consistency, Kappa value = 0.6920, the reference evaluation Principle, 320 CTA and coronary angiography on the evaluation of stent stenosis excellent consistency. Conclusion: The 320-row CTA two-dimensional and three-dimensional images can well show the lumen after coronary stenting, and can accurately and comprehensively observe the site, nature and extent of restenosis. Moreover, And follow-up has a higher clinical value.