64 MSCT对冠状动脉支架通畅性评价的准确性与支架材料的关系

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摘要目的：探讨64 MSCT对冠状动脉支架通畅性评价的准确性以及与支架材料的关系。方法：采用64排螺旋CT对42例冠状动脉支架植入术后的患者（共89个支架，其中不锈钢支架32个，镍钛合金支架57个）进行MSCT冠状动脉成像，观察支架的通畅性以及与支架材料的关系。并与传统冠状动脉造影（CAG）对照。结果：32个不锈钢支架中，CAG显示正常23个（包括支架内再狭窄<50%），支架内再狭窄（ISR）9个（ISR≥50%）；57个镍钛合金支架中，CAG显示正常47个（包括ISR<50%），狭窄10个（ISR≥50%）。与CAG对照，MSCT正确诊断不锈钢支架狭窄4个（ISR≥50%），正常（包括ISR<50%）18个，不能评价1个。镍钛合金支架狭窄9个（ISR≥50%），正常（包括ISR<50%）45个。MSCT对不锈钢支架和镍钛合金支架狭窄的敏感性、特异性、阳性预测值和阴性预测值分别为44%，81.8%，50%，78%和90%，95.7%，81.8%，97.8%。MSCT对不同材料支架通畅性评价有显著性差异（P＜0.05）。结论：64 MSCT冠脉成像是评价镍钛合金冠脉支架通畅性的一种安全可靠的方法，但对不锈钢支架评价有一定局限性。

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	于淑靖
	李忠信
	马国军

关键词 ：支架, 冠状血管, 体层摄影术, 螺旋计算机

Abstract：Objective: To investigate the accuracy of the patency of coronary stents by 64 multislice spiral CT(MSCT) and the relationship with the material of stent. Methods: Forty-two patients who had been implanted 89 stents(32 stainless steel stents, 57 NITI alloy stents) were studied by 64 MSCT. The patency of stents and the relationship with the material of stent were observed. The results were compared with coronary artery angiography(CAG). Results: In 32 stainless steel stents, 23 stents were showed normal and 9 stents displayed stenosis by CAG, but 18(18/23) stents showed normal and 4(4/9) stents revealed stenosis and 1 stent could not be evaluated by MSCT. In 57 NITI alloy stents, 47 stents showed normal and 10 stents displayed stenosis by CAG, 45(45/47) stents showed normal and 9(9/10) stents displayed stenosis by MSCT. In NITI alloy stents group, the sensitivity, specificity, the positive predictive value and the negative predictive value of diagnosing stenosis by MSCT is 90%, 95.7%, 81.8% and 97.8% respectively; but is 44%, 81.8%, 50%, 78% in stainless steel stents group. There was significant difference in evaluating different material stents patency by MSCT. Conclusion: 64 MSCT is a safe and reliable way to evaluate the patency of NITI alloy stents. But it has some limitations to stainless steel stents.

Key words： stents coronary vessels tomography spiral computed

收稿日期: 2007-03-12

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引用本文:

于淑靖;李忠信;马国军. 64 MSCT对冠状动脉支架通畅性评价的准确性与支架材料的关系[J]. , 2007, 18(10): 716-718.
YU Shu-jing;LI Zhong-xin;MA Guo-jun. Evaluating the patency of coronary stents by 64 multislice spiral CT and the relationship with the material of stent. , 2007, 18(10): 716-718.

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http://www.jccmi.com.cn/CN/ 或 http://www.jccmi.com.cn/CN/Y2007/V18/I10/716