2026 年第 8 期 第 21 卷

冠心病经皮冠状动脉介入治疗后支架内再狭窄的影像学评估

Imaging evaluation of in-stent restenosis after percutaneous coronary intervention in coronary atherosclerotic heart disease

作者：孙美辰1马钊1 聂一飞1刘世淇1张东凤1宋现涛2

英文作者：Sun Meichen1 Ma Zhao1 Nie Yifei1 Liu Shiqi1 Zhang Dongfeng1 Song Xiantao2

单位：1首都医科大学附属北京安贞医院心内冠心病中心一区，北京101118；2首都医科大学附属北京友谊医院心脏内科，北京100050

英文单位：1The First Ward Coronary Heart Disease Center Beijing Anzhen Hospital Capital Medical University Beijing 101118 China; 2Department of Cardiology Beijing Friendship Hospital Capital Medical University Beijing 100050 China

关键词：冠状动脉粥样硬化性心脏病；经皮冠状动脉介入；支架内再狭窄；影像学评估；人工智能

英文关键词：Coronaryatheroscleroticheartdisease;Percutaneouscoronaryintervention;In-stentrestenosis;Imagingevaluation;Artificialintelligence

• 摘要：

• 支架内再狭窄（ISR）是冠状动脉粥样硬化性心脏病患者经皮冠状动脉介入术后常见并发症，严重影响患者的预后和生活质量。ISR主要与血管重构、内膜增生和血栓形成等病理过程相关，且一旦发生常需再次介入治疗，加重医疗负担。影像学评估在ISR的诊断和机制分析中起到核心作用，尽管有创冠状动脉造影是金标准，但其侵入性和风险限制了其广泛应用。近年来，血管内超声、光学相干断层扫描、冠状动脉CT血管造影和磁共振血管成像等影像技术得到广泛应用，显著提升了ISR的检测和分型能力。这些技术能够从不同角度揭示支架内和血管壁的细微结构变化，为精准诊断和个体化治疗提供了重要支持。本文综述了现有影像学评估技术在ISR诊断中的应用，并探讨了人工智能技术与影像技术结合的未来前景，强调其在提高诊断准确性和治疗个性化方面的潜力。

• In-stent restenosis (ISR) is a common complication after percutaneous coronary intervention in patients with coronary atherosclerotic heart disease, which seriously affects patients′ prognosis and quality of life. ISR is mainly associated with pathological processes such as vascular remodeling, intimal hyperplasia and thrombosis, and usually requires repeated interventional therapy once it occurs, increasing the medical burden. Imaging evaluation plays a central role in the diagnosis and mechanism analysis of ISR. Although invasive coronary angiography is the gold standard, its invasiveness and potential risks limit its widespread application. In recent years, intravascular ultrasound, optical coherence tomography, coronary CT angiography and magnetic resonance angiography have been widely applied, greatly improving the ability of ISR detection and classification. These techniques can reveal subtle structural changes within the stent and vessel wall from multiple perspectives, providing important support for accurate diagnosis and individualized treatment. This article reviews the application of current imaging modalities in ISR evaluation, discusses the future prospects of combining artificial intelligence with imaging technology, and highlights their potential in improving diagnostic accuracy and personalized treatment.