Abstract
The purpose of this study was to assess the diagnostic accuracy of 16-slice multidetector-row computed tomography (MDCT) for detecting in-stent restenosis. Fifty patients with 69 previously implanted coronary stents underwent 16-slice MDCT before quantitative coronary angiography (QCA). Diagnostic accuracy of MDCT for detection of in-stent restenosis defined as >50% lumen diameter stenosis (DS) in stented and nonstented coronary segments >1.5-mm diameter was computed using QCA as reference. According to QCA, 18/69 (25%) stented segments had restenosis. In addition, 33/518 (6.4%) nonstented segments had >50% DS. In-stent restenosis was correctly identified on MDCT images in 12/18 stents, and absence of restenosis was correctly identified in 50/51 stents. Stenosis in native coronary arteries was correctly identified in 22/33 segments and correctly excluded in 482/485 segments. Thus, sensitivity (67% vs 67% p=1.0), specificity (98% vs 99%, p=0.96) and overall diagnostic accuracy (90% vs 97%, p=0.68) was similarly high for detecting in-stent restenosis as for detecting stenosis in nonstented coronary segments. MDCT has similarly high diagnostic accuracy for detecting in-stent restenosis as for detecting coronary artery disease in nonstented segments. This suggests that MDCT could be clinically useful for identification of restenosis in patients after coronary stenting.
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Abbreviations
- CAD:
-
coronary artery disease
- DS:
-
diameter stenosis
- MDCT:
-
multidetector-row computed tomography
- MLD:
-
minimal lumen diameter
- MRI:
-
magnetic resonance imaging
- NYHA:
-
New York Heart Association
- QCA:
-
quantitative coronary angiography
- RVD:
-
reference vessel diameter
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Grant Funding: Dr Gerber was supported by a grant from the Fondation Nationale de la Recherche Scientifique of the Belgian Government (FRSM 3.4557.02).
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Kefer, J.M., Coche, E., Vanoverschelde, JL.J. et al. Diagnostic accuracy of 16-slice multidetector-row CT for detection of in-stent restenosis vs detection of stenosis in nonstented coronary arteries. Eur Radiol 17, 87–96 (2007). https://doi.org/10.1007/s00330-006-0291-5
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DOI: https://doi.org/10.1007/s00330-006-0291-5