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Diagnostic accuracy of 16-slice multidetector-row CT for detection of in-stent restenosis vs detection of stenosis in nonstented coronary arteries

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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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Correspondence to Bernhard L. Gerber.

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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

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