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Coronary Stent Patency and In-Stent Restenosis: Determination with 64-Section Multidetector CT Coronary Angiography—Initial Experience¹

¹ From the Departments of Radiology (D.O., G.O.) and Cardiology (M.K.), Sifa Medical Center, Fevzipasa Boulevard No. 172/2, 35340 Basmane Izmir, Turkey. From the 2005 RSNA Annual Meeting. Received January 18, 2006; revision requested March 22; revision received April 4; accepted April 19; final version accepted June 15. Address correspondence to D.O. (e-mail: dilekoncel{at}hotmail.com).

Purpose: To prospectively assess the diagnostic performance of 64-section multidetector computed tomography (CT) for the evaluation of coronary stent stenosis and occlusion by using conventional coronary angiography as the reference standard.

Materials and Methods: Institutional review board approval and informed consent were obtained. Thirty patients (27 men, three women; mean age, 58.2 years; range, 42–67 years) with 39 coronary stents were examined with 64-section multidetector CT. Scanning was retrospectively electrocardiographically gated, and an automatic bolus-tracking method was used. For image reconstruction, an edge-enhancing kernel (B46f) was chosen. Evaluations were performed by two radiologists who were blinded to the results of conventional coronary angiography performed within 2–3 days after CT. Sensitivity, specificity, and positive and negative predictive values were calculated.

Results: At conventional angiography, nine of the 39 stents were shown to be totally occluded. All of the occluded stents were correctly diagnosed with CT angiography. Nineteen of 20 patent stents were correctly demonstrated with CT angiography. Ten stents had in-stent restenosis; eight were correctly diagnosed with CT. The sensitivity, specificity, and positive and negative predictive values of 64-section multidetector CT were 89% (17 of 19), 95% (19 of 20), 94% (17 of 18), and 90% (19 of 21), respectively, for in-stent restenosis and occlusion. With the McNemar test, no significant difference was found between 64-section multidetector CT and conventional coronary angiography for the detection of coronary in-stent restenosis and occlusion.

Conclusion: Sixty-four–section multidetector CT coronary angiography is a promising method for the noninvasive diagnosis of in-stent restenosis and occlusion.

© RSNA, 2007

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