HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: 2452061389v1 245/2/424    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Das, K. M. Articles by Al Suwaidi, J. Search for Related Content PubMed PubMed Citation Articles by Das, K. M. Articles by Al Suwaidi, J.

Contrast-enhanced 64-Section Coronary Multidetector CT Angiography versus Conventional Coronary Angiography for Stent Assessment¹

¹ From the Departments of Radiology (K.M.D.), Cardiology (A.A.E., A.M.S., W.A.K.D., H.A.A., J.A.S.), and Medical Research (R.S.), Hamad Medical Corporation, Hamad Medical St, PO Box 3050, Doha, Qatar. Received August 10, 2006; revision requested October 13; revision received December 22; accepted January 15, 2007; final version accepted April 16. Address correspondence to K.M.D. (e-mail: daskmoy{at}gmail.com).

Purpose: To prospectively evaluate the accuracy of 64-section computed tomography (CT) for diagnosis of stent restenosis, by using conventional coronary angiography as the reference standard.

Materials and Methods: The ethics committee granted permission for the study; patients gave written consent. Contrast material–enhanced coronary CT angiography was performed in 53 patients (45 men, eight women; mean age, 54 years ± 9 [standard deviation]) suspected of having stent restenosis. Coronary CT angiographic findings were compared with conventional coronary angiographic findings. Two physicians analyzed coronary CT angiographic data sets with multiplanar reformatted images and three-dimensional reformations by using a volume-rendering technique and looked for stent detectability, low-attenuation in-stent filling defects, and grades of restenosis. Conventional coronary angiographic results were interpreted by one of several observers in consensus for stent restenosis; they were blinded to coronary CT angiographic data. Statistical software and general estimating equations were used for data analysis.

Results: One hundred ten stents were identified in 53 patients. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of coronary CT angiography in detection of in-stent restenosis were 96.9%, 88.0%, 77.5%, 98.5%, and 91%, respectively. Coronary CT angiography depicted in-stent low-attenuation filling defects with an accuracy of 91% and negative predictive value of 98.5% (95% confidence interval: 90.9, 99.9). Coronary CT angiography depicted the status of 97 of 107 stents. There was no significant difference between in-stent lumen visibility and stent diameter (P = .104). Coronary CT angiography helped diagnose 15 of 18 stent restenoses with less than 50% narrowing, five of five stent restenoses with 50%–74% narrowing, and nine of nine (100%) stent restenoses with 75% or greater narrowing or total occlusion of the stent lumen.

Conclusion: Coronary CT angiography can depict in-stent low-attenuation filling defects, which appear to be a reliable sign of stent restenosis, and 64-section CT depicts such defects with a high degree of accuracy.

© RSNA, 2007

This article has been cited by other articles:

				H. B. Lim, G. Hur, S. Y. Kim, Y. H. Kim, S. U. Kwon, W. R. Lee, and S. J. Cha Coronary Stent Fracture: Detection with 64-Section Multidetector CT Angiography in Patients and in Vitro Radiology, December 1, 2008; 249(3): 810 - 819. [Abstract] [Full Text] [PDF]

				D. Oncel, G. Oncel, A. Tastan, and B. Tamci Evaluation of Coronary Stent Patency and In-Stent Restenosis with Dual-Source CT Coronary Angiography Without Heart Rate Control Am. J. Roentgenol., July 1, 2008; 191(1): 56 - 63. [Abstract] [Full Text] [PDF]