| Assessing stent restenosis using 64-multidetector computed tomography coronary angiography |
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Myung-Ki Seo, Jin-Shin Kho, So-Ra Park, Young-Ran Kwang, Min-Kyeng Kang, Jung-Hyun Cho, Youn-Jung An, Bong-Ryong Choi, Young-Hoon Jeong, Choong-Hwan Kwak, Ho-Cheol Choi, Kyung-Nyeo Jeon, Jin-Yong Hwang, Departments of Inte, Radiology, Gyeongsang Institut, College of Medicine, Gyeongsang National, Jinju, Korea |
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| 64열 다중검출 CT를 이용한 관상동맥 스텐트재협착의 평가 |
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서명기, 고진신, 박소라, 강영란, 강민경, 조정현, 안연정, 최봉룡, 정영훈, 곽충환, 최호철, 전경녀, 황진용, Departments of Inte, Radiology, Gyeongsang Institut, College of Medicine, Gyeongsang National, Jinju, Korea |
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| Abstract |
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Background/Aims: Multidetector computed tomography (MDCT) is considered to be a noninvasive, alternative method for evaluating
stent restenosis. However, the diagnostic accuracy of 16-channel MDCT for stent stenosis is reported to have severe limitations
because of high-attenuation stent-related artifacts. 64-channel MDCT, which recently became available in clinical practice,
has better spatial and temporal resolution than 16-channel MDCT. The diagnostic accuracy of 64-channel MDCT for stent restenosis
(in-segment and in-stent) was assessed by comparing it with conventional coronary angiography.
Methods: In-segment and in-stent restenosis (≥50% in diameter) were evaluated in 96 stent segments in 68 patients [61±12 years,
51 (75%) male] using both 64-channel MDCT and conventional coronary angiography. The in-stent analysis was confined to the
portion of the artery covered by the stent and the in-segment analysis included the stent and 5 mm proximal or distal to the stent
edges.
Results: The 64-channel MDCT could evaluate stent restenosis in 93 of 96 (97%) stent segments. Quantitative conventional coronary
angiography found in-segment restenosis (≥50% in diameter) in 16 of 68 (23%) patients and 16 of 96 (17%) segments. For
the patients with interpretable stent segments, the sensitivity, specificity, positive predictive value, and negative predictive value of
64-channel MDCT for in-segment restenosis per patient were 63, 96, 83, and 89%, respectively; per segment they were 63, 97, 83,
and 93%, respectively; and for in-stent restenosis per stent they were 82, 98, 82, and 98%, respectively.
Conclusions: The diagnostic accuracy of 64-channel MDCT for assessing stent restenosis had high specificity and negative predictive value in the clinical setting. The 64-channel MDCT may be a promising, less-invasive imaging tool for stent restenosis, especially
for the purpose of excluding stent restenosis. (Korean J Med 76:434-442, 2009) |
| Key Words:
Coronary restenosis; Computed tomography |
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