Coronary stent patency and in-stent restenosis: determination with 64-section multidetector CT coronary angiography--initial experience.
OBJECTIVE
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.


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.


CONCLUSIONS
Sixty-four-section multidetector CT coronary angiography is a promising method for the noninvasive diagnosis of in-stent restenosis and occlusion.
Oncel
Dilek
D
Department of Radiology, Sifa Medical Center, Fevzipasa Boulevard No. 172/2, 35340 Basmane Izmir, Turkey. dilekoncel@hotmail.com
Oncel
Guray
G
Karaca
Mustafa
M
D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage; D017023:Coronary Angiography / Q000379:methods*; D023903:Coronary Restenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003331:Coronary Vessels / Q000503:physiopathology*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007472:Iohexol / Q000008:administration & dosage / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011856:Radiographic Image Enhancement / Q000379:methods; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D015607:Stents; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014654:Vascular Patency / Q000502:physiology*
D003287:Contrast Media; C093233:iobitridol; D007472:Iohexol