Diagnostic accuracy of 64-slice CT in the assessment of coronary stents.
OBJECTIVE
The purpose of this study was to assess the diagnostic accuracy of 64-slice computed tomography (64-CT) coronary angiography in the detection of coronary in-stent restenosis.


METHODS
Ninety-five patients (72 men and 23 women, mean age 58+/-8 years) with previous percutaneous coronary intervention with stenting and suspected restenosis underwent 64-CT (Sensation 64, Siemens). The mean time between stent deployment and 64-CT was 6.1+/-4.2 months. The scan parameters were: slices 32 x 2, individual detector width 0.6 mm, rotation time 0.33 s, feed 3.84 mm/rotation, 120 kV, 900 mAs. After the intravenous administration of iodinated contrast material (Iomeprol 400 mgI/ml, Iomeron, Bracco) and a bolus chaser (40 ml of saline), the scan was completed in <12 s. All coronary segments with a stent were assessed on 64-CT by two observers in consensus and judged as: patent, with intimal hyperplasia (lumen reduction of <50%), with in-stent restenosis (> or =50%), or with in-stent occlusion (100%). The consensus reading was compared with conventional coronary angiography.


RESULTS
Four patients were excluded because of insufficient image quality. In the remaining 91, we assessed 102 stents (31 RCA; 10 LM; 54 LAD; 7 CX). In 14 (13.7%) stents, in-stent restenosis (n=8) or in-stent occlusion (n=6) was found. Intimal hyperplasia was detected in 11 (10.8%) stents. The sensitivity and negative predictive value of 64-CT for in-stent occlusion were 100% and 100%, respectively, whereas for all stenoses, >50% they were 92.9% and 98.7%, respectively.


CONCLUSIONS
We found that 64-CT has a high diagnostic accuracy for the detection of in-stent restenosis in a selected patient population.
Cademartiri
F
F
Dipartimento di Radiologia e Dipartimento Cuore, Azienda Ospedaliero-Universitaria di Parma, Viale Rustici 2, I-43100 Parma, Italy. filippocademartiri@hotmail.com
Palumbo
A
A
Maffei
E
E
La Grutta
L
L
Runza
G
G
Pugliese
F
F
Midiri
M
M
Mollet
N R A
NR
Meijboom
W B
WB
Menozzi
A
A
Vignali
L
L
Reverberi
C
C
Ardissino
D
D
Krestin
G P
GP
D017023:Coronary Angiography / Q000379:methods*; D023903:Coronary Restenosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D015607:Stents; D014057:Tomography, X-Ray Computed