title: Evaluation of coronary artery stent patency by using 64-slice multi-detector computed tomography and conventional coronary angiography: a comparison with intravascular ultrasonography.
abstract: BACKGROUND
  Most studies have investigated the diagnostic accuracy of 64-slice multi-detector computed tomography (MDCT) to detect coronary artery stent patency by using conventional coronary angiography (CCA) as the reference standard. In this study, we compared the diagnostic accuracy of MDCT and CCA by using intravascular ultrasonography (IVUS) as the reference standard.
  
  
  METHODS
  Forty-six patients with previously implanted coronary artery stents (n=87) underwent MDCT followed by CCA and IVUS within 24h. Sensitivities, specificities, positive predictive values (PPV) and negative predictive values (NPV) of MDCT and CCA for detecting or excluding in-stent diameter restenosis (ISDR) by using in-stent area restenosis (ISAR) and minimal luminal area (MLA) ≤4.0 mm(2) of IVUS as the reference standard were determined.
  
  
  RESULTS
  Eight stents (9%) were judged non-evaluable using MDCT for the detection of ISDR. ISDR was detected in 28% (22/79) of the evaluable stents using CCA. When ISAR was detected using IVUS, the sensitivity, specificity, PPV, and NPV for ISDR detection by using MDCT were 71%, 96%, 91% and 86%, and the corresponding values for CCA were 64%, 96%, 90% and 83%. When MLA ≤4.0mm(2) was detected using IVUS, the sensitivity, specificity, PPV, and NPV for ISDR detection by using MDCT were 87%, 96%, 91% and 95%, and for CCA were 78%, 96%, 90% and 92%.
  
  
  CONCLUSIONS
  When ISAR with MLA ≤4.0 mm(2)was detected on IVUS, CCA and MDCT had similar diagnostic accuracies for ISDR detection. High specificity and NPV make 64-slice MDCT a reliable non-invasive method for excluding ISDR.
authors: Section of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China. samuelhang@hotmail.com
authors: Chi-Ling
authors: CL
authors: Hang
authors: Yi-Wei
authors: YW
authors: Lee
authors: Gary Bih-Fang
authors: GB
authors: Guo
authors: Ali Ahmed
authors: AA
authors: Youssef
authors: Hon-Kan
authors: HK
authors: Yip
authors: Chu-Feng
authors: CF
authors: Liu
authors: Sarah
authors: S
authors: Chua
authors: Hseuh-Wen
authors: HW
authors: Chang
authors: Yu-Fan
authors: YF
authors: Cheng
authors: Shyh-Ming
authors: SM
authors: Chen
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000592:standards*; D023903:Coronary Restenosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000592:standards*; D012189:Retrospective Studies; D015607:Stents; D018084:Ultrasonography, Interventional / Q000592:standards*