New quantitative method to diagnose coronary in-stent restenosis by 64-multislice computed tomography.
BACKGROUND
The aim of this study is to evaluate the accuracy of a newly developed quantitative method using 64-multislice computed tomography angiography (CTA) to detect coronary in-stent restenosis (ISR).


RESULTS
CTA was performed in 45 patients who underwent stent implantation (79 lesions) and the accuracy to diagnose ISR was evaluated by comparing with invasive coronary angiography (ICA). CTA was evaluated both visually and quantitatively using a new stent restenosis index (SRI) utilizing CT densities at proximal and distal artery lumen from the stented region and the correction value depending on the stent diameter. ICA showed 11 ISR (14%). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for visual evaluation were 78%, 75%, 35%, 95%, and 76%, respectively. On the other hand, the quantitative evaluation using SRI represents 82%, 93%, 64%, 97%, and 91%, respectively.


CONCLUSIONS
Evaluation of ISR using SRI is superior to the visual estimation of CTA.
Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan.
Masayuki
M
Yoshimura
Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan.
Tomoko
T
Nao
Department of General Medicine, Tokuyama Central Hospital, Shunan, Japan. Electronic address: toshiro@tukuchuhp.jp.
Toshiro
T
Miura
Department of Radiology, Yamaguchi University Graduate School of Medicine, Ube, Japan.
Munemasa
M
Okada
Department of Radiology, Yamaguchi Grand Medical Center, Hofu, Japan.
Yoshiteru
Y
Nakashima
Hagi Civil Hospital, Hagi, Japan.
Tatsuhiro
T
Fujimura
Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan.
Takayuki
T
Okamura
Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan.
Jutaro
J
Yamada
Department of Radiology, Yamaguchi University Graduate School of Medicine, Ube, Japan.
Naofumi
N
Matsunaga
St. Hill Hospital, Ube, Japan.
Masunori
M
Matsuzaki
Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan.
Masafumi
M
Yano
D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D023903:Coronary Restenosis / Q000000981:diagnostic imaging* / Q000209:etiology*; D023921:Coronary Stenosis / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D015607:Stents / Q000009:adverse effects*
Coronary angiography; In-stent restenosis; Multidetector computed tomography