TY - JOUR
T1 - Evaluation of coronary artery stent patency by using 64-slice multi-detector computed tomography and conventional coronary angiography
T2 - A comparison with intravascular ultrasonography
AU - Hang, Chi Ling
AU - Lee, Yi Wei
AU - Guo, Gary Bih Fang
AU - Youssef, Ali Ahmed
AU - Yip, Hon Kan
AU - Liu, Chu Feng
AU - Chua, Sarah
AU - Chang, Hseuh Wen
AU - Cheng, Yu Fan
AU - Chen, Shyh Ming
PY - 2013/6/5
Y1 - 2013/6/5
N2 - 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 24 h. 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 mm2 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 ≤ 4.0 mm2 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 2was 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.
AB - 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 24 h. 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 mm2 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 ≤ 4.0 mm2 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 2was 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.
KW - Coronary angiography
KW - In-stent restenosis
KW - Intravascular ultrasonography
KW - Multi-slice computed tomography
UR - http://www.scopus.com/inward/record.url?scp=84877762838&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2011.10.003
DO - 10.1016/j.ijcard.2011.10.003
M3 - 文章
C2 - 22056475
AN - SCOPUS:84877762838
SN - 0167-5273
VL - 166
SP - 90
EP - 95
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 1
ER -