Objectives This study sought to evaluate the diagnostic accuracy of 64-slice multislice computed tomography (MSCT) coronary angiography in the follow-up of patients with previous coronary stent implantation. Background Recent investigations have shown increased image quality and diagnostic accuracy for noninvasive coronary angiography with 64-slice MSCT as compared with previous-generation MSCT scanners, but data on the evaluation of coronary stents are scarce. Methods In 182 patients (152 [84%] male, ages 58 +/- 11 years) with previous stent (>= 2.5 mm diameter) implantation (n = 192), 64-slice MSCT angiography using either a Sensation 64 (Siemens, Forchheim, Germany) or Aquilion 64 (Toshiba, Otawara, Japan) was performed. At each center, coronary stents were evaluated by 2 experienced observers and evaluated for the presence of significant (>= 50%) in-stent restenosis. Quantitative coronary angiography served as the standard of reference. Results A total of 14 (7.3%) stented segments were excluded because of poor image quality. In the interpretable stents, 20 of the 178 (11.2%) evaluated stents were significantly diseased, of which 19 were correctly detected by 64-slice MSCT. Accordingly, sensitivity, specificity, and positive and negative predictive value to identify in-stent restenosis in interpretable stents were 95.0% (95% confidence interval [CI] 85% to 100%), 93.0% (95% CI 90% to 97%), 63.3% (95% CI 46% to 81%), and 99.3% (95% CI 98% to 100%), respectively. Conclusions In-stent restenosis can be evaluated with 64-slice MSCT with good diagnostic accuracy. In particular, a high negative predictive value of 99% was observed, indicating that 64-slice MSCT may be most valuable as a noninvasive method of excluding in-stent restenosis.

Usefulness of 64-slice multislice computed tomography coronary angiography to assess in-stent restenosis / Cademartiri, Filippo; Schuijf Joanne, D.; Pugliese, Francesca; Mollet Nico, R.; Jukema J., Wouter; Maffiel, Erica; Kroft Lucia, J.; Palumbo, Alessandro; Ardissino, D; Serruys Patrick, W.; Krestin Gabriel, P.; Van der Wall Ernst, E.; de Feyter Pim, J.; Bax Jeroen, J.. - In: JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY. - ISSN 0735-1097. - 49:22(2007), pp. 2204-2210. [10.1016/j.jacc.2007.02.045]

Usefulness of 64-slice multislice computed tomography coronary angiography to assess in-stent restenosis

Ardissino D;
2007

Abstract

Objectives This study sought to evaluate the diagnostic accuracy of 64-slice multislice computed tomography (MSCT) coronary angiography in the follow-up of patients with previous coronary stent implantation. Background Recent investigations have shown increased image quality and diagnostic accuracy for noninvasive coronary angiography with 64-slice MSCT as compared with previous-generation MSCT scanners, but data on the evaluation of coronary stents are scarce. Methods In 182 patients (152 [84%] male, ages 58 +/- 11 years) with previous stent (>= 2.5 mm diameter) implantation (n = 192), 64-slice MSCT angiography using either a Sensation 64 (Siemens, Forchheim, Germany) or Aquilion 64 (Toshiba, Otawara, Japan) was performed. At each center, coronary stents were evaluated by 2 experienced observers and evaluated for the presence of significant (>= 50%) in-stent restenosis. Quantitative coronary angiography served as the standard of reference. Results A total of 14 (7.3%) stented segments were excluded because of poor image quality. In the interpretable stents, 20 of the 178 (11.2%) evaluated stents were significantly diseased, of which 19 were correctly detected by 64-slice MSCT. Accordingly, sensitivity, specificity, and positive and negative predictive value to identify in-stent restenosis in interpretable stents were 95.0% (95% confidence interval [CI] 85% to 100%), 93.0% (95% CI 90% to 97%), 63.3% (95% CI 46% to 81%), and 99.3% (95% CI 98% to 100%), respectively. Conclusions In-stent restenosis can be evaluated with 64-slice MSCT with good diagnostic accuracy. In particular, a high negative predictive value of 99% was observed, indicating that 64-slice MSCT may be most valuable as a noninvasive method of excluding in-stent restenosis.
Usefulness of 64-slice multislice computed tomography coronary angiography to assess in-stent restenosis / Cademartiri, Filippo; Schuijf Joanne, D.; Pugliese, Francesca; Mollet Nico, R.; Jukema J., Wouter; Maffiel, Erica; Kroft Lucia, J.; Palumbo, Alessandro; Ardissino, D; Serruys Patrick, W.; Krestin Gabriel, P.; Van der Wall Ernst, E.; de Feyter Pim, J.; Bax Jeroen, J.. - In: JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY. - ISSN 0735-1097. - 49:22(2007), pp. 2204-2210. [10.1016/j.jacc.2007.02.045]
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11381/2883749
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