Quantitive evaluation of coronary artery stenosis and in-stent restenosis by 64-slice spiral CT angiography and DSA / 中华放射学杂志

ABSTRACT

Objective To evaluate the diagnostic accuracy and reliability for coronary artery stenosis and in-stent restenosis detection using 64-slice spiral computed tomography(multislice CT,MSCT) angiography and digital subtraction angiography(DSA).Methods A pulsating cardiac phantom with two simulated coronary arteries was scanned on a 64- slice CT scanner and underwent DSA at static state,at 4 different sinus rhythms of 0,50,70,and 90 beats per minute(bpm).One simulated artery was 3 mm in lumen diameter with 3 segments of 25%,50%,and 75% stenoses.A stent with 2 segments of 50% and 75% stenoses was placed into the other artery with 4mm in lumen diameter.Images from MSCT were analyzed and compared with those from DSA.Results(1)The mean values of the 25%,50%,and 75% stenoses measured with MSCT were(30.0?1.4)%,(49.5?1.3)%,and(72.9?3.9)%,respectively (P values were 0.005,0.531,and 0.369 respectively).The mean values of the 25%,50%,and 75% stenoses measured with DSA were(24.8?2.0)%,(48.2?2.1)%,(75.3?2.4)% respectively (P values were 0.883,0.180,and 0.796,respectively).(2)MSCT was susceptible to heart rate,with artifact increasing as heart rate increasing,especially when the heart rate were ≥70 bpm.(3)There was a good correlation between 64-slice MSCT and DSA(r=0.995,P=0.000).(4)64-slice MSCT could show the stent and in- stent restenosis simutaneously.Its capability to depict in-stent restenosis was limited.The depiction rate of 50% in- stent restenosis were(46.4?4.5)%(0 bpm)and(43.6?5.7)%(50 bpm) respectively(P