Diagnostic value of 320-slice computed tomography coronary angiography to assess in-stent restenosis / 中华心血管病杂志
Chinese Journal of Cardiology
; (12): 487-491, 2012.
Article
en Zh
| WPRIM
| ID: wpr-275019
Biblioteca responsable:
WPRO
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the diagnostic accuracy of 320-slice CT coronary angiography (CTA) in the evaluation of in-stent restenosis (ISR, ≥50% luminal narrowing) in comparison with quantitative coronary angiography (CAG).</p><p><b>METHODS</b>A total of 69 patients with previous stent implantation who underwent both CTA and CAG were prospectively included. We assessed diagnostic valve for ISR with CTA in comparison with CAG.</p><p><b>RESULTS</b>A total of 110 stents were implanted in these patients.CAG identified 14 ISR. CTA correctly identified 13 ISR and misdiagnosed 5 ISR in stents without ISR. Besides, 6 stents could not be evaluated by CTA due to unsatisfied image quality. Accordingly, sensitivity, specificity, positive and negative predictive value of CTA for diagnosing ISR were 93%, 89%, 54% and 99%, respectively. The image quality of CTA was significantly better in larger stents (percentages of good and moderate stent image of ≥3.0 mm and <3.0 mm: 56% vs. 27%, 25% vs. 49%) and which was linked with better diagnostic coincidence rate (95% vs. 78%) for larger stents. The image quality of CTA was significantly better in stents with thinner stent strut thickness (percentages of poor CTA stent image quality of stent strut thickness<140 µm and ≥140 µm: 12% vs. 45%, P<0.01) and which was associated with better diagnostic coincidence rate for stents with thinner stent strut thickness (94% vs. 76%, P<0.05). The image quality of CTA was also significantly better in single stent (percentages of poor CTA stent image quality of single stent vs. overlap and dedicated stent: 17% vs. 36%, P<0.05). However, heart rate (≥65 beats/min vs. <65 beats/min) during CTA acquisition was not associated with image quality and the diagnostic coincidence rate (all P>0.05).</p><p><b>CONCLUSIONS</b>Our results indicate that 320-slice CTA allows accurate noninvasive assessment of significant in-stent restenosis in selected patients. Stents with a large diameter and thin struts are associated with better image quality and higher diagnostic accuracy.</p>
Texto completo:
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Índice:
WPRIM
Asunto principal:
Diagnóstico por Imagen
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Tomografía Computarizada por Rayos X
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Stents
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Valor Predictivo de las Pruebas
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Estudios Prospectivos
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Sensibilidad y Especificidad
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Angiografía Coronaria
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Reestenosis Coronaria
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Métodos
Tipo de estudio:
Diagnostic_studies
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Observational_studies
Límite:
Aged
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Aged80
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Female
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Humans
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Male
Idioma:
Zh
Revista:
Chinese Journal of Cardiology
Año:
2012
Tipo del documento:
Article