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Evaluation of coronary artery in-stent restenosis by 64-section computed tomography: factors affecting assessment and accurate diagnosis

 Sang-Hoon Chung  ;  Young Jin Kim  ;  Jin Hur  ;  Hye Jeong Lee  ;  Kyu Ok Choe  ;  Tae Hoon Kim  ;  Byoung Wook Choi 
 JOURNAL OF THORACIC IMAGING, Vol.25(1) : 57-63, 2010 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Contrast Media ; Coronary Angiography/methods* ; Coronary Restenosis/diagnostic imaging* ; Female ; Graft Occlusion, Vascular/diagnostic imaging* ; Humans ; Image Processing, Computer-Assisted/methods ; Iopamidol ; Male ; Middle Aged ; Observer Variation ; Predictive Value of Tests ; Prosthesis Design ; Radiographic Image Enhancement/methods ; Reproducibility of Results ; Retrospective Studies ; Risk Factors ; Sensitivity and Specificity ; Stents* ; Tomography, X-Ray Computed/methods*
coronary artery ; in-stent restenosis ; 64-multislice computed tomography
PURPOSE: To determine factors affecting the ability of 64-multislice computed tomography (MSCT) to detect, assess, and accurately diagnose significant coronary arterial in-stent restenosis (ISR). MATERIALS AND METHODS: The institutional review board approved this study and waived informed consent. Sixty patients underwent CT coronary angiography using 64-MSCT, after implantation of coronary artery stents (n=91). We assessed diagnostic accuracy for ISR with CT in comparison with conventional coronary angiography as the gold standard, visually and with measurement of in-stent coronary lumen density. Possible factors that influenced the diagnostic performance of CT were evaluated, which included image quality (IQ), stent characteristics, and location. RESULTS: Sixty-nine stents (75.8%) were assessable. Low IQ, location in the left circumflex coronary artery, and narrow stent diameter were associated with poor assessment (P<0.05). In stents that could be assessed, sensitivity, specificity, positive predictive value, and negative predictive value of 64-MSCT were 90.0%, 73.5%, 58.1%, and 94.7%, respectively, for significant ISR. The diagnostic accuracy in assessable stents showed a significant increase with better IQ, thinner strut thickness, and nondrug eluting stent. False-positive diagnoses of ISR by CT were explained by coronary lumen density measurements. CONCLUSIONS: Evaluation of stents by 64-MSCT is not recommended in stents with diameters of < or = 2.75 mm or stents located at the left circumflex coronary artery. The diagnostic accuracy of 64-MSCT is affected by IQ and strut thickness in assessable stents. Significant ISR can be excluded with high reliability in selected patients
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Jin(김영진) ORCID logo https://orcid.org/0000-0002-6235-6550
Kim, Tae Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-3598-2529
Lee, Hye Jeong(이혜정) ORCID logo https://orcid.org/0000-0003-4349-9174
Choe, Kyu Ok(최규옥)
Choi, Byoung Wook(최병욱) ORCID logo https://orcid.org/0000-0002-8873-5444
Hur, Jin(허진) ORCID logo https://orcid.org/0000-0002-8651-6571
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