NEW YORK (Reuters Health), Oct 31 - In-stent restenosis can be accurately assessed by 64-section CT in selected patients, according to a report in the November issue of Radiology.
Promising results have been obtained with multisection CT for detecting restenosis in native coronary arteries, the authors explain, but results of evaluation of metallic stents have been less promising.
Dr. Jeroen J. Bax from Leiden University Medical Center, the Netherlands, and colleagues evaluated the diagnostic accuracy of 64-section CT for the assessment of in-stent or persistent restenosis in 50 consecutive patients, with conventional coronary angiography as the reference standard.
Image quality was good in 41 stents (54%), moderate in 24 stents (32%), and the stent lumen could not be visualized in the remaining 11 stents (14%).
Image quality was higher in stents positioned without any overlap than in stents with partial overlap, the report indicates. Elevated heart rate also contributed to motion artifact that made some images uninterpretable.
Multisection CT correctly identified all 52 nonoverlapping stents that lacked significant in-stent restenosis and all six nonoverlapping stents with significant in-stent restenosis, the authors report, for sensitivity and specificity of 100%.
Multisection CT identified the presence of significant stenosis in all five peri-stent lumina that were seen on coronary angiography, the researchers note, but multisection CT incorrectly identified as significant two lesions that were insignificant by coronary angiography.
"In selected patients with previous stent implantation, 64-section CT can be used to evaluate in-stent restenosis with high accuracy," the investigators conclude. "Accordingly, this technique may be useful for noninvasive exclusion of in-stent or persistent restenosis, thereby avoiding invasive imaging in a considerable number of patients."
Last Updated: 2007-10-30 17:18:53 -0400 (Reuters Health)
Radiology 2007;245:416-423.
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