Third generation dual-source CT enables accurate diagnosis of coronary restenosis in all size stents with low radiation dose and preserved image quality.

Abstract

OBJECTIVES:

To investigate the diagnostic performance of low dose stent imaging in patients with large (≥ 3 mm) and small (< 3 mm) calibre stents by third-generation dual-source CT.

METHODS:

Symptomatic patients suspected of having in-stent restenosis (ISR) were prospectively enrolled. Coronary computed tomography angiography (CCTA) and invasive coronary angiography (ICA) were performed within 1 month for correlation. Binary ISR was defined as an in-stent neointimal proliferation with diameter stenosis ≥ 50%. The radiation dose and image quality of CCTA were also assessed.

RESULTS:

Sixty-nine patients with 140 stents were ultimately included for analysis. The mean total radiation dose of CCTA was 1.3 ± 0.72 mSv in all patients and 0.95 ± 0.17 mSv in patients with high pitch acquisition. The overall diagnostic accuracy of CCTA stent imaging of patient-based, lesion-based and stent-based analysis was 95.7%, 94.1% and 94.3%, respectively. Further, the diagnostic accuracy of CCTA in the small calibre stent group (diameter < 3 mm) was slightly lower than that of the large calibre stent group (diameter ≥ 3 mm) (88.5% versus 98.7%, p = 0.01).

CONCLUSIONS:

Third-generation dual-source CT enables accurate diagnosis of coronary ISR of both large and small calibre stents. Low radiation dose could be achieved with preserved image quality.

KEY POINTS:

• Third-generation DSCT enables accurate diagnosis of coronary ISR of all size stents. • Low radiation dose could be achieved with preserved image quality. • The diagnostic accuracy of CCTA of small calibre stents was 88.5%.

• Authors: Yuehua Li, Mengmeng Yu, Wenbin Li, Zhigang Lu, Meng Wei, Jiayin Zhang
• Journal: European radiology (Eur Radiol) Vol. 28 Issue 6 Pg. 2647-2654 (Jun 2018) ISSN: 1432-1084 [Electronic] Germany
• PMID: 29349698 (Publication Type: Journal Article)

Topics

• Aged
• Aged, 80 and over
• Computed Tomography Angiography (methods)
• Coronary Angiography (methods)
• Coronary Restenosis (diagnostic imaging)
• Drug-Eluting Stents
• Female
• Heart (diagnostic imaging)
• Humans
• Male
• Middle Aged
• Multidetector Computed Tomography (methods)
• Percutaneous Coronary Intervention (methods)
• Prospective Studies
• Radiation Dosage