Mazzarotto Pietro, Di Renzi Paolo, Paluello Giovanni Minio, Carunchio Alessandro, Ricci Roberto, Molisso Antonio, Ceci Vincenzo, Indolfi Ciro
U O Cardiologia invasiva e interventistica endovascolare, Ospedale S Carlo-I D I, Rome, Italy.
J Cardiovasc Med (Hagerstown). 2006 May;7(5):328-34. doi: 10.2459/01.JCM.0000223254.24309.b3.
The present study aimed to evaluate the diagnostic accuracy of four-slice computed tomography for the detection, localization and patency assessment of metal coronary stents in a general population referred for coronary angiography late after coronary angioplasty.
Twenty-four consecutive patients with 34 coronary stents underwent multislice computed tomography within 24 h before a clinically driven coronary angiography performed 245 +/- 92 days after coronary stent implantation. For each patient, two independent operators were asked to evaluate the overall number of stents, the treated coronary vessels and segments, the presence of side-branches in the stented segment, the vessel patency, and the presence of binary in-stent restenosis.
Four-slice computed tomography was feasible in 23 out of 24 patients (96%). Diagnostic accuracy was 94% for stent detection, 96% for the recognition of the stented coronary vessel and 97% for the identification of the stented segment. Accuracy in detection of side-branches in the stented segment, vessel patency and in-stent restenosis was 86%, 88% and 50%, respectively.
Four-slice computed tomography is accurate in the identification of the stented coronary vessel and segment. By contrast, accuracy is low in the detection of vessel patency and in-stent restenosis. Such a technique does not appear to be useful as a screening tool before invasive diagnostic procedures.
本研究旨在评估四层计算机断层扫描对接受冠状动脉成形术较晚后因冠状动脉造影转诊的普通人群中金属冠状动脉支架的检测、定位及通畅性评估的诊断准确性。
24例连续患者共34个冠状动脉支架在冠状动脉支架植入术后245±92天进行临床驱动的冠状动脉造影前24小时内接受多层计算机断层扫描。对于每位患者，两名独立操作人员被要求评估支架总数、接受治疗的冠状动脉血管和节段、支架节段内分支的存在情况、血管通畅性以及支架内二元再狭窄的存在情况。
24例患者中有23例（96%）可行四层计算机断层扫描。支架检测的诊断准确性为94%，识别支架置入的冠状动脉血管的准确性为96%，识别支架置入节段的准确性为97%。支架节段内分支检测、血管通畅性及支架内再狭窄的准确性分别为86%、88%和50%。
四层计算机断层扫描在识别支架置入的冠状动脉血管和节段方面准确。相比之下，血管通畅性及支架内再狭窄检测的准确性较低。这种技术似乎不作为侵入性诊断程序前的筛查工具。
