Department of Radiology, Yonsei University Wonju College of Medicine, Wonju Christian Hospital, Wonju, Republic of Korea.
Int J Cardiovasc Imaging. 2012 Jun;28 Suppl 1:21-31. doi: 10.1007/s10554-012-0057-x. Epub 2012 May 6.
We aimed to prospectively assess the optimal cutoff value for a minimum lumen cross-sectional area (CSA) on a 64-slice multidetector computed tomography (MDCT) compared with an intravascular ultrasound (IVUS). In 39 patients with 43 stents, the minimum lumen diameter, stent diameter, diameter stenosis, minimum lumen CSA, stent CSA, and area stenosis at the narrowest point were measured independently on 64-slice MDCT and IVUS images. For the assessment of diameter and CSA, 64-slice MDCT showed good correlations with IVUS (r = 0.82 for minimum lumen diameter, r = 0.66 for stent diameter, r = 0.79 for minimum lumen CSA, and r = 0.75 for stent CSA, respectively, P < 0.0001). For the assessment of diameter and area stenoses, a 64-slice MDCT showed good correlations with IVUS (r = 0.89 and 0.91, respectively, P < 0.0001). The overall sensitivity, specificity, positive predictive value, and negative predictive value to detect in-stent area restenosis (≥ 50 % area stenosis) of a 64-slice MDCT were 77, 100, 100, and 91 %, respectively. The cutoff value of a 64-slice MDCT, determined by receiver operator characteristic (ROC) analysis, was 5.0 mm(2) with 76.5 % sensitivity and 92.3 % specificity for significant in-stent area restenosis; the area under the ROC curve was 0.902 (P < 0.0001). A good correlation was found between a 64-slice MDCT and the IVUS, regarding the assessment of diameter and area stenoses of coronary stents in selected patients implanted with stents of more than 3 mm in diameter. Optimal cutoff value for the minimum lumen CSA of coronary stents on the 64-slice MDCT is 5 mm(2) to predict a CSA of 4 mm(2) on IVUS.
我们旨在前瞻性评估与血管内超声（IVUS）相比，64 层多排螺旋 CT（MDCT）上最小管腔横截面积（CSA）的最佳截断值。在 39 例 43 个支架的患者中，分别在 64 层 MDCT 和 IVUS 图像上独立测量最小管腔直径、支架直径、直径狭窄度、最小管腔 CSA、支架 CSA 和最狭窄点的面积狭窄度。对于直径和 CSA 的评估，64 层 MDCT 与 IVUS 显示出良好的相关性（最小管腔直径 r = 0.82，支架直径 r = 0.66，最小管腔 CSA r = 0.79，支架 CSA r = 0.75，均 P <0.0001）。对于直径和面积狭窄度的评估，64 层 MDCT 与 IVUS 显示出良好的相关性（r = 0.89 和 0.91，均 P <0.0001）。64 层 MDCT 检测支架内面积再狭窄（≥50%面积狭窄）的总体敏感性、特异性、阳性预测值和阴性预测值分别为 77%、100%、100%和 91%。通过接受者操作特征（ROC）分析确定的 64 层 MDCT 的截断值为 5.0mm²，对有意义的支架内面积再狭窄的敏感性为 76.5%，特异性为 92.3%；ROC 曲线下面积为 0.902（P <0.0001）。在选定的植入直径大于 3mm 的支架的患者中，64 层 MDCT 与 IVUS 之间在评估冠状动脉支架的直径和面积狭窄方面具有良好的相关性。64 层 MDCT 上冠状动脉支架最小管腔 CSA 的最佳截断值为 5mm²，以预测 IVUS 上 4mm² 的 CSA。
