Interventional Cardiology Unit, Heart Disease Institute, Hospital Universitari de Bellvitge, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, Barcelona 08907, Spain.
Heart. 2013 Aug;99(15):1106-12. doi: 10.1136/heartjnl-2013-303679. Epub 2013 May 30.
To evaluate the agreement between multislice CT (MSCT) and intravascular ultrasound (IVUS) to assess the in-stent lumen diameters and lumen areas of left main coronary artery (LMCA) stents.
Prospective, observational single centre study.
A single tertiary referral centre.
Consecutive patients with LMCA stenting excluding patients with atrial fibrillation and chronic renal failure.
MSCT and IVUS imaging at 9-12 months follow-up were performed for all patients.
Agreement between MSCT and IVUS minimum luminal area (MLA) and minimum luminal diameter (MLD). A receiver operating characteristic (ROC) curve was plotted to find the MSCT cut-off point to diagnose binary restenosis equivalent to 6 mm(2) by IVUS.
52 patients were analysed. Passing-Bablok regression analysis obtained a β coefficient of 0.786 (0.586 to 1.071) for MLA and 1.250 (0.936 to 1.667) for MLD, ruling out proportional bias. The α coefficient was -3.588 (-8.686 to -0.178) for MLA and -1.713 (-3.583 to -0.257) for MLD, indicating an underestimation trend of MSCT. The ROC curve identified an MLA ≤ 4.7 mm(2) as the best threshold to assess in-stent restenosis by MSCT.
Agreement between MSCT and IVUS to assess in-stent MLA and MLD for LMCA stenting is good. An MLA of 4.7 mm(2) by MSCT is the best threshold to assess binary restenosis. MSCT imaging can be considered in selected patients to assess LMCA in-stent restenosis.
评估多层螺旋 CT（MSCT）与血管内超声（IVUS）评估左主干冠状动脉（LMCA）支架内管腔直径和管腔面积的一致性。
前瞻性、观察性单中心研究。
一家单一的三级转诊中心。
连续接受 LMCA 支架置入术的患者，不包括心房颤动和慢性肾功能衰竭的患者。
对所有患者进行 9-12 个月的 MSCT 和 IVUS 成像。
MSCT 和 IVUS 最小管腔面积（MLA）和最小管腔直径（MLD）的一致性。绘制受试者工作特征（ROC）曲线，以找到 MSCT 截止点，以诊断等效于 IVUS 6mm²的二元再狭窄。
分析了 52 例患者。通过 Passing-Bablok 回归分析，MLA 的β系数为 0.786（0.586-1.071），MLD 的β系数为 1.250（0.936-1.667），排除了比例偏差。MLA 的α系数为-3.588（-8.686-0.178），MLD 的α系数为-1.713（-3.583-0.257），表明 MSCT 存在低估趋势。ROC 曲线确定 MLA≤4.7mm²是评估 MSCT 支架内再狭窄的最佳阈值。
MSCT 与 IVUS 评估 LMCA 支架内 MLA 和 MLD 的一致性良好。MSCT 测量的 MLA 为 4.7mm² 是评估二元再狭窄的最佳阈值。在选定的患者中，可以考虑使用 MSCT 成像来评估 LMCA 支架内再狭窄。
