Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, #600, Yishan Rd, Shanghai, 200233, China.
Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, #600, Yishan Rd, Shanghai, China.
Eur Radiol. 2018 Jun;28(6):2647-2654. doi: 10.1007/s00330-017-5256-3. Epub 2018 Jan 18.
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.
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.
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).
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.
• 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%.
利用第三代双源 CT 研究大（≥3mm）小（＜3mm）口径支架的低剂量支架成像的诊断性能。
前瞻性纳入疑似支架内再狭窄（ISR）的有症状患者。在 1 个月内进行冠状动脉计算机断层血管造影（CCTA）和有创冠状动脉造影（ICA）以进行相关性分析。将二进制 ISR 定义为支架内新生内膜增殖导致的管腔狭窄≥50%。还评估了 CCTA 的辐射剂量和图像质量。
最终纳入 69 例患者的 140 个支架进行分析。所有患者 CCTA 的平均总辐射剂量为 1.3±0.72mSv，高螺距采集的患者为 0.95±0.17mSv。基于患者、基于病变和基于支架的 CCTA 支架成像的总体诊断准确性分别为 95.7%、94.1%和 94.3%。此外，CCTA 在小口径支架组（直径＜3mm）的诊断准确性略低于大口径支架组（直径≥3mm）（88.5%对 98.7%，p=0.01）。
第三代双源 CT 能够准确诊断大、小口径支架的冠状动脉 ISR。在保留图像质量的情况下可实现低辐射剂量。
•第三代 DSCT 能够准确诊断所有大小支架的冠状动脉 ISR。•在保留图像质量的情况下可实现低辐射剂量。•小口径支架的 CCTA 诊断准确性为 88.5%。
