Lee Yoon Seong, Park Eun-Ah, Lee Whal
J Korean Soc Radiol. 2024 Mar;85(2):258-269. doi: 10.3348/jksr.2024.0026. Epub 2024 Mar 27.
Treatment of patients with coronary artery disease commonly involves the use of balloon-expandable stent placements, currently recognized as the most prevalent approach for coronary artery revascularization. Nevertheless, the occurrence of restenosis remains a significant complication following percutaneous coronary interventions. The diagnostic role of coronary CT angiography (CCTA) in detecting stent restenosis has limitations primarily attributable to challenges in accurately discerning the lumen, due to issues such as blooming and motion artifacts. As a result, many cases often necessitate a transition to conventional coronary angiography. However, recent advancements in CT technology have led to notable improvements in both sensitivity and specificity, underscoring the growing significance of CCTA as a diagnostic tool. The consistent reporting of high negative predictive value is particularly noteworthy. This review aims to explore the historical context, current status, and recent trends in diagnosing coronary artery stent restenosis using CCTA.
冠状动脉疾病患者的治疗通常涉及使用球囊扩张式支架植入,这是目前公认的冠状动脉血运重建最普遍的方法。然而,再狭窄的发生仍然是经皮冠状动脉介入治疗后的一个重大并发症。冠状动脉CT血管造影(CCTA)在检测支架再狭窄方面的诊断作用存在局限性,主要是由于诸如伪影和运动伪影等问题,难以准确辨别管腔。因此,许多病例往往需要转而进行传统冠状动脉造影。然而,CT技术的最新进展已使灵敏度和特异性都有显著提高,凸显了CCTA作为一种诊断工具的重要性日益增加。高阴性预测值的持续报告尤其值得注意。本综述旨在探讨使用CCTA诊断冠状动脉支架再狭窄的历史背景、现状和最新趋势。