New diagnostic technique in multi-slice computed tomography for in-stent restenosis: Pixel count method
New diagnostic technique in multi-slice computed tomography for in-stent restenosis: Pixel count method
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DOI：
10.1016/j.ijcard.2005.05.013
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发表时间：
2006-04-04
影响因子：
3.5
通讯作者：
Andou, T
中科院分区：
文献类型：
--
作者：
Ohnuki, K;Yoshida, S;Andou, T
目的：发展多（16）层计算机断层扫描（MSCT）客观判断冠状动脉支架内狭窄的诊断技术，并与临床病例中的冠状动脉造影（CAG）进行比较。 背景：MSCT有望取代冠状动脉造影成为一种新的无创检查。一般认为用CT评估高度钙化或支架内病灶是困难的。方法：对连续16例植入冠状动脉支架的患者中的20个病灶进行MSCT和CAG随访时检查。通过多平面重建 (MPR) 以 1.5 mm 的间隔重建支架的短轴横截面。统计支架外近端标准截面中CT值高于最低CT值的像素，判断是否存在狭窄病变。结果：20个病变中，1例无法进行MSCT评估。 MSCT 正确检出 4 例支架内狭窄病例中的 3 例（敏感性 75%），16 例无支架内狭窄病例中正确检出 14 例（特异性 88%，阴性预测值 93%，阳性预测值 75%）。如果按动脉进行分析，检测支架内狭窄的敏感性和特异性分别为 100%（3 个中的 3 个）和 87%（15 个中的 13 个）。 结论：本研究旨在检验一种独特的诊断技术：像素计数法，用于通过 MSCT 诊断冠状动脉支架内狭窄。结果表明，当支架支柱成像清晰时，可以确定冠状动脉支架内狭窄程度。各种支架需要进一步检查，特别是直径为3.0 min或更小的支架。 (c) 2005 Elsevier Ireland Ltd. 保留所有权利。
Objectives: A diagnostic technique to objectively determine coronary in-stent stenosis was developed with multi(16)-slice computed tomography (MSCT), and it was compared with coronary angiography (CAG) in clinical cases.Background: MSCT is expected to replace coronary angiography as a new non-invasive examination. Evaluation of highly calcified or instent lesions with CT is generally thought to be difficult.Methods: Twenty lesions among 16 consecutive patients that were implanted with coronary stents were examined with both MSCT and CAG at follow-tip. The minor axis cross sections of the stents were reconstructed at intervals of 1.5 mm with multiplanar reformation (MPR). The pixel with a higher CT value than the lowest CT value in the standard cross section at the proximal site out of stent was counted to determine the presence/absence of a stenotic lesion.Results: Among 20 lesions, one case was not able to be evaluated with MSCT. MSCT correctly detected 3 of 4 cases with in-stent stenosis (sensitivity 75%), and 14 of 16 cases with no in-stent stenosis (specificity 88%, negative predictive value 93%, positive predictive value 75%). If analysis was made per-artery, sensitivity and specificity were 100% (3 of 3) and 87% (13 of 15), respectively, for detection of instent stenosis.Conclusions: This study was performed to examine a unique diagnostic technique: pixel count method, for coronary in-stent stenosis with MSCT. It showed that the coronary in-stent stenosis could be determined when stent struts were clearly imaged. Further examination is required with various stents, especially those with a diameter of 3.0 min or smaller. (c) 2005 Elsevier Ireland Ltd. All rights reserved.