Evaluation of in-stent restenosis in coronary arteries with 64 multislice computed tomography

Objective: To evaluate the diagnostic accuracy of coronary in-stent restenosis using 64- slice multislice computed tomography (MSCT) coronary angiography. Methods: Fifty nine patients after stent implantation with 112 coronary stents were examined with 64-section MSCT. Scanning was undertaken by electrocardiographically gated, but an automatic bolus-tracking method. For image reconstruction, an edgeenhancing kernel (B46f)was applied. All segments within stent were assessed by two observers in consensus, and were graded according to the following scheme: patient stent, in-stent intimal hyperplasia (lumen reduction <50%), in-stent restenosis ( =>50%). Consensus reading was compared with those of coronary angiography. Results: 109 stented lesions (97.3%) were classified as evaluable in MSCT. Overall, 10 of 12 in-stent restenosis were correctly detected by MSCT. Sensitivity, specificity, positive predictive value, and negative predictive value were 83.3%, 99%, 90.9%, and 97.3%, respectively. Conclusion: 64-MSCT has high diagnostic accuracy for detecting in-stent restenosis, indicating and suggesting as a useful tool for the follow up after coronary stenting. (authors)