Objective To evaluate the diagnostic accuracy of coronary artery in-stent restenosis with 320 dynamic volume computed tomography in comparison of selective coronary angiography.
Methods Two hundred and eight patients with suspected coronary artery in-stent restenosis underwent 320-DVCT coronary angiography, and selective coronary angiography was performed within 2 to 7 days subsequently.
Results The images acquired from 320-DVCT were excellent and sufficient enough to be used to evaluate coronary in -stent restenosis. For the stents with diameter of more than 3.0 mm, the image of optimization rate and success rate are significantly higher than those with a diameter of <3.0 mm. The sensitivity, specificity, positive and negative predictive value, rate of accuracy of 320-DVCT for detecting in-stent restenosis were 91.30%, 95.21%, 86.3%, 97.07% and 94.24%, respectively. The sensitivity, specificity, positive and negative predictive value, rate of accuracy of in-stent restenosis in the left anterior descending stent were 89.29%, 96.77%, 89.29%, 96.77% and 95.04%, respectively. The sensitivity, specificity, positive and negative predictive value, rate of accuracy of in-stent restenosis in the left circumflex stent were 88.89%, 92.73% , 80.00%, 96.23% and 91.78%, respectively. The sensitivity, specificity, positive and negative predictive value, rate of accuracy rate of in-stent restenosis in the right coronary artery stent were 88.00%, 94.92%, 88.00%, 94.92% and 92.86%, respectively.
Conclusions 320-DVCT angiography is a safe, noninvasive and effective method for the diagnosis of coronary in-stent restenosis at present.