(Circulation. 1997;96:2785-2788.)
© 1997 American Heart Association, Inc.
Articles |
Detection of High-Grade Restenosis After PTCA Using Contrast-Enhanced Electron Beam CT
From the Department of Internal Medicine II, University of Erlangen-Nürnberg (Germany).
Correspondence to Dr med Stephan Achenbach, Medizinische Klinik II, Universität Erlangen-Nürnberg, Östliche Stadtmauerstr 29, 91054 Erlangen, Germany. E-mail stephan.achenbach{at}stud.uni-erlangen.de
Background Contrast-enhanced electron beam computed tomography (EBCT) has been shown to permit noninvasive visualization of the coronary arteries. We determined the value of EBCT to noninvasively detect high-grade restenosis after percutaneous transluminal coronary angioplasty (PTCA).
Methods and Results Fifty patients (37 to 68 years of age), were investigated by EBCT at a mean interval of 9 months after PTCA of coronary artery stenoses. Forty axial cross-sections of the heart (3-mm slice thickness, 1-mm overlap) were acquired triggered to the ECG after intravenous injection of contrast agent. Three-dimensional reconstructions of the coronary arteries were rendered with a lower threshold of 80 HU to selectively visualize the contrast-enhanced vessel lumen. EBCT results were compared with conventional quantitative coronary angiography (QCA) performed within 1 week. In 6 patients, the PTCA segment could not be evaluated because of impaired image quality. Sixteen of the remaining 44 patients had high-grade restenoses in QCA (>70% diameter reduction), which was correctly detected by EBCT in 15 cases (94% sensitivity). There were 5 false-positive EBCT results of high-grade restenosis (82% specificity).
Conclusions EBCT with intravenous injection of contrast agent permits the noninvasive diagnosis of restenosis after PTCA, with high sensitivity and sufficient specificity.
Key Words: angioplasty • computed tomography • follow-up studies • imaging • stenosis
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