Authors:
Zsolt Szelid Heart Center, Semmelweis University, Budapest, Hungary
Department of Cardiology, National Healthcare Center, Budapest, Hungary
Pozitron Diagnostic Center, Budapest, Hungary
Heart Center, Semmelweis University, Városmajor u. 68, H-1122, Budapest, Hungary

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G. Kerecsen Heart Center, Semmelweis University, Budapest, Hungary
Department of Cardiology, National Healthcare Center, Budapest, Hungary
Pozitron Diagnostic Center, Budapest, Hungary

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P. Maurovich-Horvat Heart Center, Semmelweis University, Budapest, Hungary
Department of Cardiology, National Healthcare Center, Budapest, Hungary
Pozitron Diagnostic Center, Budapest, Hungary

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Á. Lux Heart Center, Semmelweis University, Budapest, Hungary
Department of Cardiology, National Healthcare Center, Budapest, Hungary
Pozitron Diagnostic Center, Budapest, Hungary

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E. Marosi Heart Center, Semmelweis University, Budapest, Hungary
Department of Cardiology, National Healthcare Center, Budapest, Hungary
Pozitron Diagnostic Center, Budapest, Hungary

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A. Kovács Heart Center, Semmelweis University, Budapest, Hungary
Department of Cardiology, National Healthcare Center, Budapest, Hungary
Pozitron Diagnostic Center, Budapest, Hungary

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R. G. Kiss Heart Center, Semmelweis University, Budapest, Hungary
Department of Cardiology, National Healthcare Center, Budapest, Hungary
Pozitron Diagnostic Center, Budapest, Hungary

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I. Préda Heart Center, Semmelweis University, Budapest, Hungary
Department of Cardiology, National Healthcare Center, Budapest, Hungary
Pozitron Diagnostic Center, Budapest, Hungary

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B. Merkely Heart Center, Semmelweis University, Budapest, Hungary
Department of Cardiology, National Healthcare Center, Budapest, Hungary
Pozitron Diagnostic Center, Budapest, Hungary

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Abstract

Diagnostic accuracy of 64-slice CT angiography in the evaluation of in-stent restenosis is improved compared to previous CT methods. The image quality and exact diagnostic performance is, however, limited by several method, stent and patient-related factors. In this retrospective multicenter study the first results with dual source 64-slice scanner are presented in a Hungarian post PCI patient population (n=99). Radiation dose was 11.3±5.2 mSv (average±STD) using a helical scan. In 5.6% of all (n=142) examined stents clinicians were not able to give a final diagnosis using CT scan. This limitation showed correlation with the stent diameter. Nondiagnostic stents were smaller compared to the diagnostic stents (diameter 2.4±0.2 mm versus 3.2±0.5 mm, average±STD, respectively, P<0.01). Despite its high negative predictive value in the detection of restenosis, positive predictive value of CTA is lower, than that of invasive angiography. CT was not powerful enough in our study to distinguish vessel occlusion from severe restenosis. Heart rate was decreased by administration of intravenous metoprolol and in 75.8% of the patients scan was performed at a heart rate over 70 beats/minute, which did not have a significant influence on the diagnostic value.

  • 1. I.M. Singh S.J. Filby F.E. Sakr et al.2009 Clinical outcomes of drug-eluting versus bare-metal in-stent restenosis Catheter Cardiovasc Interv 75 338 342.

    • Search Google Scholar
    • Export Citation
  • 2. D.R. Holmes M.B. Leon J.W. Moses et al.2004 Analysis of 1-year clinical outcomes in the SIRIUS trial: A randomized trial of a sirolimuseluting stent versus a standard stent in patients at high risk for coronary restenosis Circulation 109 634 640.

    • Search Google Scholar
    • Export Citation
  • 3. Mowatt G , Cummins E, Waugh N et al.: Systematic review of the clinical effectiveness and cost-effectiveness of 64-slice or higher computed tomography angiography as an alternative to invasive coronary angiography in the investigation of coronary artery disease. Health Technol Assess 12, iii–iv, ix143 (2008).

    • Search Google Scholar
    • Export Citation
  • 4. Nemeskéri B. Matlakovics I. Dudás et al.2009 Combination of post mortem coronary angiography, corrosion cast method and multislice computed tomography (MSCT) for diagnostic improvement in pathology and forensics IMAS 1 20 34.

    • Search Google Scholar
    • Export Citation
  • 5. Z. Sun A.M.D. Almutairi 2008 Diagnostic accuracy of 64 multislice CT angiography in the assessment of coronary in-stent restenosis: A meta-analysis Eur J Radiol 73 266 273.

    • Search Google Scholar
    • Export Citation
  • 6. H. Brodoefel C. Burgstahler I. Tsiflikas et al.2008 Dual-source CT: Effect of heart rate, heart rate variability, and calcification on image quality and diagnostic accuracy Radiology 247 346 355.

    • Search Google Scholar
    • Export Citation
  • 7. P. Maurovich-Horvath G. Kerecsen I. Préda et al.2009 Technical background and clinical application of coronary CT angiography Orvosképzés 84 107 113.

    • Search Google Scholar
    • Export Citation
  • 8. J. Hausleiter T. Meyer F. Hermann et al.2009 Estimated radiation dose associated with cardiac CT angiography JAMA 301 500 507.

  • 9. P.A. Araoz J. Kirsch A.N. Primak et al.2009 Optimal image reconstruction phase at low and high heart rates in dual-source CT coronary angiography Int J Cardiovasc Imaging 25 837 845.

    • Search Google Scholar
    • Export Citation
  • 10. M.J. Budoff S. Achenbach R.S. Blumenthal et al.2006 Assessment of coronary artery disease by cardiac computed tomography: A scientific statement from the American Heart Association Committee on Cardiovascular Imaging and Intervention, Council on Cardiovascular Radiology and Intervention, and Committee on Cardiac Imaging, Council on Clinical Cardiology Circulation 114 1761 1791.

    • Search Google Scholar
    • Export Citation
  • 11. M. Hamon L. Champ-Rigot R. Morello J.W. Riddell M. Hamon 2008 Diagnostic accuracy of in-stent coronary restenosis detection with multislice spiral computed tomography: A meta-analysis Eur Radiol 18 217 225.

    • Search Google Scholar
    • Export Citation
  • 12. Zhao L , Zhang Z, Fan Z, Yang L, Du J: Prospective versus retrospective ECG gating for dual source CT of the coronary stent: Comparison of image quality, accuracy, and radiation dose. Eur J Radiol DOI: (2009).

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13. Haraldsdottir S , Gudnason T, Sigurdsson AF et al.: Diagnostic accuracy of 64-slice multidetector CT for detection of in-stent restenosis in an unselected, consecutive patient population. Eur J Radiol DOI:.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14. D. Maintz M.C. Burg H. Seifarth et al.2009 Update on multidetector coronary CT angiography of coronary stents: In vitro evaluation of 29 different stent types with dual-source CT Eur Radiol 19 42 49.

    • Search Google Scholar
    • Export Citation
  • 15. J. Horiguchi C. Fujioka M. Kiguchi et al.2009 Prospective ECG-triggered axial CT at 140-kV tube voltage improves coronary in-stent restenosis visibility at a lower radiation dose compared with conventional retrospective ECG-gated helical CT European Radiology 19 2363 2372.

    • Search Google Scholar
    • Export Citation
  • 16. T. Pflederer M. Marwan A. Renz et al.2009 Noninvasive assessment of coronary in-stent restenosis by dual-source computed tomography The American Journal of Cardiology 103 812 817.

    • Search Google Scholar
    • Export Citation
  • 17. D. Kumbhani C. Ingelmo P. Schoenhagen et al.2009 Meta-analysis of diagnostic efficacy of 64-slice computed tomography in the evaluation of coronary in-stent restenosis The American Journal of Cardiology 103 1675 1681.

    • Search Google Scholar
    • Export Citation
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2019  
Scimago
H-index
11
Scimago
Journal Rank
0,220
Scimago
Quartile Score
Medicine (miscellaneous) Q3
Scopus
Cite Score
155/133=1,2
Scopus
Cite Score Rank
General Medicine 199/529 (Q2)
Scopus
SNIP
0,343
Scopus
Cites
206
Scopus
Documents
23

 

Interventional Medicine and Applied Science
Language English
Size  
Year of
Foundation
2009
Publication
Programme
changed title
Volumes
per Year
 
Issues
per Year
 
Founder Akadémiai Kiadó
Founder's
Address
H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Publisher Akadémiai Kiadó
Publisher's
Address
H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Responsible
Publisher
Chief Executive Officer, Akadémiai Kiadó
ISSN 2061-1617 (Print)
ISSN 2061-5094 (Online)

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