European Journal of Radiology
Volume 73, Issue 2 , Pages 266-273, February 2010

Diagnostic accuracy of 64 multislice CT angiography in the assessment of coronary in-stent restenosis: A meta-analysis

  • Zhonghua Sun

      Affiliations

    • Corresponding Author InformationCorresponding author. Present address: Discipline of Medical Imaging, Department of Imaging and Applied Physics, Curtin University of Technology, GPO Box U1987, Perth, WA 6845, Australia. Tel.: +61 8 9266 7509; fax: +61 8 9266 4344.
    • ,
  • Abdulrahman Marzouq D. Almutairi

Discipline of Medical Imaging, Department of Imaging and Applied Physics, Curtin University of Technology, Perth, WA, Australia

Received 7 July 2008; received in revised form 18 September 2008; accepted 28 October 2008.

Abstract 

Purpose

The aim of this study was to perform a meta-analysis of the diagnostic accuracy of 64-slice CT angiography for the detection of coronary in-stent restenosis in patients treated with coronary stents when compared to conventional coronary angiography.

Materials and methods

A search of PUBMED/MEDLINE, ProQuest and Cochrane library databases for English literature was performed. Only studies comparing 64-slice CT angiography with conventional coronary angiography for the detection of coronary in-stent restenosis (more than 50% stenosis) were included for analysis. Sensitivity and specificity estimates pooled across studies were tested using a fixed effects model.

Results

Fourteen studies met selection criteria for inclusion in the analysis. The mean value of assessable stents was 89%. Prevalence of in-stent restenosis following coronary stenting was 20% among these studies. Pooled estimates of the sensitivity and specificity of overall 64-slice CT angiography for the detection of coronary in-stent restenosis was 90% (95% CI: 86%, 94%) and 91% (95% CI: 90%, 93%), respectively, based on the evaluation of assessable stents. Diagnostic value of 64-slice CT angiography was found to decrease significantly when the analysis was performed with inclusion of nonassessable segments in five studies, with pooled sensitivity and specificity being 79% (95% CI: 68%, 88%) and 81% (95% CI: 77%, 84%). Stent diameter is the main factor affecting the diagnostic value of 64-slice CT angiography.

Conclusion

Our results showed that 64-slice CT angiography has high diagnostic value (both sensitivity and specificity) for detection of coronary in-stent restenosis based on assessable segments when compared to conventional coronary angiography.

Keywords: Multislice computed tomography, Stent, Restenosis, Coronary artery disease

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 31.50 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

PII: S0720-048X(08)00582-2

doi:10.1016/j.ejrad.2008.10.025

European Journal of Radiology
Volume 73, Issue 2 , Pages 266-273, February 2010

Article Tools

* Image Usage & Resolution