CTMRI在评价缺血性心脏病中地作用.pptVIP

Example of evidence of neointimal proliferation but the stent is patent. The long axis views of the proximal LAD suggest that the stent appears patent but the metal around the stent does cause blurring artifact and attenuation. One of the advantages of CT is that you can see in the short axis. This shows the view from the short axis: You see areas of hyperattenuation which suggests soft tissue or neointimal proliferation. This is confirmed by the images by X ray angiography The bottom panel shows complete occlusion of the stent. From the long axis view, you can see there is hyperattenutation in the stent center which suggests occlusion. This is confirmed on the long axis view and complete stent occlusion. Results are promising but if there is a high suspicion of instent restenosis,need to do cath. OBJECTIVE. Dual-source CT has excellent temporal resolution and allows good visualization of coronary vessels without heart rate control. Our aim was to evaluate the diagnostic performance of dual-source CT in the evaluation of coronary stent patency to determine whether the good temporal resolution would improve visualization of stents. SUBJECTS AND METHODS. Thirty-five consecutively registered patients (10 women, 25 men; mean age, 65 years) with 48 stents were examined prospectively without heart rate controlling agents. Observers evaluating image quality and patency of the stents were blinded to the results of invasive coronary angiography. In-stent restenosis was defined as more than 50% narrowing of the lumen. RESULTS. All stents were considered assessable for diagnosis with dual-source CT. In 85% (41/48) of the stents, image quality was good. Only two patent stents were misidentified as being stenotic. All other stents with stenosis and occlusion were correctly diagnosed. The sensitivity, specificity, positive and negative predictive values, and accuracy of dual-source CT in the detection of in-stent restenosis and occlusion were 100%, 94%, 89%, 100%, and 9