Multidetector computed tomography angiography for assessment of in-stent restenosis: Meta-analysis of diagnostic performance

被引：15

作者：

Vanhoenacker P.K. ^{[1
]}

Decramer I. ^{[1
,2
]}

Bladt O. ^{[1
]}

Sarno G. ^{[2
]}

Van Hul E. ^{[1
]}

Wijns W. ^{[2
]}

Dwamena B.A. ^{[3
]}

机构：

[1] Department of Radiology and Imaging, OLV Ziekenhuis, Aalst

[2] Cardiovascular Center Aalst, Aalst

[3] Division of Nuclear Medicine, Department of Radiology, University of Michigan Health System, Ann Arbor, MI

来源：

BMC Medical Imaging | / 8卷 / 1期

关键词：

Diagnostic Performance; Negative Likelihood Ratio; Positive Likelihood Ratio; Stent Patency; Stent Diameter;

D O I：

10.1186/1471-2342-8-14

中图分类号：

学科分类号：

摘要：

Background: Multi-detector computed tomography angiography (MDCTA)of the coronary arteries after stenting has been evaluated in multiple studies. The purpose of this study was to perform a structured review and meta-analysis of the diagnostic performance of MDCTA for the detection of in-stent restenosis in the coronary arteries. Methods: A Pubmed and manual search of the literature on in-stent restenosis (ISR) detected on MDCTA compared with conventional coronary angiography (CA) was performed. Bivariate summary receiver operating curve (SROC) analysis, with calculation of summary estimates was done on a stent and patient basis. In addition, the influence of study characteristics on diagnostic performance and number of non-assessable segments (NAP) was investigated with logistic meta-regression. Results: Fourteen studies were included. On a stent basis, Pooled sensitivity and specificity were 0.82(0.72-0.89) and 0.91 (0.83-0.96). Pooled negative likelihood ratio and positive likelihood ratio were 0.20 (0.13-0.32) and 9.34 (4.68-18.62) respectively. The exclusion of non-assessable stents and the strut thickness of the stents had an influence on the diagnostic performance. The proportion of non-assessable stents was influenced by the number of detectors, stent diameter, strut thickness and the use of an edge-enhancing kernel. Conclusion: The sensitivity of MDTCA for the detection of in-stent stenosis is insufficient to use this test to select patients for further invasive testing as with this strategy around 20% of the patients with in-stent stenosis would be missed. Further improvement of scanner technology is needed before it can be recommended as a triage instrument in practice. In addition, the number of non-assessable stents is also high. © 2008 Vanhoenacker et al; licensee BioMed Central Ltd.

引用

共 48 条

[1]

Kiemeneij F., Serruys P.W., Macaya C., Rutsch W., Heyndrickx G., Albertsson P., Fajadet J., Legrand V., Materne P., Belardi J., Sigwart U., Colombo A., Goy J.J., Disco C.M., Morel M.A., Continued benefit of coronary stenting versus balloon angioplasty: Five-year clinical follow-up of Benestent-I trial, J Am Coll Cardiol, 37, pp. 1598-1603, (2001)

[2]

Morice M.C., Serruys P.W., Sousa J.E., Fajadet J., Ban H.E., Perin M., Colombo A., Schuler G., Barragan P., Guagliumi G., Molnar F., Falotico R., A randomized comparison of a sirolimus-eluting stent with a standard stent for coronary revascularization, N Engl J Med, 346, pp. 1773-1780, (2002)

[3]

Roiron C., Sanchez P., Bouzamondo A., Lechat P., Montalescot G., Drug eluting stents: An updated meta-analysis of randomised controlled trials, Heart, 92, pp. 641-649, (2006)

[4]

Johnson L.W., Krone R., Cardiac catheterization 1991: A report of the Registry of the Society for Cardiac Angiography and Interventions (SCA&I), Cathet Cardiovasc Diagn, 28, pp. 219-220, (1993)

[5]

Scanlon P.J., Faxon D.P., Audet A.M., Carabello B., Dehmer G.J., Eagle K.A., Legako R.D., Leon D.F., Murray J.A., Nissen S.E., Pepine C.J., Watson R.M., Ritchie J.L., Gibbons R.J., Cheitlin M.D., Gardner T.J., Garson Jr. A., Russell Jr. R.O., Ryan T.J., Smith Jr. S.C., ACC/AHA guidelines for coronary angiography: Executive summary and recommendations. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Coronary Angiography) d

[6]

Wyman R.M., Safian R.D., Portway V., Skillman J.J., McKay R.G., Baim D.S., Current complications of diagnostic and therapeutic cardiac catheterization, J Am Coll Cardiol, 12, pp. 1400-1406, (1988)

[7]

Schuijf J.D., Bax J.J., Jukema J.W., Lamb H.J., Warda H.M., Vliegen H.W., de R.A., Wall E.E., Feasibility of assessment of coronary stent patency using 16-slice computed tomography, Am J Cardiol, 94, pp. 427-430, (2004)

[8]

Cademartiri F., Mollet N., Lemos P.A., Pugliese F., Baks T., McFadden E.P., Krestin G.P., de Feyter P.J., Usefulness of multislice computed tomographic coronary angiography to assess in-stent restenosis, Am J Cardiol, 96, pp. 799-802, (2005)

[9]

Gilard M., Cornily J.C., Rioufol G., Finet G., Pennec P.Y., Mansourati J., Blanc J.J., Boschat J., Noninvasive assessment of left main coronary stent patency with 16-slice computed tomography, Am J Cardiol, 95, pp. 110-112, (2005)

[10]

Gaspar T., Halon D.A., Lewis B.S., Adawi S., Schliamser J.E., Rubinshtein R., Flugelman M.Y., Peled N., Diagnosis of coronary in-stent restenosis with multidetector row spiral computed tomography, J Am Coll Cardiol, 46, pp. 1573-1579, (2005)

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