Yang Gao, Presenter: Nothing to Disclose

Bin Lu MD, Abstract Co-Author: Nothing to Disclose

Zhi-Hui Hou MD, Abstract Co-Author: Nothing to Disclose

Fang-Fang Yu, Abstract Co-Author: Nothing to Disclose

Wei-Hua Yin, Abstract Co-Author: Nothing to Disclose

Zhi-Qiang Wang, Abstract Co-Author: Nothing to Disclose

Yong-jian Wu, Abstract Co-Author: Nothing to Disclose

Chao-wei Mu, Abstract Co-Author: Nothing to Disclose

Felix G. Meinel MD, Abstract Co-Author: Nothing to Disclose

U. Joseph Schoepf MD, Abstract Co-Author: Research Grant, Bracco Group Research Grant, Bayer AG Research Grant, General Electric Company Research Grant, Siemens AG

Andrew Douglas McQuiston BS, Abstract Co-Author: Nothing to Disclose

To determine whether changes in corrected coronary opacification (CCO) across stents can identify in-stent restenosis (ISR) severity compared with invasive coronary angiography (ICA) as a reference standard.

Between September 2009 and December 2012, patients with previous stents implantation who underwent ICA for recurrent typical or atypical chest pain after coronary CT angiography (CTA) within three months were enrolled. Attenuation values of coronary lumen were measured at proximal and distal of stents and normalized to the descending aorta. Changes in CCO were calculated and CCO difference across the stent was compared with severity of ISR.

A total of 141 stents were assessed. 76 stents were normal, 18 stents had ISR < 50%, 28 stents had with ISR 50% to 99%, and 19 stents were occluded. The median of CCO difference in group of no ISR, ISR < 50%, ISR 50% to 99%, and ISR 100% were 0.078, 0.163, 0.346 and 0.606, respectively (all P < 0.01). For stents <3mm, CCO difference of no ISR and non-obstructive ISR were significantly lower than obstructive ISR and occluded (all P <0.001). To all the stents with any ISR and stents with ISR equal or more than 50%, the accuracy of ISR diagnosed by CCO (c statistic 0.934 ± 0.023 and 0.994 ± 0.004, respectively) were significant better than that of CTA alone (c statistic 0.794 ± 0.004 and 0.692 ± 0.047, respectively) (all P < 0.01).

CCO difference across coronary stents could predict ISR severity especially obstructive ISR in stents less than 3mm diameter. The performance of ISR diagnosed by CTA improved significantly when CCO difference was taken into account.

In patients with coronary in-stent restenosis, coronary CT angiography is able to help identify the difference of coronary attenuation and predict the severity of restenosis.

Gao, Y, Lu, B, Hou, Z, Yu, F, Yin, W, Wang, Z, Wu, Y, Mu, C, Meinel, F, Schoepf, U, McQuiston, A, Corrected Coronary Opacification Difference Measured with Computed Tomography Angiography Predict Coronary In-stent Restenosis.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14002456.html