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Yun J, Shen Y, He Y, Gong B, Liu M, Wu X, Xu J. Exploring the value of the double source CT angiography in diagnosing in-stent restenosis in lower limb artery. Vascular 2020; 28:267-273. [PMID: 31924148 DOI: 10.1177/1708538119899317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This paper is aimed to explore the value of double source CT angiography (DS-CTA) for diagnosing in-stent restenosis in lower limb artery. METHODS From January 2016 to October 2018, all patients with stent in lower limb artery in our hospital were investigated by both DS-CTA and digital subtraction angiography. We measured the minimum lumen diameter and the diameter of the proximal normal vessels under each stent placement. The in-stent restenosis is defined as restenosis when the lumen area decreased by more than 50%. Digital subtraction angiography was performed within 1 week after DS-CT scan. Relationship between DS-CTA and digital subtraction angiography for diagnosing in-stent restenosis in lower limb artery was analyzed. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of DS-CTA for diagnosis of in-stent restenosis were analyzed with digital subtraction angiography as the reference standard. A total of 68 stents were placed in 51 patients. Among these patients, 27 cases were diagnosed as in-stent restenosis, presenting as endovascular contrast agent bias or crescent filling defect with the lumen area reducing over 50%, 6 cases of which had no significant in-stent restenosis by digital subtraction angiography analysis. Furthermore, 12 cases were occlusion, in which there was no high density contrast agent in stents; the remaining 41 stents were unobstructed and the contrast agent was filled well, 8 cases of which had significant in-stent restenosis by digital subtraction angiography analysis. In addition, four stents were deformed or distorted. Statistical analysis demonstrated the concentrations of DS-CTA and digital subtraction angiography in diagnosing in-stent restenosis for lower limb artery were closely related, and the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of DS-CTA were 72.4%, 84.6%, 77.8%, 80.5%, and 79.4%, respectively. CONCLUSION DS-CTA has a potential reliability for diagnosis of in-stent restenosis in lower limb artery, which may be further improved to be used for clinical interventional treatment of vascular diseases.
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Affiliation(s)
- Jian Yun
- Department of Radiology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, China.,Department of Radiology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, China
| | - Ye Shen
- Department of Radiology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, China.,Department of Radiology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, China
| | - Yun He
- Department of Radiology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, China.,Department of Radiology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, China
| | - Bo Gong
- Department of Radiology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, China.,Department of Radiology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, China
| | - Minhai Liu
- Department of Radiology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, China.,Department of Radiology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, China
| | - Xiaosong Wu
- Department of Radiology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, China.,Department of Radiology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, China
| | - Jianxing Xu
- Department of Radiology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, China.,Department of Radiology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, China
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Liu HF, Wang M, Xu YS, Shrestha MK, Lu XR, Lei JQ. Diagnostic accuracy of dual-source and 320-row computed tomography angiography in detecting coronary in-stent restenosis: a systematic review and meta-analysis. Acta Radiol 2019; 60:149-159. [PMID: 29758995 DOI: 10.1177/0284185118774956] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Dual-source and 320-row computed tomography angiography (CTA) are increasingly used in diagnosing coronary in-stent restenosis (CISR). PURPOSE We sought to perform this meta-analysis to evaluate the diagnostic accuracy of dual-source computed tomography angiography (DSCTA) and 320-row CTA in detecting CISR when compared to invasive coronary angiography. MATERIAL AND METHODS Five scientific databases (PubMed, Embase, Scopus, The Cochrane Library, and Web of Science) were searched for research studies in which DSCTA and/or 320-row CTA were used as diagnostic tools for CISR, as recently as October 2017. Study inclusion, data extraction, systematic review, pooled meta-analysis, and subgroup analysis were conducted by two researchers independently. RESULTS Thirteen studies with 1384 assessable stents on DSCTA and five studies including 622 assessable stents on 320-row CTA were finally included. The sensitivity, specificity, and area under the curve (AUC) of DSCTA in diagnosing CISR were 0.92 (0.87-0.96), 0.91 (0.87-0.94), and 0.97 (0.95-0.98), respectively, and they were 0.91 (0.82-0.96), 0.95 (0.88-0.98), and 0.96 (0.94-0.97) for 320-row CTA. Subgroup analysis result suggested that DSTCA performed significantly better in CISR detection when the stent diameter was ≥ 3 mm compared to stent diameter < 3 mm: 0.98 (0.97-0.99) vs. 0.82 (0.79-0.86) with P < 0.05. CONCLUSION Our meta-analysis indicated both DSCTA and 320-row CTA had high diagnostic accuracy in detecting CISR and may serve as alternatives for further patient evaluation with CISR, especially for stent diameters ≥ 3 mm.
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Affiliation(s)
- Hai Feng Liu
- Department of Radiology, First Hospital of LanZhou University, Lanzhou, Gansu, PR China
| | - Min Wang
- Department of Anesthesia, First Hospital of LanZhou University, Lanzhou, Gansu, PR China
| | - Yong Sheng Xu
- Department of Radiology, First Hospital of LanZhou University, Lanzhou, Gansu, PR China
| | - Manish Kumar Shrestha
- Department of Radiology, First Hospital of LanZhou University, Lanzhou, Gansu, PR China
| | - Xing Ru Lu
- Department of Radiology, First Hospital of LanZhou University, Lanzhou, Gansu, PR China
| | - Jun Qiang Lei
- Department of Radiology, First Hospital of LanZhou University, Lanzhou, Gansu, PR China
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Liu WJ, Li GZ, Liu HF, Lei JQ. Diagnostic accuracy of dual-source computed tomography angiography for the detection of coronary in-stent restenosis: A systematic review and meta-analysis. Echocardiography 2018; 35:541-550. [PMID: 29569751 DOI: 10.1111/echo.13863] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
We sought to perform a meta-analysis to comprehensively evaluate the diagnostic accuracy of dual-source computed tomography angiography (DSCTA) in detecting coronary in-stent restenosis (CISR) when compared to invasive coronary angiography. The stent-based research studies in which DSCTA was used as diagnostic tool for CISR, as recent as of October 2017, from several reputed scientific libraries (PubMed, Embase, Scopus, The Cochrane Library, and Web of Science) were evaluated. Study inclusion, data extraction, and risk bias assessment were conducted by two researchers independently. Pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under summary receiver operator characteristics (SROC) curve (AUC) were calculated to assess the diagnostic value. In addition, heterogeneity and subgroup analysis were also carried out. A total of 13 studies with a total of 894 patients and 1384 assessable stents were included. The pooled results of DSCTA diagnosing CISR were as follows: SEN 0.92 (95% confidence interval [CI] 0.87-0.96), SPE 0.91 (95% CI 0.87-0.94), PLR 9.83 (95% CI 6.93-13.94), NLR 0.09 (95% CI 0.05-0.15), DOR 114.73 (95% CI 64.12-205.28), and AUC 0.97 (95% CI 0.95-0.98), respectively. The subgroup analysis result suggested that DSTCA performed significantly better in CISR detection when the stent diameter was ≥3 mm compared with the stent diameter <3 mm: (0.98 [0.97-0.99] vs 0.82 [0.79-0.86]) with P < .05. This study revealed that DSCTA has excellent diagnostic performance for detecting CISR and may serve as an alternative for further patient evaluation with CISR, especially for stent diameter ≥3 mm.
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Affiliation(s)
- Wen-Jun Liu
- Department of Radiology, Qingyang City Hospital of Traditional Chinese Medcine, Qingyang, Gansu, China
| | - Gui-Zhen Li
- Department of Radiology, Qingyang City Hospital of Traditional Chinese Medcine, Qingyang, Gansu, China
| | - Hai-Feng Liu
- Department of Radiology, First Hospital of LanZhou University, Lanzhou, Gansu, China
| | - Jun-Qiang Lei
- Department of Radiology, First Hospital of LanZhou University, Lanzhou, Gansu, China
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Christian TF. The unsaid word. J Nucl Cardiol 2017; 24:1054-1056. [PMID: 28540629 DOI: 10.1007/s12350-017-0886-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 03/09/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Timothy F Christian
- St Francis Hospital, The Heart Center, 100 Port Washington Blvd, Roslyn, NY, USA.
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