Comparison Of 128 - Layer Energy Spectrum CT And 640 - Slice CT Coronary Angiography In The Diagnosis Of Stent Restenosis

Objective To compare the ability of 128-slice energy spectrum CT computed tomography coronary angiography and 640-slice CTCA in displaying the intra-lumen of coronary stent and their value in diagnosing in-stent restenosis.Methods Totally 177 patients after coronary stenting(227 metal stents) were collected, among them, 88 with 112 stents underwent 128-slice energy spectrum CTCA and 89 with 115 stents underwent 640-slice CTCA. The imaging quality and the display rate of intralumen of coronary stent were evaluated and compared between the two CTCA methods. The sensitivity, specificity, positive predictive value,negative predictive value and accuracy of the two methods in diagnosing in-stent restenosis were calculated taking CAG result as gold standards.Results The imaging quality scores of 128-slice energy spectrum CTCA(1.63±0.25) in displaying the intra-lumen of coronary stent were significantly higher than those of 640-slice CTCA(0.54±0.34,P<0.05). There was a higher display ratio of intra-lumen of coronary stent in 128-slice energy spectrum CTCA(108/112, 96.43%) compared with 640-slice CT(60/115, 52.17%, P<0.05). The sensitivity, specificity, positive predictive value,negative predictive value and accuracy in diagnosing in-stent restenosis was 100%(14/14)、90.00%(18/20)、87.50%(14/16)、100%(18/18) and 94.12%(32/34) in 128-slice HD-CTCA and 100%(20/20)、41.67%(5/12)、74.07%(20/27)、100%(5/5)、78.13%(25/32) in 640-slice CTCA.Conclusion The accuracy of 128-slice energy spectrum CTCA in diagnosing in-stent restenosis is higher than 640-slice CTCA, which is of great value in following up of patients with coronary stent.