多层螺旋CT对冠状动脉支架的评价及其成像质量控制

目的 研究多层(16层)螺旋CT(multi slice spiral CT,MSCT)冠状动脉造影成像在评价冠状动脉支架通畅性的临床意义,并分析影响其成像质量的因素.方法 采用MSCT对32例冠状动脉支架患者行冠状动脉成像检查,以多种方式重建显示冠状动脉支架的位置、形态、术后再狭窄等.其中7例经X线冠状动脉造影进一步证实.将CT冠状动脉图像质量分三级予以评价,分析其影响图像质量的因素.结果 MSCT显示所有32例患者41个冠状动脉支架的形态、位置,其中5个支架术后出现再狭窄;7例患者9个支架与冠状动脉造影对照,诊断符合率为88.9%;图像质量优良率为87.5%(28/32例),心率＜60/min、61～70/min和＞71次/min图像质量优良率分别占94.7%、88.9%和50.0%,三种不同心率对图像质量显示有显著性差异(χ2=16.354,P＜0.01).结论 MSCT冠状动脉成像是一种较可靠的冠状动脉支架无创性评价方法,对支架开通性显示较好,但对支架内情况显示受限,图像质量受心率等因素影响,质量控制是关键.     

多层螺旋CT在评价冠状动脉支架中的价值

目的：探讨多层螺旋CT冠状动脉造影（multi slice spiral computed tomographic angiog raphy,MSCTA）在冠状动脉支架评价中的价值.方法：对 28例冠状动脉支架患者行冠状动脉M SCTA检查,利用MSCT的各种先进的后处理功能对冠状动脉进行重建,以显示冠状动脉支架的形态、位置及有无支架术后的再狭窄.结果：在28 例多层螺旋CT冠状动脉造影中2例由于患者有严重的窦性心率不齐,多层螺旋CT检查重建图像质量欠佳,其余患者多层螺旋CT冠状造影检查均成功的显示冠状动脉各主支 （左主支、回旋支、前降支右支冠状动脉）,且可显示所有冠状动脉支架的形态、位置,其中9例患者的10个支架术后出现再狭窄,所有患者行MSC T冠脉造影检查无1例患者出现并发征,所有MSCT冠脉造影检查怀疑支架再狭窄的患者均同时行选择性血管造影检查,其中8例患者的8个支架诊断与MSCT冠脉造影检查结果相一致,其符合率为88.89%.结论：冠状MSCTA是一种安全可靠的检查方法,可作为冠状动脉一种无创检查方法,是评价冠状动脉支架有无再狭窄的重要检查手段之一.     

Coronary artery stents in multislice computed tomography: in vitro artifact evaluation

RATIONALE AND OBJECTIVE: The aim of this study was to systematically compare the ability to assess the coronary artery lumen in the presence of coronary artery stents in multislice spiral CT (MSCT). METHODS: Ten different coronary artery stents were examined with 4- and 16-detector row MSCT scanners. For image reconstruction, a standard and a dedicated convolution kernel for coronary artery stent visualization were used. Images were analyzed regarding lumen visibility, intraluminal attenuation, and artifacts outside the stent lumen. Results were compared using repeated-measure analysis of variance. RESULTS: Depending on stent type, scanner hardware, and convolution kernel, artificial lumen narrowing ranged from 20% to 100%. The convolution kernel had the most significant influence on the visibility of the stent lumen. Artificial lumen narrowing and intraluminal attenuation changes decreased significantly using the dedicated convolution kernel. In general, most severe artifacts were caused by gold or gold-coated stents. CONCLUSIONS: Independent of the scanner hardware or dedicated convolution kernels, routine evaluation of most coronary artery stents is not yet feasible using MSCT.     

双源CT双能量冠脉成像对冠脉支架术后的临床价值

目的 探讨双源CT双能量冠脉成像对冠脉支架术后的临床价值.方法 对32例冠心病支架术后患者行双能量扫描,对比分析冠脉支架CT血管成像和选择性冠脉造影检查,将14例临床确诊陈旧性心梗患者进行心肌灌注分析.结果 32例患者置入46枚支架均成功显示,1例患者2枚支架因钙化评价受限.14例确诊为陈旧性心梗的患者均显示不同程度的心肌灌注缺损.结论 双源CT双能量扫描不但能较好的评价冠脉支架植入术后支架情况,还能对心肌灌注改变做出判断.     

冠状动脉造影及支架置入术在冠心病诊断与治疗的临床应用

目的　评价冠状动脉造影及支架置入术在冠心病诊断与治疗的临床应用价值。方法　对 40例 47支冠状动脉病变内置入 5 6只支架 ,其中置入前降支 2 9只 ,右冠状动脉 1 8只 ,左回旋支 9只。结果　 40例全部置入成功 ,置入后经冠状动脉造影证实狭窄消失 ,即刻效果良好 ,由术前狭窄 ( 88.9± 8.1 ) %减至术后残余狭窄 ( 5 .6± 5 .1 ) %,支架置入成功率 1 0 0 %。术后低血压反应 2例 ,血肿 3例。结论　冠状动脉造影及支架置入术是冠心病诊断与治疗的一种安全可靠、效果良好的介入性诊断治疗方法 ,值得临床广泛应用。     

In vivo evaluation of patency and in-stent stenoses after implantation of nitinol stents in iliac arteries using MR angiography

OBJECTIVE: Our study was a prospective in vivo study to evaluate whether MR angiography is suitable for assessing stent patency and grading in-stent stenoses and to examine whether the accuracy of MR angiography changes with time after stent implantation. SUBJECTS AND METHODS: In a prospective study, 34 iliac stenoses in 27 patients were treated by implantation of 35 nitinol stents. MR angiography was performed immediately after stent placement for 32 stents, and both digital subtraction angiography (DSA) and MR angiography were repeated at the 6-month follow-up for 23 stents. Three blinded observers assessed stent patency and the degree of in-stent stenoses on MR angiography and DSA (the standard of reference) images. The difference between the observers' grading of stenoses on DSA and on MR angiography was determined. Statistical analysis was performed using the Student's t test for paired samples. RESULTS: Stent patency was assessed correctly for all stents and both sets of MR angiography images. Evaluation of DSA 1 images (obtained at end of implantation procedure) revealed that 96.9% of in-stent stenoses were less than 50%. On DSA 2 images (obtained at follow-up), 95.7% of in-stent stenoses were graded as less than 50%. The difference between grading of stenoses on DSA and MR angiography images was 15.0% +/- 16.0% (minimum, 0.0%; maximum, 63.3%) for DSA 1 versus MR angiography 1 (statistically significant, p = 0.037) and 9.8% +/- 13.5% (minimum, 0.0%; maximum, 63.3%) for MR angiography 2 versus DSA 2 (not statistically significant, p = 0.355). CONCLUSION: Patency was correctly assessed for all stents on MR angiography. The quality of MR angiography regarding characterization of in-stent stenoses improved with time after stent placement. However, discrepancies of more than 60% between grading of lumen narrowing on DSA and MR angiography images occurred even at the 6-month follow-up. Thus, MR angiography is not yet a reliable technique for characterization of in-stent stenoses.     

Appearance of vascular stents in computed tomographic angiography: in vitro examination of 14 different stent types

RATIONALE AND OBJECTIVES: To evaluate the appearance of the vessel lumen after implantation of different vascular stents with the use of a computed tomographic (CT) angiography model. METHODS: A vascular phantom was studied with helical CT and different slice thicknesses (2 and 3 mm) and pitch values (1.0, 1.5, and 2.0). Original transverse CT images and coronal reformations were evaluated. Fourteen different stents were analyzed with regard to changes in the stent lumen (attenuation values, noise, and artificial lumen narrowing). RESULTS: Some stents caused artifacts resulting in potential errors during evaluation of their patency. Assessment of the lumen was impaired in two stents (Strecker tantalum and Passager). Increased attenuation values were measured in all stents (increase of 8%-145%). The degree of artificial lumen narrowing was 4.4% to 77.8%. CONCLUSIONS: In most stents, reliable evaluation of the stent lumen seems possible. However, knowledge of the artifacts caused by different stent types is useful for the assessment of stent patency with CT angiography.     

Flat-panel detector computed tomography for the assessment of coronary artery stents: phantom study in comparison with 16-slice spiral computed tomography

PURPOSE: The evaluation of coronary artery stents is a major limitation of cardiac multislice spiral computed tomography (MSCT). The development of flat-panel detector computed tomography (FPCT) with truly isotropic spatial resolution may overcome this limitation. Thus, we evaluated the use of FPCT in comparison to MSCT for the assessment of coronary artery stents. MATERIAL AND METHODS: Eight different coronary artery stents with a diameter of 3 mm each were placed in a static chest phantom. The phantom was positioned in the CT gantry at angles of 0 degrees , 45 degrees , and 90 degrees toward the z-axis and examined with the prototype of a FPCT (Siemens, Forchheim, Germany) and a commercially available 16-detector row MSCT (Sensation 16, Siemens). Slice thickness was 0.25 mm with FPCT whereas for MSCT, an effective slice thickness of 1 mm with a reconstruction increment of 0.5 mm was used. Image quality was assessed visually using a 5-point grading scale. Stent diameters were measured and compared using a repeated-measures analysis of variance. RESULTS: When compared with MSCT, artificial lumen reduction was significantly less using FPCT. On average the visible stent lumen was reduced by 16.1% with FPCT, whereas the mean of the lumen reduction was 47.2% with 16-detector row MSCT. Visible lumen diameter as well as image noise significantly increased using FPCT (P < 0.001). With FPCT delineation of the different stent struts became possible. CONCLUSION: FPCT proved to be superior when compared with 16-detector row MSCT for the in vitro assessment of coronary artery stents. Improved spatial resolution allows for a detailed assessment of the coronary artery stent lumen.     

多层螺旋CT冠脉造影的标准体位

目的:探讨建立多层螺旋CT冠脉造影标准体位.材料和方法:对120例临床怀疑冠心病患者进行16层螺旋CT心电门控平扫及增强扫描.所有患者用舒张期增强扫描重建像行最大密度投影(MIP)重建及容积漫游技术(VRT)重建,其中30例与常规冠状动脉造影对照.总结16层螺旋CT心脏冠状动脉造影不同体位的显示情况,得出CT冠状动脉造影统一体位.结果:分别定义了6个MIP重建体位和9个VRT重建体位.结论:多层螺旋CT冠状动脉造影是一种无创、简便、优良的冠状动脉造影方法,建立起标准造影体位有利于对冠脉病变进行更全面评价.     

Evaluation of patients with previous coronary stent implantation with 64-section CT

PURPOSE: To prospectively evaluate the diagnostic accuracy of 64-section computed tomography (CT) for the assessment of in-stent or peristent restenosis, with conventional coronary angiography as the reference standard. MATERIALS AND METHODS: The study was approved by the medical ethics committee, and informed consent was obtained in all 50 enrolled patients (40 men, 10 women; mean age, 60 years +/- 11 [standard deviation]). In addition to conventional coronary angiography with quantitative coronary angiography, 64-section CT was performed. For each stent, assessability was determined and was related to stent characteristics and heart rate by using a chi(2) test. On the interpretable images of stents and peristent lumina (5.00 mm proximal and distal to the stent), the presence of significant (> or =50%) restenosis was determined. For this analysis, partially overlapping stents were considered to represent a single stent. RESULTS: Of 76 stents, 65 (86%) were determined to be assessable. Increased heart rate and overlapping positioning were associated with increased uninterpretability of the images of stents (P < .05), whereas location of the stent and thickness of the strut were not. In seven patients, stents were placed in an overlapping manner, resulting in 58 stents available for the evaluation of significant (> or =50%) in-stent restenosis. All six significant (> or =50%) in-stent restenoses were detected, and the absence of significant (> or =50%) restenosis was correctly identified in the 52 remaining stents, resulting in sensitivity and specificity of 100%. Sensitivity and specificity for the detection of significant (> or =50%) peristent stenosis were 100% and 98%, respectively. CONCLUSION: In selected patients with previous stent implantation, 64-section CT can be used to evaluate in-stent restenosis with high accuracy. Accordingly, the technique may be useful for noninvasive exclusion of in-stent or peristent restenosis, thereby avoiding invasive imaging in a considerable number of patients.     

Role of 320-slice multislice computed tomography coronary angiography in the assessment of coronary artery stenosis

Objective

To evaluate the effectiveness of the multislice CT coronary angiography, as a non-invasive imaging tool in assessment of coronary artery stenosis.

Patients and methods

The study included 50 patients who were referred for MSCT coronary angiography followed by catheter coronary angiography. Patients with previous coronary bypass grafts and those with coronary stents were excluded. History of contrast allergy, renal impairment and severe chest conditions were exclusion criteria. The coronary angiographic CT studies were performed using a 320 CT scanner. The catheter coronary angiographic studies were performed via femoral arterial puncture. The results of CT angiography were compared with the gold standard catheter angiography.

Results

The positive predictive value and negative predictive value of MSCT coronary angiography in detection of coronary artery stenosis were 94% and 100%, respectively.

Conclusion

In conclusion, MSCT coronary angiography is a very helpful and rapid non-invasive coronary imaging modality that was able to detect and grade coronary artery stenosis better than other noninvasive examinations used to detect CAD, such as exercise stress testing. Due to its very high negative predictive value, it may eliminate the need for invasive coronary procedures in the presence of normal coronary imaging.     

Multislice CT angiography in aortic stent grafting: relationship between image noise and body mass index

PURPOSE: To investigate the correlation between image noise and body mass index (BMI) in multislice CT angiography (MSCT) for patients with abdominal aortic aneurysm (AAA) treated with endovascular stent grafts. MATERIALS AND METHODS: Seventeen patients who underwent MSCT following endovascular repair of AAA were included in the study. Image noise (standard deviation of the CT attenuation: S.D.) and signal to noise ratio (SNR) were plotted against BMI to demonstrate the correlation using a linear regression method. Image quality of 3D reconstructions was correlated to the SNR and BMI. RESULTS: The r-value of linear regression between S.D. and BMI was 0.578 (p<0.05), 0.835 and 0.802 (p<0.001), respectively, at the level of renal artery, aortic aneurysm and common iliac artery. The r-value of linear regression between SNR and BMI was 0.332, 0.516 and 0.552 (p<0.05), respectively, at above three levels. Image quality of 3D reconstructions was compromised in five patients and diagnosis was affected in two patients with BMI more than 30. CONCLUSION: A significant correlation was observed between image noise and BMI in MSCT angiography of endovascular repair of AAA. Our findings are valuable for optimisation of MSCT angiography scanning protocols and reduction of radiation dose in MSCT examinations.     

Diagnostic accuracy of in-stent coronary restenosis detection with multislice spiral computed tomography: a meta-analysis

This study was designed to define the current role of multislice spiral computed tomography (MSCT) for the diagnosis of coronary in-stent restenosis using a meta-analytic process. Restenosis remains a limitation after coronary stent implantation and contributes to a substantial number of coronary re-assessments by conventional invasive coronary angiography (CA). We identified 15 studies (807 patients) evaluating in-stent restenosis by means of both MSCT (≥16 slices) and conventional CA until February 2007. After data extraction the analysis was performed according to a random-effects model. The analysis pooled the results from 15 studies with a total of 1,175 stents. A substantial number of unassessable stents (13%) were excluded from the analysis underscoring the shortcomings of MSCT. With this major limitation the diagnostic performance of MSCT for in-stent restenosis detection can be summarized as follows: the sensitivity and specificity were 84% [95% confidence interval (CI) 77–89%] and 91% (95% CI 89–93%), respectively, with positive and negative likelihood ratios of 12.2 (95% CI 6.6–22.6) and 0.23 (95% CI 0.17–0.31), respectively, and with a diagnostic odds ratio of 67.9 (95% CI 34.4–134.1). MSCT has shortcomings difficult to overcome in daily practice for in-stent restenosis detection and continues to have moderately high sensitivity and specificity. The diagnostic role of this emerging technology as an alternative to CA for in-stent restenosis detection remains limited.     

Contrast-enhanced 64-section coronary multidetector CT angiography versus conventional coronary angiography for stent assessment

PURPOSE: To prospectively evaluate the accuracy of 64-section computed tomography (CT) for diagnosis of stent restenosis, by using conventional coronary angiography as the reference standard. MATERIALS AND METHODS: The ethics committee granted permission for the study; patients gave written consent. Contrast material-enhanced coronary CT angiography was performed in 53 patients (45 men, eight women; mean age, 54 years +/- 9 [standard deviation]) suspected of having stent restenosis. Coronary CT angiographic findings were compared with conventional coronary angiographic findings. Two physicians analyzed coronary CT angiographic data sets with multiplanar reformatted images and three-dimensional reformations by using a volume-rendering technique and looked for stent detectability, low-attenuation in-stent filling defects, and grades of restenosis. Conventional coronary angiographic results were interpreted by one of several observers in consensus for stent restenosis; they were blinded to coronary CT angiographic data. Statistical software and general estimating equations were used for data analysis. RESULTS: One hundred ten stents were identified in 53 patients. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of coronary CT angiography in detection of in-stent restenosis were 96.9%, 88.0%, 77.5%, 98.5%, and 91%, respectively. Coronary CT angiography depicted in-stent low-attenuation filling defects with an accuracy of 91% and negative predictive value of 98.5% (95% confidence interval: 90.9, 99.9). Coronary CT angiography depicted the status of 97 of 107 stents. There was no significant difference between in-stent lumen visibility and stent diameter (P = .104). Coronary CT angiography helped diagnose 15 of 18 stent restenoses with less than 50% narrowing, five of five stent restenoses with 50%-74% narrowing, and nine of nine (100%) stent restenoses with 75% or greater narrowing or total occlusion of the stent lumen. CONCLUSION: Coronary CT angiography can depict in-stent low-attenuation filling defects, which appear to be a reliable sign of stent restenosis, and 64-section CT depicts such defects with a high degree of accuracy.     

Coronary stent patency and in-stent restenosis: determination with 64-section multidetector CT coronary angiography--initial experience

PURPOSE: To prospectively assess the diagnostic performance of 64-section multidetector computed tomography (CT) for the evaluation of coronary stent stenosis and occlusion by using conventional coronary angiography as the reference standard. MATERIALS AND METHODS: Institutional review board approval and informed consent were obtained. Thirty patients (27 men, three women; mean age, 58.2 years; range, 42-67 years) with 39 coronary stents were examined with 64-section multidetector CT. Scanning was retrospectively electrocardiographically gated, and an automatic bolus-tracking method was used. For image reconstruction, an edge-enhancing kernel (B46f) was chosen. Evaluations were performed by two radiologists who were blinded to the results of conventional coronary angiography performed within 2-3 days after CT. Sensitivity, specificity, and positive and negative predictive values were calculated. RESULTS: At conventional angiography, nine of the 39 stents were shown to be totally occluded. All of the occluded stents were correctly diagnosed with CT angiography. Nineteen of 20 patent stents were correctly demonstrated with CT angiography. Ten stents had in-stent restenosis; eight were correctly diagnosed with CT. The sensitivity, specificity, and positive and negative predictive values of 64-section multidetector CT were 89% (17 of 19), 95% (19 of 20), 94% (17 of 18), and 90% (19 of 21), respectively, for in-stent restenosis and occlusion. With the McNemar test, no significant difference was found between 64-section multidetector CT and conventional coronary angiography for the detection of coronary in-stent restenosis and occlusion. CONCLUSION: Sixty-four-section multidetector CT coronary angiography is a promising method for the noninvasive diagnosis of in-stent restenosis and occlusion.     

Current status of coronary multislice CT angiography

Multislice computed tomography (MSCT) is an emerging technique which has an enormous potential to improve the current practice of coronary artery imaging. This article reviews the current status of coronary MSCT angiography (MSCTA) with emphasis on the imaging techniques and clinical utilities of 16-slice CTA. Results and experiences gained from coronary MSCTA in the past few years have taught us that accurate diagnosis of coronary artery disease relies on good technical studies and can be achieved by optimizing image parameters including image timing and image reconstruction ECG-trigger delay. Current clinical applications of coronary MSCTA include: quantitative assessment of coronary artery stenosis, characterization of coronary atherosclerotic plaques, and follow-up of coronary artery stent and bypass graft. Furthermore, MSCT has brought an increasing awareness to the amount of radiation used in CT. This has prompted CT researchers and manufacturers to improve various techniques and develop new strategies to reduce radiation dose. It is anticipated that MSCT will become a sensitive and accurate tool for detecting coronary artery disease and monitoring outcomes after treatment for coronary artery disease.     

Non-invasive assessment of coronary artery stent patency with multislice CT: preliminary experience

PURPOSE: To evaluate the diagnostic accuracy of multislice computed tomography coronary angiography (MSCT-CA) in the detection of in-stent restenosis. MATERIALS AND METHODS: Forty-two patients (33 male, 9 female, mean age 58+/-8 years) previously subjected to percutaneous implantation of coronary stent with suspected in-stent restenosis, underwent a 16-row MSCT (Sensation 16, Siemens) examination. The average time between stent implantation and MSCT-CA was 7.4+/-5.3 months. The following scan parameters were used: collimation 16x0.75 mm, rotation time 0.42 s, feed 3.0 mm/rot., kV 120, mAs 500. After administration of iodinated contrast material (Iomeprol 400 mgI/ml, 100 ml at 4 ml/s) and bolus chaser (40 ml of saline at 4 ml/s) the scan was completed in <20 s. All segments with a stent were assessed by two observers in consensus and were graded according to the following scheme: patent stent, in-stent intimal hyperplasia (IIH) (lumen reduction <50%), in-stent restenosis (ISR) (=/>50%), in-stent occlusion (ISO) (100%). Consensus reading was compared with coronary angiography. RESULTS: Forty-seven stents were assessed (16 in the right coronary artery; 4 in the left main; 22 in the left anterior descending; 5 in the circumflex). In 7 (17%) stents there was ISR (3) or ISO (4), and in 4 (10%) stents there was IIH. The sensitivity and negative predictive values for the detection of ISO were 80% and 98%, respectively, while for the detection of ISR+ISO they were 50% and 89%, respectively. CONCLUSIONS: Although the results are encouraging, the follow-up of stent patency with MSCT-CA does not show a diagnostic accuracy suitable for clinical implementation.     

Metallic artifacts of coronary and iliac arteries stents in MR angiography and contrast-enhanced CT.

Metallic artifacts of intravascular stents were assessed with MR angiography and contrast-enhanced spiral CT. Stainless steel showed less metal artifact than tantalum stent in CT. Metallic artifact in coronary and iliac arteries treated with tantalum stent was not remarkable in MR angiography. Contrast-enhanced CT might be preferable to assess patency of arteries treated with stainless steel stent. while MR angiography was useful in depicting intraluminal signal in tantalum stent.     

Discrepancy between computed tomography coronary angiography and selective coronary angiography in the pre-stenting assessment of coronary lesion length

We aimed to compare the lesion length measured on computed tomography coronary angiography (CT-CA) with the selective coronary angiography (SCA) lesion length measured on quantitative coronary angiography (QCA). Compared with SCA, CT-CA has the advantage of showing the lumen and the atherosclerotic plaque in the arterial wall. This prospective observational study involved 44 coronary lesions. Computed tomography coronary angiography was carried out with an electrocardiogram-gated 16-slice CT before percutaneous coronary intervention. A cardiologist and a radiologist measured CT lesion lengths in consensus, whereas an interventional cardiologist carried out QCA to obtain SCA lesion lengths independently. The median difference of (CT lesion length - SCA lesion length) was 9.84 mm (95%CI: [7.26, 13.34]). The median difference of (stent length - SCA lesion length) was 7.68 mm (95%CI: [6.29, 9.26]); the median difference of (stent length - CT length) was -2.63 mm (95%CI: [-5.80, 0.05]). The mean ratio of stent length to SCA lesion length was 2.07 (95%CI: [1.83, 2.30]). The mean ratio of stent length to CT-CA lesion length was 0.97 (95%CI: [0.83, 1.11]). In the subgroup of drug-eluting stents (17 lesions), the median difference of (stent length - SCA lesion length) was 9.76 mm (95%CI: [6.59, 13.28]); the median difference of (stent length - CT length) was -5.2 mm (95%CI: [-11, 0.5]). The mean ratio of stent length to CT-CA lesion length was 0.93 (95%CI: [0.68, 1.17]). Computed tomography lesion length was substantially longer than SCA lesion length measured by QCA. Routine practice of choosing stent length based on QCA may underestimate the actual length of target lesion. This may lead to incomplete coverage of the target lesion, particularly when drug-eluting stents are used.     

Noninvasive evaluation of coronary artery stents patency after PTCA: role of Multislice Computed Tomography

PURPOSE: Restenosis of a coronary artery treated with stent implantation is a well-known process that can compromise over time the success of a coronary angioplasty and, accordingly, treated patients must undergo periodic controls. We have recently witnessed a shift towards a greater use of Multi-slice CT (msCT) in the study of coronary disease without its precise indications and limits having yet been underlined. The purpose of our study is to assess the role of msCT in the follow-up of patients treated with coronary angioplasty. MATERIALS AND METHODS: Forty-eight patients, for a total of 72 lesions, who underwent treatment with a slotted tube stent implant, had an msCT examination 1 week before scheduled coronary angiography, and the results were compared. 34 stents/72 (47.2%) were inserted on the left anterior descending; 21/72 (29.2%) on the right coronary; 17/72 (23.6%) on the circumflex artery or obtuse marginal branches. RESULTS: The observation of the opacification of the vessel located distally to treated segments allowed us to assess the patency of all stents. Coronary angiography identified a significant intrastent restenosis or a stent occlusion in 12 of the 72 stents analysed (16.7%). msCT enabled easier visualization of the lumen of the treated artery and its differentiation from the stent struts in the ones located on the left anterior descending artery than those on the circumflex (28 stents out of 34 [82.4%] vs 13/17 [76.5%]; p<0.05), and on the right coronary artery, which were difficult to evaluate (11/21 [52.4%]). We were also able to visualize the lumen of 14/15 stents with a calibre over 3.5 mm [93.3%] vs 35/45 stent with dimensions between 3.1 e 3.4 mm [77.8%], and only 4 stents <3 mm/12 [33.3%]. On multivariate analysis, the characteristics that were significantly and independently associated with accurate visualization of the lumen of a stented vessel were location on the proximal anterior descending artery (OR 4.03 [IC 95%: from 2.34 to 8.05]; p<0.0001) and stent size of >3.5 mm (OR 2.97 [IC 95%: from 1.67 to 4.86]; p<0.01). CONCLUSIONS: The msCT technology available at present makes the study of smaller stents and those positioned on the right coronary artery and circumflex rather complex; on the other hand msCT appears a promising study method for stents greater then 3.5 mm and for those positioned on the proximal segment of the left anterior descending artery.