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Article Type

Original Study

Abstract

Objective Our aim was to assess the diagnostic accuracy of multislice computed tomography (CT) coronary angiography in the evaluation of coronary stent patency using different methods of image reconstruction. Background Over the past 25 years, catheter-based intervention has become the dominant form of coronary revascularization. Although the use of recently introduced drug-eluting stents has resulted in even further reductions in the occurrence of re-stenosis, in-stent thrombosis and neointimal hyperplasia may still occur and cause partial or complete obstruction. Conventional coronary angiography is still the technique of choice for the diagnosis of in-stent re-stenosis, but may involve major complications; therefore, multidetector CT can be useful to assess the condition of the whole coronary tree, as it provides information about the number, severity, and location of coronary lesions. Patients and methods We studied 30 patients with past history of percutaneous coronary intervention who were referred for coronary multislice CT coronary angiography using different methods of image reconstruction, either filtered back projection or iterative reconstruction, compared with the standard coronary angiography. Results By comparing filtered back projection and iterative reconstruction, we found that I46f showed statistically lower noise than B46f (29.8 ± 3.9 vs. 36.2 ± 3.2) (P < 0.001) regarding signal-to-noise ratio (14.8 ± 2.1 for I46f vs. 12.0 ± 3.7 for B46f) (P < 0.001). The contrast-to-noise ratio was also statistically better with I46f than with B46f (7.3 ± 0.9 for I46f vs. 5.9 ± 0.5 for B46f) (P < 0.001). Conclusion We concluded that the sharp kernel for each filter has higher image noise than the medium kernel, and when comparing both filters together we found that iterative reconstruction, sharp kernel (I46f), has the best image quality.

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