Dataset related to the article: "CT Perfusion Versus Coronary CT Angiography in Patients With Suspected In-Stent Restenosis or CAD Progression"

This record contains raw data related to the article "CT Perfusion Versus Coronary CT Angiography in Patients With Suspected In-Stent Restenosis or CAD Progression" OBJECTIVES The goal of this study was to assess the diagnostic performance of coronary computed tomography angiography (CTA) alone, adenosine-stress myocardial perfusion assessed by computed tomography (CTP) alone, and coronary CTA þ CTP by using a 16-cm Z-axis coverage scanner versus invasive coronary angiography (ICA) and fractional flow reserve (FFR) as the clinical standard. BACKGROUND Diagnostic performance of coronary CTA for in-stent restenosis detection is still challenging. Recently, CTP showed additional diagnostic power over coronary CTA in patients with suspected coronary artery disease. However, few data are available on CTP performance in patients with previous stent implantation. METHODS Consecutive stable patients with previous coronary stenting referred for ICA were enrolled. All patients underwent stress myocardial CTP and rest CTP þ coronary CTA. Invasive FFR was performed during ICA when clinically indicated. The diagnostic rate and diagnostic accuracy of coronary CTA, CTP, and coronary CTA þ CTP were evaluated in stent-, territory-, and patient-based analyses. RESULTS In the 150 enrolled patients (132 men; mean age 65.1 9.1 years), the CTP diagnostic rate was significantly higher than that of coronary CTA in all analyses (territory based [96.7% vs. 91.1%; p &lt; 0.0001] and patient based [96% vs. 68%; p &lt; 0.0001]). When ICA was used as gold standard, CTP diagnostic accuracy was significantly higher than that of coronary CTA in all analyses (territory based [92.1% vs. 85.5%, p &lt; 0.03] and patient based [86.7% vs. 76.7%, p &lt; 0.03]). The concordant coronary CTA þ CTP assessment exhibited the highest diagnostic accuracy values versus ICA (95.8%in the territory-based analysis). The diagnostic accuracy of CTP was significantly higher than that of coronary CTA (75% vs. 30.5%; p &lt; 0.001). The radiation exposure of coronary CTA þ CTP was 4.15 1.5 mSv. CONCLUSIONS In patients with coronary stents, CTP significantly improved the diagnostic rate and accuracy of coronary CTA alone compared with both ICA and invasive FFR as gold standard.本数据集包含与题为《疑似支架内再狭窄或冠状动脉粥样硬化性心脏病（Coronary Artery Disease, CAD）进展患者的冠状动脉CT灌注与冠状动脉CT血管造影对比》的学术文章相关的原始数据。 研究目的：本研究旨在采用16厘米Z轴覆盖范围扫描仪，分别评估单纯冠状动脉计算机断层扫描血管造影（Coronary Computed Tomography Angiography, CTA）、单纯计算机断层扫描灌注（CT Perfusion, CTP）评估的腺苷负荷心肌灌注，以及冠状动脉CTA联合CTP的诊断性能，并以侵入性冠状动脉造影（Invasive Coronary Angiography, ICA）与血流储备分数（Fractional Flow Reserve, FFR）作为临床金标准。 研究背景：冠状动脉CTA用于检测支架内再狭窄的诊断性能仍颇具挑战。近期研究显示，在疑似冠状动脉疾病患者中，相较于单纯冠状动脉CTA，CTP可带来额外的诊断效能提升，但针对既往接受冠状动脉支架植入术患者的CTP诊断性能相关数据仍较为稀缺。 研究方法：本研究纳入连续就诊的稳定型患者，这些患者既往接受过冠状动脉支架植入术且被转诊行ICA检查。所有受试者均接受负荷心肌CTP及静息CTP联合冠状动脉CTA检查。若临床有指征，在ICA术中同步开展侵入性FFR检测。分别以支架层面、血管区域层面及患者个体层面为分析单元，评估冠状动脉CTA、CTP以及冠状动脉CTA联合CTP的诊断检出率与诊断准确率。 研究结果：本研究共纳入150例受试者（其中男性132例，平均年龄65.1±9.1岁）。所有分析维度中，CTP的诊断检出率均显著高于冠状动脉CTA：血管区域层面[96.7% vs. 91.1%；p < 0.0001]、患者个体层面[96% vs. 68%；p < 0.0001]。以ICA作为金标准时，所有分析维度中CTP的诊断准确率均显著高于冠状动脉CTA：血管区域层面[92.1% vs. 85.5%，p < 0.03]、患者个体层面[86.7% vs. 76.7%，p < 0.03]。冠状动脉CTA联合CTP的评估方案展现出最高的诊断准确率，在血管区域层面的分析中，其准确率达95.8%。在支架层面分析中，CTP的诊断准确率亦显著高于冠状动脉CTA（75% vs. 30.5%；p < 0.001）。冠状动脉CTA联合CTP的辐射暴露剂量为4.15±1.5 mSv。 结论：对于既往接受冠状动脉支架植入术的患者，以ICA及侵入性FFR作为金标准时，CTP可显著提升单纯冠状动脉CTA的诊断检出率与诊断准确率。