Circulation. 2003;107:664-666
Published online before print January 27, 2003, doi: 10.1161/01.CIR.0000055738.31551.A9
Published online before print January 27, 2003, doi: 10.1161/01.CIR.0000055738.31551.A9
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(Circulation. 2003;107:664.)
© 2003 American Heart Association, Inc.
Brief Rapid Communications |
Detection of Coronary Artery Stenoses With Thin-Slice Multi-Detector Row Spiral Computed Tomography and Multiplanar Reconstruction
From the Department of Cardiology (D.R., K.P., C.S., W.G.D., S.A.), Institute of Diagnostic Radiology (U.B., K.A., W.B.), and Institute of Medical Physics (S.U.), University of Erlangen-Nürnberg, Germany; Siemens Medical Solutions, Forchheim, Germany (B.O.); and the Department of Radiology, Massachusetts General Hospital, Boston, Mass (S.A.).
Correspondence to Stephan Achenbach, CIMIT, Massachusetts General Hospital, 100 Charles River Plaza 400, Boston, MA 02114. E-mail Sachenbach{at}partners.org
Background— We analyzed the accuracy of multi-detector row spiral computed tomography (MDCT) using a 16-slice CT scanner with improved spatial and temporal resolution, as well as routine premedication with ß-blockers for detection of coronary stenoses.
Methods and Results— Seventy-seven patients with suspected coronary disease were studied by MDCT (12x0.75-mm cross-sections, 420 ms rotation, 100 mL contrast agent IV at 5 mL/s). Patients with a heart rate above 60/min received 50 mg atenolol before the scan. In axial MDCT images and multiplanar reconstructions, all coronary arteries and side branches with a diameter of 1.5 mm or more were assessed for the presence of stenoses exceeding 50% diameter reduction. In comparison to invasive coronary angiography, MDCT correctly classified 35 of 41 patients (85%) as having at least 1 coronary stenosis and correctly detected 57 of 78 coronary lesions (73%). After excluding 38 of 308 coronary arteries (left main, left anterior descending, left circumflex, and right coronary artery in 77 patients) classified as unevaluable by MDCT (12%), 57 of 62 lesions were detected, and absence of stenosis was correctly identified in 194 of 208 arteries (sensitivity: 92%; specificity: 93%; accuracy: 93%; positive and negative predictive values: 79% and 97%).
Conclusions— MDCT coronary angiography with improved spatial resolution and premedication with oral ß-blockade permits detection of coronary artery stenoses with high accuracy and a low rate of unevaluable arteries.
Key Words: imaging • coronary disease • tomography
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M. Kantarci, C. Duran, I. Durur, F. Alper, O. Onbas, M. Gulbaran, and A. Okur Detection of Myocardial Bridging with ECG-Gated MDCT and Multiplanar Reconstruction Am. J. Roentgenol., June 1, 2006; 186(6_Supplement_2): S391 - S394. [Abstract] [Full Text] [PDF]
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H. Vernhet-Kovacsik, P. Battistella, R. Demaria, J. L. Pasquie, C. Bousquet, G. Dogas, F. Leclercq, B. Albat, and J. P. Senac Early Postoperative Assessment of Coronary Artery Bypass Graft Patency and Anatomy: Value of Contrast-Enhanced 16-MDCT with Retrospectively ECG-Gated Reconstructions Am. J. Roentgenol., June 1, 2006; 186(6_Supplement_2): S395 - S400. [Abstract] [Full Text] [PDF]
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M. Gilard, J.-C. Cornily, P.-Y. Pennec, C. Joret, G. Le Gal, J. Mansourati, J.-J. Blanc, and J. Boschat Accuracy of Multislice Computed Tomography in the Preoperative Assessment of Coronary Disease in Patients With Aortic Valve Stenosis J. Am. Coll. Cardiol., May 16, 2006; 47(10): 2020 - 2024. [Abstract] [Full Text] [PDF]
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D. R. Coles, M. A. Smail, I. S. Negus, P. Wilde, M. Oberhoff, K. R. Karsch, and A. Baumbach Comparison of Radiation Doses From Multislice Computed Tomography Coronary Angiography and Conventional Diagnostic Angiography J. Am. Coll. Cardiol., May 2, 2006; 47(9): 1840 - 1845. [Abstract] [Full Text] [PDF]
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U. Hoffmann, M. Ferencik, R. C. Cury, and A. J. Pena Coronary CT Angiography J. Nucl. Med., May 1, 2006; 47(5): 797 - 806. [Abstract] [Full Text] [PDF]
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M A S Cordeiro, J M Miller, A Schmidt, A C Lardo, B D Rosen, D E Bush, J A Brinker, D A Bluemke, E P Shapiro, and J A C Lima Non-invasive half millimetre 32 detector row computed tomography angiography accurately excludes significant stenoses in patients with advanced coronary artery disease and high calcium scores Heart, May 1, 2006; 92(5): 589 - 597. [Abstract] [Full Text] [PDF]
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U. Hoffmann, F. Moselewski, K. Nieman, I.-K. Jang, M. Ferencik, A. M. Rahman, R. C. Cury, S. Abbara, H. Joneidi-Jafari, S. Achenbach, et al. Noninvasive Assessment of Plaque Morphology and Composition in Culprit and Stable Lesions in Acute Coronary Syndrome and Stable Lesions in Stable Angina by Multidetector Computed Tomography J. Am. Coll. Cardiol., April 18, 2006; 47(8): 1655 - 1662. [Abstract] [Full Text] [PDF]
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M. A.S. Cordeiro and J. A.C. Lima Atherosclerotic plaque characterization by multidetector row computed tomography angiography. J. Am. Coll. Cardiol., April 18, 2006; 47(8 Suppl): C40 - C47. [Abstract] [Full Text] [PDF]
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G. Pache, U. Saueressig, A. Frydrychowicz, D. Foell, N. Ghanem, E. Kotter, A. Geibel-Zehender, C. Bode, M. Langer, and T. Bley Initial experience with 64-slice cardiac CT: non-invasive visualization of coronary artery bypass grafts Eur. Heart J., April 2, 2006; 27(8): 976 - 980. [Abstract] [Full Text] [PDF]
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C. Jahnke, I. Paetsch, S. Achenbach, B. Schnackenburg, R. Gebker, E. Fleck, and E. Nagel Coronary MR Imaging: Breath-hold Capability and Patterns, Coronary Artery Rest Periods, and {beta}-Blocker Use Radiology, April 1, 2006; 239(1): 71 - 78. [Abstract] [Full Text] [PDF]
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F. Cademartiri, N. R. Mollet, G. Runza, T. Baks, M. Midiri, E. P. McFadden, T. G. Flohr, B. Ohnesorge, P. J. de Feyter, and G. P. Krestin Improving Diagnostic Accuracy of MDCT Coronary Angiography in Patients with Mild Heart Rhythm Irregularities Using ECG Editing. Am. J. Roentgenol., March 1, 2006; 186(3): 634 - 638. [Abstract] [Full Text] [PDF]
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M. Ferencik, K. Nieman, and S. Achenbach Noncalcified and Calcified Coronary Plaque Detection by Contrast-Enhanced Multi-Detector Computed Tomography: A Study of Interobserver Agreement J. Am. Coll. Cardiol., January 3, 2006; 47(1): 207 - 209. [Full Text] [PDF]
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D. S. Berman, R. Hachamovitch, L. J. Shaw, J. D. Friedman, S. W. Hayes, L. E.J. Thomson, D. S. Fieno, G. Germano, P. Slomka, N. D. Wong, et al. Roles of Nuclear Cardiology, Cardiac Computed Tomography, and Cardiac Magnetic Resonance: Assessment of Patients with Suspected Coronary Artery Disease J. Nucl. Med., January 1, 2006; 47(1): 74 - 82. [Abstract] [Full Text] [PDF]
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C. Herzog, M. Arning-Erb, S. Zangos, K. Eichler, R. Hammerstingl, S. Dogan, H. Ackermann, and T. J. Vogl Multi-Detector Row CT Coronary Angiography: Influence of Reconstruction Technique and Heart Rate on Image Quality Radiology, January 1, 2006; 238(1): 75 - 86. [Abstract] [Full Text] [PDF]
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