Circulation. 2005;112:2318-2323
Published online before print October 3, 2005, doi: 10.1161/CIRCULATIONAHA.105.533471
Published online before print October 3, 2005, doi: 10.1161/CIRCULATIONAHA.105.533471
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(Circulation. 2005;112:2318-2323.)
© 2005 American Heart Association, Inc.
Imaging |
High-Resolution Spiral Computed Tomography Coronary Angiography in Patients Referred for Diagnostic Conventional Coronary Angiography
From the Erasmus Medical Center, Departments of Cardiology (N.R.M., F.C., C.A.G.v.M., E.P.M., T.B., P.W.S., P.J.d.F.) and Radiology (N.R.M., F.C., C.A.G.v.M., G.R., T.B., G.P.K., P.J.d.F.), Rotterdam, the Netherlands.
Correspondence to P.J. de Feyter, MD, PhD, Erasmus Medical Center, Thoraxcenter, Room Bd-410, Dr Molewaterplein 40, 3015GD Rotterdam, Netherlands. E-mail p.j.defeyter{at}erasmusmc.nl
Received January 4, 2005; revision received June 23, 2005; accepted June 24, 2005.
Background— The diagnostic performance of the latest 64-slice CT scanner, with increased temporal (165 ms) and spatial (0.4 mm3) resolution, to detect significant stenoses in the clinically relevant coronary tree is unknown.
Methods and Results— We studied 52 patients (34 men; mean age, 59.6±12.1 years) with atypical chest pain, stable or unstable angina pectoris, or non–ST-segment elevation myocardial infarction scheduled for diagnostic conventional coronary angiography. All patients had stable sinus rhythm. Patients with initial heart rates 
70 bpm received ß-blockers. Mean scan time was 13.3±0.9 seconds. The CT scans were analyzed by 2 observers unaware of the results of invasive coronary angiography, which was used as the standard of reference. All available coronary segments, regardless of size, were included in the evaluation. Lesions with 50 luminal narrowing were considered significant stenoses. Invasive coronary angiography demonstrated the absence of significant disease in 25% (13 of 52), single-vessel disease in 31% (16 of 52), and multivessel disease in 45% (23 of 52) of patients. One unsuccessful CT scan was classified as inconclusive. Ninety-four significant stenoses were present in the remaining 51 patients. Sensitivity, specificity, and positive and negative predictive values of CT for detecting significant stenoses on a segment-by-segment analysis were 99% (93 of 94; 95% CI, 94 to 99), 95% (601 of 631; 95% CI, 93 to 96), 76% (93 of 123; 95% CI, 67 to 89), and 99% (601 of 602; 95% CI, 99 to 100), respectively.
Conclusions— Noninvasive 64-slice CT coronary angiography accurately detects coronary stenoses in patients in sinus rhythm and presenting with atypical chest pain, stable or unstable angina, or non–ST-segment elevation myocardial infarction.
Key Words: angina • angiography • coronary disease • imaging • tomography
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H. Alkadhi, H. Scheffel, L. Desbiolles, O. Gaemperli, P. Stolzmann, A. Plass, G. W. Goerres, T. F. Luescher, M. Genoni, B. Marincek, et al. Dual-source computed tomography coronary angiography: influence of obesity, calcium load, and heart rate on diagnostic accuracy Eur. Heart J., March 2, 2008; 29(6): 766 - 776. [Abstract] [Full Text] [PDF]
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P. T. Johnson, J. Eng, H. K. Pannu, and E. K. Fishman 64-MDCT Angiography of the Coronary Arteries: Nationwide Survey of Patient Preparation Practice Am. J. Roentgenol., March 1, 2008; 190(3): 743 - 747. [Abstract] [Full Text] [PDF]
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J. P. Earls, E. L. Berman, B. A. Urban, C. A. Curry, J. L. Lane, R. S. Jennings, C. C. McCulloch, J. Hsieh, and J. H. Londt Prospectively Gated Transverse Coronary CT Angiography versus Retrospectively Gated Helical Technique: Improved Image Quality and Reduced Radiation Dose Radiology, March 1, 2008; 246(3): 742 - 753. [Abstract] [Full Text] [PDF]
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S. Leschka, P. Koepfli, L. Husmann, A. Plass, R. Vachenauer, O. Gaemperli, T. Schepis, M. Genoni, B. Marincek, F. R. Eberli, et al. Myocardial Bridging: Depiction Rate and Morphology at CT Coronary Angiography--Comparison with Conventional Coronary Angiography Radiology, March 1, 2008; 246(3): 754 - 762. [Abstract] [Full Text] [PDF]
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S. Schroeder, S. Achenbach, F. Bengel, C. Burgstahler, F. Cademartiri, P. de Feyter, R. George, P. Kaufmann, A. F. Kopp, J. Knuuti, et al. Cardiac computed tomography: indications, applications, limitations, and training requirements: Report of a Writing Group deployed by the Working Group Nuclear Cardiology and Cardiac CT of the European Society of Cardiology and the European Council of Nuclear Cardiology Eur. Heart J., February 2, 2008; 29(4): 531 - 556. [Abstract] [Full Text] [PDF]
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J. Horiguchi, M. Kiguchi, C. Fujioka, Y. Shen, R. Arie, K. Sunasaka, and K. Ito Radiation Dose, Image Quality, Stenosis Measurement, and CT Densitometry Using ECG-Triggered Coronary 64-MDCT Angiography: A Phantom Study Am. J. Roentgenol., February 1, 2008; 190(2): 315 - 320. [Abstract] [Full Text] [PDF]
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F. Pugliese, N. R. Mollet, M. G. M. Hunink, F. Cademartiri, K. Nieman, R. T. van Domburg, W. B. Meijboom, C. Van Mieghem, A. C. Weustink, M. L. Dijkshoorn, et al. Diagnostic Performance of Coronary CT Angiography by Using Different Generations of Multisection Scanners: Single-Center Experience Radiology, February 1, 2008; 246(2): 384 - 393. [Abstract] [Full Text] [PDF]
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L. Husmann, I. Valenta, O. Gaemperli, O. Adda, V. Treyer, C. A. Wyss, P. Veit-Haibach, F. Tatsugami, G. K. von Schulthess, and P. A. Kaufmann Feasibility of low-dose coronary CT angiography: first experience with prospective ECG-gating Eur. Heart J., January 2, 2008; 29(2): 191 - 197. [Abstract] [Full Text] [PDF]
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G Pundziute, J D Schuijf, J W Jukema, J M van Werkhoven, E Boersma, A de Roos, E E van der Wall, and J J Bax Gender influence on the diagnostic accuracy of 64-slice multislice computed tomography coronary angiography for detection of obstructive coronary artery disease Heart, January 1, 2008; 94(1): 48 - 52. [Abstract] [Full Text] [PDF]
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J. Abdulla, S. Z. Abildstrom, O. Gotzsche, E. Christensen, L. Kober, and C. Torp-Pedersen 64-multislice detector computed tomography coronary angiography as potential alternative to conventional coronary angiography: a systematic review and meta-analysis Eur. Heart J., December 2, 2007; 28(24): 3042 - 3050. [Abstract] [Full Text] [PDF]
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A. R. Simon, H. Baraki, J. Weidemann, W. Harringer, M. Galanski, and A. Haverich High-resolution 64-slice helical-computer-assisted-tomographical-angiography as a diagnostic tool before CABG surgery: the dawn of a new era? Eur. J. Cardiothorac. Surg., December 1, 2007; 32(6): 896 - 901. [Abstract] [Full Text] [PDF]
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C. S. White and D. Kuo Chest Pain in the Emergency Department: Role of Multidetector CT Radiology, December 1, 2007; 245(3): 672 - 681. [Abstract] [Full Text] [PDF]
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X. Liu, X. Zhao, J. Huang, C. J. Francois, D. Tuite, X. Bi, D. Li, and J. C. Carr Comparison of 3D Free-Breathing Coronary MR Angiography and 64-MDCT Angiography for Detection of Coronary Stenosis in Patients with High Calcium Scores Am. J. Roentgenol., December 1, 2007; 189(6): 1326 - 1332. [Abstract] [Full Text] [PDF]
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F. Saremi, A. Abolhoda, O. Ashikyan, J. C. Milliken, J. Narula, S. V. Gurudevan, K. Kaushal, and A. Raney Arterial Supply to Sinuatrial and Atrioventricular Nodes: Imaging with Multidetector CT Radiology, December 1, 2007; 246(1): 99 - 107. [Abstract] [Full Text] [PDF]
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M. Hamon, R. Morello, J. W. Riddell, and M. Hamon Coronary Arteries: Diagnostic Performance of 16- versus 64-Section Spiral CT Compared with Invasive Coronary Angiography Meta-Analysis Radiology, December 1, 2007; 245(3): 720 - 731. [Abstract] [Full Text] [PDF]
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C. Burgstahler and S. Schroeder Magnetic resonance imaging versus computed tomography for the detection of coronary stenosis: do we really have to focus on "stenoses"? Heart, November 1, 2007; 93(11): 1322 - 1324. [Abstract] [Full Text] [PDF]
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W. B Meijboom, N. R Mollet, C. A Van Mieghem, A. C Weustink, F. Pugliese, N. van Pelt, F. Cademartiri, E. Vourvouri, P. de Jaegere, G. P Krestin, et al. 64-Slice CT coronary angiography in patients with non-ST elevation acute coronary syndrome Heart, November 1, 2007; 93(11): 1386 - 1392. [Abstract] [Full Text] [PDF]
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J. D. Schuijf, G. Pundziute, J. W. Jukema, H. J. Lamb, J. C. Tuinenburg, B. L. van der Hoeven, A. de Roos, J. H. C. Reiber, E. E. van der Wall, M. J. Schalij, et al. Evaluation of Patients with Previous Coronary Stent Implantation with 64-Section CT Radiology, November 1, 2007; 245(2): 416 - 423. [Abstract] [Full Text] [PDF]
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W. B. Meijboom, C. A.G. van Mieghem, N. R. Mollet, F. Pugliese, A. C. Weustink, N. van Pelt, F. Cademartiri, K. Nieman, E. Boersma, P. de Jaegere, et al. 64-Slice Computed Tomography Coronary Angiography in Patients With High, Intermediate, or Low Pretest Probability of Significant Coronary Artery Disease J. Am. Coll. Cardiol., October 9, 2007; 50(15): 1469 - 1475. [Abstract] [Full Text] [PDF]
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M. Dewey, H.-P. Dubel, T. Schink, G. Baumann, and B. Hamm Head-to-head comparison of multislice computed tomography and exercise electrocardiography for diagnosis of coronary artery disease Eur. Heart J., October 2, 2007; 28(20): 2485 - 2490. [Abstract] [Full Text] [PDF]
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