title: Comparison of electron beam computed tomography with intracoronary ultrasound and coronary angiography for detection of coronary atherosclerosis.
abstract: OBJECTIVE
  This analysis compared the results of electron beam computed tomography (EBCT) with those of coronary angiography and intracoronary ultrasound (ICUS) for the in vivo detection of coronary atherosclerotic plaques.
  
  
  BACKGROUND
  EBCT is a new imaging modality for identification of coronary calcifications. Coronary angiography depicts advanced changes in coronary morphology, whereas ICUS is an established diagnostic tool that detects the early stages of coronary artery disease.
  
  
  METHODS
  In 57 patients (54 +/- 9 years old), 267 coronary segments were analyzed with EBCT (3-mm slices, acquisition time 100 ms, threshold definition of coronary calcification at 130 Hounsfield units in an area > or = 1 mm2, Agatston calcium score), coronary angiography and ICUS. The analysis was based on the number and extent of coronary calcifications on EBCT, coronary lumen reduction on coronary angiography and plaque formation with and without ultrasound signs of calcifications on ICUS.
  
  
  RESULTS
  Compared with coronary angiography, EBCT yielded a sensitivity of 66%, a specificity of 78%, a positive predictive value of 39% and a negative predictive value of 91%. Compared with ICUS, EBCT yielded an overall sensitivity of 66%, a specificity of 88% and an overall accuracy of 81%. For plaques with and without ultrasound signs of calcifications, the sensitivity of EBCT was 97% and 47%, specificity 80% and 75% and overall accuracy 82% and 69%, respectively.
  
  
  CONCLUSIONS
  This in vivo correlation between ICUS and EBCT demonstrates that EBCT is a noninvasive method that helps to visualize the atherosclerotic process by localization and quantification of coronary artery calcifications. EBCT detects calcified plaques with high accuracy. Plaques without ultrasound signs of calcifications can be detected by EBCT but with lower sensitivity but equivalent specificity.
authors.affiliation: Division of Cardiology, Center of Internal Medicine, University of Essen, Germany. dhaum3@t-online.de
authors.forename: D
authors.initials: D
authors.lastname: Baumgart
authors.forename: A
authors.initials: A
authors.lastname: Schmermund
authors.forename: G
authors.initials: G
authors.lastname: Goerge
authors.forename: M
authors.initials: M
authors.lastname: Haude
authors.forename: J
authors.initials: J
authors.lastname: Ge
authors.forename: M
authors.initials: M
authors.lastname: Adamzik
authors.forename: C
authors.initials: C
authors.lastname: Sehnert
authors.forename: K
authors.initials: K
authors.lastname: Altmaier
authors.forename: D
authors.initials: D
authors.lastname: Groenemeyer
authors.forename: R
authors.initials: R
authors.lastname: Seibel
authors.forename: R
authors.initials: R
authors.lastname: Erbel
mesh_terms: D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D004583:Electrons; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods; D018084:Ultrasonography, Interventional