[Spiral CT for the detection of coronary artery calcifications and the prognosis of coronary heart disease--a comparison with fluoroscopy and coronary angiography].
OBJECTIVE
Evaluation of clinical relevance of coronary calcifications detected by helical CT. Evaluation of congruence with fluoroscopy (FS) and coronary angiography. Comparison with studies reporting on application of ultrafast computed tomography.


METHODS
40 patients underwent helical CT (2 mm slice thickness, table-feed 3 mm/s). Coronary angiography and FS were performed in usual technique. Stenosis and calcifications were evaluated semiquantitatively.


RESULTS
28 of 28 stenoses > or = 75% were detected via helical CT by evaluation of calcification (FS: 19). One non-detected solitary stenosis was calculated as 40%. FS did not detect 4 cases with 2-vessel and 3-vessel disease each one case with 1-vessel disease, and one case with a main stem stenosis. Sensitivity of helical CT was 97% (FS: 66%). For the evaluation of stenosis III degree (> or = 75%), sensitivity was 100% (FS: 58%), specificity was 77% (FS: 48%).


CONCLUSIONS
Helical CT is more sensitive for haemodynamically relevant stenoses than FS. Helical CT is suitable as a substantial non-invasive diagnostic procedure in coronary heart disease. In certain cases, e.g. if the patient suffers from additional risks, helical CT should be done prior to coronary angiography. Coronary calcifications found incidentally in symptomatic patients at chest CT warrant further cardiological investigation.
Heussel
C P
CP
Klinik und Poliklinik für Radiologie, Johannes Gutenberg-Universität Mainz. HEUSSEL@GOOFY.ZDV.UNI-MAINZ.DE
Voigtländer
T
T
Kauczor
H U
HU
Braun
M
M
Meyer
J
J
Thelen
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002114:Calcinosis / Q000000981:diagnostic imaging*; D017023:Coronary Angiography / Q000706:statistics & numerical data; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D005069:Evaluation Studies as Topic; D005260:Female; D005471:Fluoroscopy / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods* / Q000706:statistics & numerical data