General utilities of multislice tomography in the cardiac field.
OBJECTIVE
To show all cardiac evaluations multislice computed tomography (MSCT) can perform.


METHODS
MSCTs were performed on an MSCT scanner (Mx8000; Philips Medical Systems) with enhanced contrast acquisition. The reconstructed images were sent to a workstation for multiplanar reconstruction, volume rendering, and 3-D reconstruction. A total of 140 patients were studied with MSCT and conventional angiography (CA) to assess coronary artery stenosis. 30 of these patients were also evaluated by intravascular ultrasound (IVUS) for plaque characterization. A group of 20 patients were studied with MSCT, gated single-photon emission computed tomography (SPECT), and echocardiography for myocardial perfusion test and volumetric analysis.


RESULTS
The results of MSCT versus CA showed a sensitivity of 79.2% and a specificity of 93.7%, whereas for MSCT versus IVUS the sensitivity was 84.4% and the specificity 91.6%. A total of 156 plaques were detected by both methods. 105 (67%) were soft, 14 (24%) were fibrous and 37 (9%) were calcified. In the evaluation of myocardial perfusion, the cardiac software showed a sensitivity of 55% and a specificity of 80%. However, general evaluation disclosed a sensitivity of 88.5% and a specificity of 96.4%. The volumetric analysis showed a good correlation between MSCT and echocardiography for end-systolic volume (ESV), rS = 0.874, and end-diastolic volume (EDV), rS = 0.828. There was also a good correlation for the evaluation of the left ventricular anatomy: septal wall rS = 0.96, posterior wall rS = 0.81, and diameter of left ventricle rS = 0.69.


CONCLUSIONS
Nowadays, MSCT allows different cardiologic evaluations with the same acquisition as that for the coronary arteries. These data show a general view of the patient providing information that is obtained by the hand of multiple cardiologic methods such as DA, IVUS, gated SPECT, and echocardiography.
Carrascosa
Patricia Marina
PM
Diagnóstico Maipú, San Isidro, Buenos Aires, Argentina. investigacion@diagnosticomaipu.com.ar
Capuñay
Carlos María
CM
Parodi
Juan Carlos
JC
Padilla
Lucio Tiburcio
LT
Johnson
Peter
P
Carrascosa
Jorge Manuel
JM
Chandra
Shalabh
S
Smith
Dava
D
Belardi
Jorge
J
D000787:Angina Pectoris / Q000000981:diagnostic imaging; D000789:Angina, Unstable / Q000000981:diagnostic imaging; D002306:Cardiac Volume / Q000502:physiology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003326:Coronary Circulation / Q000502:physiology; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D012984:Software; D015899:Tomography, Emission-Computed, Single-Photon; D036542:Tomography, Spiral Computed; D018084:Ultrasonography, Interventional