Visual assessment of coronary artery stenosis with electrocardiographically-gated multislice computed tomography.
BACKGROUND
With faster image acquisition times and thinner slice widths, multislice detector computed tomography (MSCT) allows visualization of human coronary arteries. Significantly improved image quality, with high resolution and new software for three-dimensional post-processing, has made noninvasive examination of the cavities within human body possible.


OBJECTIVE
The aims of this study are to evaluate the diagnostic accuracy of ECG-gated MSCT for the detection of significant coronary artery stenosis and occlusions.


METHODS
In 25 patients (19 male and 6 female aged 65+/-9 years) with suspected obstructive coronary artery disease, ECG-gated MSCT angiography was performed with an 8-slice MSCT scanner. Visual coronary arteries were simulated in three coronary arteries. Conventional coronary angiographies were performed in all patients. And coronary lesions in MSCT were estimated by two observers, who did not know the results of the coronary angiography.


RESULTS
Current MSCT allows visual coronary artery with good image quality. The overall sensitivity for diagnosing significant coronary stenosis were 75.0%, the specificity was 95.6%. The positive and negative predictive values were 84.9 and 92.2%, respectively. The accuracy of MSCT for detecting coronary stenosis is the highest in the left main tranck and left anterior descending coronary artery, and lowest in the circumflex coronary artery.


CONCLUSIONS
MSCT was feasible for the detection of coronary artery stenosis.
Matsuo
Shinro
S
Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Seta Otsu, Shiga 520-2192, Japan. smatsuo@belle.shiga-med.ac.jp
Nakamura
Yasuyuki
Y
Matsumoto
Tetsuya
T
Nakae
Ichiro
I
Nagatani
Yukihiro
Y
Takazakura
Ryutaro
R
Takahashi
Masashi
M
Murata
Kiyoshi
K
Horie
Minoru
M
D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed / Q000379:methods*