[Non-invasive coronary angiography with 16 multidetector-row spiral computed tomography: a comparative study with invasive coronary angiography].
OBJECTIVE
Non-invasive coronary artery angiography by 16 multidetector-row spiral computed tomography is a novel diagnostic tool whose reliability is still unclear. The aim of our study was to compare this technique with invasive coronary angiography.


METHODS
A total of 31 selected patients were examined with both angiographic methods. Non-invasive studies were performed with a helical computer tomography system (Toshiba Aquilion 16-slices). A contrast agent was injected into a peripheral vein, and cross-sectional images were reconstructed with a slice thickness of 0.5 mm or 1.0 mm. Findings from both techniques were analyzed according to a predetermined segmented anatomical model of the coronary artery. The detection and relevance of coronary artery lesions were evaluated, and lesions with a reduction in diameter of more than 50% were considered significant.


RESULTS
Non-invasive coronary angiography yielded an appropriate assessment in 88.4% of the coronary artery segments. The reasons that prevented correct segment evaluation were extensive coronary calcifications, inappropriate breath-hold, motion artefacts and small vessel size. Sensitivity and specificity for the detection of significant coronary lesions with the non-invasive method were 75% and 91%, respectively. Sensitivity and specificity for individual coronary artery segments were as follows: proximal, 89% and 93%; medial, 87% and 90%; distal, 50% and 90%; and secondary branches, 62% and 92%.


CONCLUSIONS
Non-invasive coronary artery angiography with 16 multidetector-row computed tomography is a powerful diagnostic tool, especially for the evaluation of the proximal and medial segments of the major coronary arteries.
Leta
Rubén
R
Sección de Imagen Cardíaca y Unidad de Hemodinámica, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. rleta@hsp.santpau.es
Carreras
Francesc
F
Alomar
Xavier
X
Monell
Joan
J
García-Picart
Joan
J
Augé
Josep M
JM
Salvador
Antonio
A
Pons-Lladó
Guillem
G
D000328:Adult; D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000033:anatomy & histology / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed / Q000295:instrumentation / Q000379:methods*