Diagnostic accuracy of noninvasive coronary imaging using 16-detector slice spiral computed tomography with 188 ms temporal resolution.
OBJECTIVE
The aim of our study was to evaluate the diagnostic accuracy of 16-multi-detector spiral computed tomography (MDCT) with 188 ms temporal resolution.


BACKGROUND
Because of rapid technical innovations, MDCT coronary imaging has significantly improved in the last five years. Recent results indicate a high diagnostic accuracy, especially in patients with clinical suspicion of coronary artery disease (CAD).


METHODS
A total of 72 consecutive patients (30 women, 42 men, age 64 +/- 10 years) scheduled for invasive coronary angiography (ICA) because of suspected CAD were additionally studied by MDCT (Sensation 16 Speed 4D, Siemens, Forchheim, Germany). Thirty-seven of 72 patients (51%) received an additional beta-blockade before MDCT because of heart rates >65 beats/min. The MDCT scans were analyzed regarding the presence of coronary artery lesions. Results were compared with ICA.


RESULTS
All 72 scans showed diagnostic image quality (heart rate: 64.1 +/- 9.2 beats/min, calcium mass: 86 +/- 156 mg). Thirteen coronary segments were evaluated in each patient. Sixty-two of 936 (6.6%) segments showed a nondiagnostic image quality. All segments were included in the analysis. A total of 117 relevant lesions (diameter stenosis >50%) were detected using ICA, and 96 of 117 (82%) were detected by MDCT. Sensitivity, specificity, and positive and negative predictive values for the whole study group were as follows: 82%, 98%, 87%, and 97%, respectively. The correct clinical diagnosis of presence or absence of significant CAD was obtained in 65 of 72 (90%) patients. All stenoses were detected by MDCT in 52 of 72 (72%) patients.


CONCLUSIONS
Our results indicate a high diagnostic accuracy of 16-slice MDCT with improved temporal resolution.
Kuettner
Axel
A
Department for Radiology, Division of Diagnostic Radiology, Eberhard-Karls-University of Tuebingen, Germany.
Beck
Torsten
T
Drosch
Tanja
T
Kettering
Klaus
K
Heuschmid
Martin
M
Burgstahler
Christof
C
Claussen
Claus D
CD
Kopp
Andreas F
AF
Schroeder
Stephen
S
D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D012737:Sex Factors; D036542:Tomography, Spiral Computed / Q000379:methods*