title: Noninvasive coronary imaging and assessment of left ventricular function using 16-slice computed tomography.
abstract: In recent years, multislice computed tomography (MSCT) has been demonstrated to be a feasible imaging modality for noninvasive coronary angiography and left ventricular function analysis. The present study evaluated overall performance of 16-slice MSCT in the detection of significant coronary artery disease, stent, or bypass graft stenosis in combination with global left ventricular function analysis. Forty-five patients underwent 16-slice MSCT. Multislice computed tomograms were used to evaluate the presence of significant coronary artery stenoses (>/=50% decrease in luminal diameter) in native coronary segments, bypass grafts, and coronary stents and were compared with conventional coronary angiograms. In addition, left ventricular ejection fraction was calculated and compared with 2-dimensional echocardiography. MSCT was performed successfully in all patients. A close correlation between MSCT and 2-dimensional echocardiography was demonstrated for the assessment of left ventricular ejection fraction (y = 0.93x +3.33, r = 0.96, p <0.001). A total of 298 of native coronary artery segments (94%) were evaluated with MSCT, whereas 81 of 94 grafts (85%) and 41 of 52 coronary stents (79%) were also evaluated. For all segments, overall sensitivity, specificity, and positive and negative predictive values were 85%, 89%, 71%, and 95%, respectively. In conclusion, 16-slice MSCT is a feasible modality for noninvasive evaluation and exclusion of coronary artery disease in patients who present with chest pain.
authors.affiliation: Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Joanne D
authors.initials: JD
authors.lastname: Schuijf
authors.forename: Jeroen J
authors.initials: JJ
authors.lastname: Bax
authors.forename: Liesbeth P
authors.initials: LP
authors.lastname: Salm
authors.forename: J Wouter
authors.initials: JW
authors.lastname: Jukema
authors.forename: Hildo J
authors.initials: HJ
authors.lastname: Lamb
authors.forename: Ernst E
authors.initials: EE
authors.lastname: van der Wall
authors.forename: Albert
authors.initials: A
authors.lastname: de Roos
mesh_terms: D003287:Contrast Media; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging; D004452:Echocardiography; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D015607:Stents; D014057:Tomography, X-Ray Computed / Q000379:methods*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media; C093233:iobitridol; D007472:Iohexol