Diagnostic accuracy of non-invasive 64-slice CT coronary angiography in patients with stable angina pectoris.
Multislice computed tomography (CT) is an emerging technique for the non-invasive detection of coronary stenoses. While the diagnostic accuracy of 4-slice scanners was limited, 16-slice CT imagers showed promising results due to increased temporal and spatial resolution. These technical advances prompted us to evaluate the diagnostic performance of 64-slice CT coronary angiography in the detection of significant stenoses (defined as > or = 50% luminal diameter reduction) versus invasive quantitative coronary angiography (QCA). Thirty-five patients with stable angina pectoris underwent CT coronary angiography performed with a 64-slice scanner (gantry rotation time 330 ms, individual detector width 0.6 mm) prior to conventional coronary angiography. Patients with heart rates >70 beats/min received 100 mg metoprolol orally. One hundred millilitres of contrast agent with an iodine concentration of 400 mgl/ml were injected at a rate of 5 ml/s into the antecubital vein. The CT scan was triggered with the bolus tracking technique. The sensitivity, specificity and the positive and negative predictive values of 64-slice CT were 99%, 96%, 78% and 99%, respectively, on a per-segment basis. The values obtained on a per-patient basis were 100%, 90%, 96% and 100%, respectively. When referral to catheterisation is questionable, CT coronary angiography may identify subjects with normal angiograms and consistently decrease the number of unnecessary invasive procedures.
Pugliese
Francesca
F
Department of Radiology, Erasmus Medical Center, Dr. Molenwaterplein 40, 3015 GD, Rotterdam, The Netherlands. pndj7571@yahoo.com
Mollet
Nico R A
NR
Runza
Giuseppe
G
van Mieghem
Carlos
C
Meijboom
Willem B
WB
Malagutti
Patrizia
P
Baks
Timo
T
Krestin
Gabriel P
GP
deFeyter
Pim J
PJ
Cademartiri
Filippo
F
D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000150:complications*; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed
D003287:Contrast Media