title: Diagnostic accuracy of non-invasive 64-slice CT coronary angiography in patients with stable angina pectoris.
abstract: 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.
authors.affiliation: Department of Radiology, Erasmus Medical Center, Dr. Molenwaterplein 40, 3015 GD, Rotterdam, The Netherlands. pndj7571@yahoo.com
authors.forename: Francesca
authors.initials: F
authors.lastname: Pugliese
authors.forename: Nico R A
authors.initials: NR
authors.lastname: Mollet
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Runza
authors.forename: Carlos
authors.initials: C
authors.lastname: van Mieghem
authors.forename: Willem B
authors.initials: WB
authors.lastname: Meijboom
authors.forename: Patrizia
authors.initials: P
authors.lastname: Malagutti
authors.forename: Timo
authors.initials: T
authors.lastname: Baks
authors.forename: Gabriel P
authors.initials: GP
authors.lastname: Krestin
authors.forename: Pim J
authors.initials: PJ
authors.lastname: deFeyter
authors.forename: Filippo
authors.initials: F
authors.lastname: Cademartiri
mesh_terms: 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
chemical_list: D003287:Contrast Media