Noninvasive imaging of the coronary arteries.
A reliable noninvasive imaging method for significant coronary artery stenosis would have enormous implications related to cost of diagnosis and enhanced patient safety. Cardiac motion and calcified plaques, in the past, rendered a substantial number of computed tomographic (CT) images of the coronary arteries uninterpretation. The accuracy of multidetector CT for the detection of coronary stenosis appears to have progressively improved as the imaging equipment increased from 4-slice and 16-slice to 64-slice CT. With 64-slice CT, scanning of the entire coronary artery tree is possible in 10 to 13 s. Pooled data of results of a few investigations with 64-slice CT showed that the proportion of unevaluable segments is only 4%. The sensitivity of 64-slice CT for the detection of significant (>50% or = or >50%) coronary stenosis in a patient, based on pooled data, was 97% and specificity was 91%. Regarding detection of significant stenosis in any segment, the sensitivity, based on pooled data, was 91% with 64-slice CT and specificity was 96%. In a limited number of patients, sensitivity for detection of significant stenoses in proximal segments was 100%, in mid segments it was 94%, and in distal segments sensitivity it was 80%. Multi-detector CT provides the opportunity to quantify non-calcified coronary artery plaques, which may potentially be a strong predictor of cardiac events. It was also shown to be useful for the detection of stenosis in coronary artery bypass grafts.
Stein
P D
PD
St. Joseph Mercy Oakland Hospital, 44405 Woodward Avenue, Pontiac, MI 48341-5023, USA. steinp@trinity-health.org
Hoffmann
U
U
Beemath
A
A
Moselewski
F
F
D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D006801:Humans; D014057:Tomography, X-Ray Computed