Multislice CT in graft vascular disease. A pilot study.
BACKGROUND
Graft vessel disease (GVD) is one of the main long-term complications in heart transplant (HT) patients. At present, the diagnosis of this complication requires invasive procedures. Multislice CT is an emerging technique that allows visualization of the coronary anatomy, including the vascular lumen and wall thickness. Our objective was to establish the value of 16-detector multislice CT in the detection of GVD, compared with angiography and intravascular ultrasound (IVUS).


METHODS
We studied 32 HT patients, who had a mean follow-up of 2016 days. CT was performed 24 hours prior to angiography, associated with IVUS if the latter proved normal. Comparisons were subsequently made using contingency tables to establish the sensitivity, specificity, and predictive values of the CT.


RESULTS
Angiography was not performed on two patients, and eight were excluded from CT assessment due to serum creatinine values >1.5 mg/dL. Comparison of the CT findings with the invasive techniques yielded a sensitivity of 50%, a specificity of 81%, a negative predictive value of 81%, a positive predictive value of 50%, and a precision of 72%.


CONCLUSIONS
Our results suggested good performance of the technique in screening for GVD because a high negative predictive value was recorded. We plan to increase the number of patients and use the 64-detector CT system to ensure greater time and spatial resolution.
Moro
J
J
Cardiology Department La Fe University Hospital, Valencia, Spain. moro@uv.es
Almenar
L
L
Igual
B
B
Martínez-Dolz
L
L
Sánchez
E
E
Martín
J
J
Andrés
L
L
Cano
O
O
Chamorro
C
C
Sánchez
I
I
Salvador
A
A
D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000000981:diagnostic imaging / Q000401:mortality; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed / Q000379:methods; D014652:Vascular Diseases / Q000000981:diagnostic imaging*