title: Reliable high-speed coronary computed tomography in symptomatic patients.
abstract: OBJECTIVE
  Our objective was to prospectively evaluate the diagnostic performance of the high-speed dual-source computed tomography scanner (DSCT), with an increased temporal resolution (83 ms), for the detection of significant coronary lesions (> or =50% lumen diameter reduction) in a clinically wide range of patients.
  
  
  BACKGROUND
  Cardiac motion artifacts may decrease coronary image quality with use of earlier computed tomography scanners that have a limited temporal resolution.
  
  
  METHODS
  We prospectively studied 100 symptomatic patients (79 men, 21 women, mean age 61 +/- 11 years) with atypical (18%) or typical (55%) angina pectoris, or unstable coronary artery disease (27%) scheduled for conventional coronary angiography. Mean scan time was 8.58 +/- 1.52 s. Mean heart rate was 68 +/- 11 beats/min. Quantitative coronary angiography was used as the standard of reference. Irrespective of image quality or vessel size, all segments were included for analysis.
  
  
  RESULTS
  Invasive coronary angiography demonstrated no significant disease in 23%, single-vessel disease in 31%, and multivessel disease in 46% of patients; 1,489 coronary segments, containing 220 significant (14.8%) stenoses, were available for analysis. Sensitivity, specificity, and positive and negative predictive values of DSCT coronary angiography for the detection of significant lesions on a segment-by-segment analysis were 95% (95% confidence interval [CI] 90 to 97), 95% (95% CI 93 to 96), 75% (95% CI 69 to 80), 99% (95% CI 98 to 99), respectively, and on a patient-based analysis 99% (95% CI 92 to 100), 87% (95% CI 65 to 97), 96% (95% CI 89 to 99), and 95% (95% CI 74 to 100), respectively.
  
  
  CONCLUSIONS
  Noninvasive DSCT coronary angiography is highly sensitive to detect and to reliably rule out the presence of a significant coronary stenosis in patients presenting with atypical or typical angina pectoris, or unstable coronary artery disease.
authors: Department of Cardiology, Thoraxcenter, Rotterdam, The Netherlands.
authors: Annick C
authors: AC
authors: Weustink
authors: Willem B
authors: WB
authors: Meijboom
authors: Nico R
authors: NR
authors: Mollet
authors: Masato
authors: M
authors: Otsuka
authors: Fransesca
authors: F
authors: Pugliese
authors: Carlos
authors: C
authors: van Mieghem
authors: Roberto
authors: R
authors: Malago
authors: Niels
authors: N
authors: van Pelt
authors: Marcel L
authors: ML
authors: Dijkshoorn
authors: Filippo
authors: F
authors: Cademartiri
authors: Gabriel P
authors: GP
authors: Krestin
authors: Pim J
authors: PJ
authors: de Feyter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000000981:diagnostic imaging; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed