[Forty-slice multidetector computed tomography for non-invasive diagnostic approach to coronary artery disease].
BACKGROUND
Multidetector computed tomography coronary angiography (MDCT-CA) is a non-invasive technique that clearly shows coronary anatomy and correctly identifies plaque location and morphology. In this study we assessed diagnostic accuracy of MDCT-CA in detectiong significant stenosis in patients with clinically relevant coronary tree disease.


METHODS
. Fifty patients (38 males, 12 females, mean age 60.9 +/- 9.2 years) with atypical chest pain, stable or unstable angina pectoris, or non-ST-elevation myocardial infarction underwent MDCT-CA (Brilliance 40, Philips Medical Systems, Cleveland, OH, USA) within 3 days before diagnostic conventional coronary angiography. Inclusion criteria were sinus rhythm, heart rate <70 b/min, and ability to hold breath for more than 12 s. Exclusion criteria were known intolerance to contrast medium, serum creatinine >2 mg/dl, pregnancy, respiratory insufficiency, unstable clinical conditions, and severe heart failure. Beta-blockers were administered if heart rate was >70 b/min. To synchronize arrival of the contrast bolus (Iomeron 400, Bracco, Milan) in the coronary arteries with the start of the scan the bolus-tracking technique was used. Diagnostic accuracy was evaluated per segment, per vessel, and per patient.


RESULTS
Mean heart rate during examination was 61.9 +/- 6.2 b/min; 618 segments were evaluated. The assessment was impaired by respiratory artifacts only in 1 patient (2%). MDCT-CA showed good sensitivity, specificity, and positive and negative predictive values in detecting significant coronary artery stenosis (94, 94, 91, and 96% per segment; 91, 97, 95, and 92% per vessel; 100, 100, 100, and 100% per-patient, respectively).


CONCLUSIONS
Forty-slice MDCT-CA showed a good diagnostic capability in detecting significant coronary artery stenosis in patients referred to our institution for suspected or known significant coronary artery disease.
Runza
Giuseppe
G
Cattedra di Radiologia, Azienda Ospedaliera Universitaria, Policlinico Paolo Giaccone, Università degli Studi, Palermo. grunza@sirm.org
Rizzo
Marco
M
Evola
Salvatore
S
Alaimo
Valerio
V
Novo
Giuseppina
G
Corrado
Egle
E
Evola
Giovanna
G
Palazzolo
Giuseppina
G
Triolo
Oreste Fabio
OF
Gennaro
Francesca
F
Hoffmann
Enrico
E
Midiri
Massimo
M
Novo
Salvatore
S
D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D003663:Decision Trees; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods*