title: Influence of intra-coronary enhancement on diagnostic accuracy with 64-slice CT coronary angiography.
abstract: We assessed the effect of intra-coronary attenuation on diagnostic accuracy using 64-slice computed tomography coronary angiography (CT-CA). We enrolled 170 patients with suspected coronary artery disease who underwent conventional coronary angiography (CA) and 64-slice CT-CA (100 ml of Iomeprol 400 mg I/ml at 4 ml/s). The study population was divided into two groups (85 patients each based on median attenuation of 326 HU) based on mean arterial attenuation; group 1 with low attenuation and group 2 with high attenuation. Diagnostic accuracy for the detection of significant coronary artery stenosis was determined for both groups using CA as reference standard. Overall, 163 significant stenoses were detected in 1,030 assessable coronary artery segments in group 1 compared with 160 significant stenoses in 1,020 assessable segments in group 2. The average intra-coronary attenuation was significantly (P < 0.05) higher for group 2 (388 +/- 46 HU) compared with group 1 (291 +/- 33 HU). The corresponding sensitivity and specificity values for detection of significant coronary artery stenosis were higher for group 2 (96.3% and 97.6%, respectively) than for group 1 (82.8% and 93.2%, respectively) and were more marked in distal coronary segments than in proximal segments. Higher intra-coronary attenuation on CT-CA results in greater diagnostic accuracy for detection of coronary artery stenosis.
authors.affiliation: Department of Radiology and Cardiology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy. filippocademartiri@hotmail.com
authors.forename: Filippo
authors.initials: F
authors.lastname: Cademartiri
authors.forename: Erica
authors.initials: E
authors.lastname: Maffei
authors.forename: Anselmo Alessandro
authors.initials: AA
authors.lastname: Palumbo
authors.forename: Roberto
authors.initials: R
authors.lastname: Malagò
authors.forename: Ludovico
authors.initials: L
authors.lastname: La Grutta
authors.forename: W Bob
authors.initials: WB
authors.lastname: Meiijboom
authors.forename: Annachiara
authors.initials: A
authors.lastname: Aldrovandi
authors.forename: Michele
authors.initials: M
authors.lastname: Fusaro
authors.forename: Luigi
authors.initials: L
authors.lastname: Vignali
authors.forename: Alberto
authors.initials: A
authors.lastname: Menozzi
authors.forename: Valerio
authors.initials: V
authors.lastname: Brambilla
authors.forename: Paolo
authors.initials: P
authors.lastname: Coruzzi
authors.forename: Massimo
authors.initials: M
authors.lastname: Midiri
authors.forename: Miles A
authors.initials: MA
authors.lastname: Kirchin
authors.forename: Nico R A
authors.initials: NR
authors.lastname: Mollet
authors.forename: Gabriel P
authors.initials: GP
authors.lastname: Krestin
mesh_terms: D017023:Coronary Angiography / Q000379:methods* / Q000592:standards; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000379:methods*; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods* / Q000592:standards