Screening strategies for the diagnosis of coronary artery stenosis in patients with cerebral infarction using dual-source spiral CT.
This study was to evaluate the benefit of the screening of coronary artery stenosis (CAS) using dual-source CT (DSCT) in patients with cerebral infarction caused by a Large Artery Atherosclerosis (LAA). From November 2007 to February 2008, 34 patients (25 males and 9 females; mean age, 62.4 +/- 9.5 years) were enrolled. All of them had ischemic strokes of LAA type but with no cardiac symptoms. All patients underwent coronary CT angiography (CCTA) using DSCT. A significant coronary artery stenosis was defined as the one having more than 50% of luminal narrowing. We evaluated diagnostic accuracy for CAS in stroke patients of LAA with a receiver operating characteristics curve analysis. Of the 34 ischemic stroke patients, 18 (52.9%) had normal coronary arteries, 5 (14.7%) had insignificant CAS, and 11 (32.4%) had a significant CAS. The Agatston scores were more than 400 in 54.5% of the patients with a significant CAS, but less than 40 in 86.9% of the patients without it (p for trend = 0.001). For age, the optimal cut-off point for a diagnosis of CAS was 63, which had a sensitivity of 90.9%, a specificity of 69.6%, a positive predictive value of 58.8%, and a negative predictive value of 94.1%, respectively. For the Agatston score, the optimal cut-off was 40, which had 81.8%, 91.3%, 81.8%, and 91.3%, respectively. CCTA using DSCT appears to be a promising screening technique for CAS in patients with an ischemic stroke of LAA.
Jin
Gong-Yong
GY
Department of Radiology, Chonbuk National University Medical School and Hospital, Research Institute of Clinical Medicine, Institute for Medical Science, Jeonju, Jeonbuk 561-712, South Korea.
Jeong
Seul-Ki
SK
Lee
Sang-Rok
SR
Kwon
Keun-Sang
KS
Han
Young-Min
YM
Cho
Young Il
YI
D000368:Aged; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging; D002544:Cerebral Infarction / Q000150:complications* / Q000517:prevention & control; D015897:Comorbidity; D017023:Coronary Angiography / Q000379:methods*; D001026:Coronary Artery Bypass; D023921:Coronary Stenosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D020766:Intracranial Embolism / Q000209:etiology; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D015588:Observer Variation; D012307:Risk Factors; D055502:Secondary Prevention; D016037:Single-Blind Method; D036542:Tomography, Spiral Computed / Q000295:instrumentation