Evaluation of cardiac allograft vasculopathy by multidetector computed tomography and whole-heart magnetic resonance coronary angiography.
BACKGROUND
Cardiac allograft vasculopathy (CAV) is a major complication that limits the long-term survival of recipients of heart transplants. In the present study the feasibility of 2 noninvasive approaches for detecting CAV (multidetector computed tomography (MDCT) and whole-heart magnetic resonance coronary angiography (MRCA)) was compared with conventional coronary angiography (CCAG).


RESULTS
Of 22 heart transplant recipients who underwent CCAG screening, 13 had only MDCT, 16 had only MRCA, and 7 had both noninvasive modalities. The coronary arterial tree was divided into 9 segments. Detection of vasculopathy by coronary segments was compared between 16-/64-detector computed tomography (CT) or MRCA and CCAG. The sensitivity of both 16- and 64-detector CT for diagnosing CAV was 69.6%, and specificity was 96.8%. The sensitivity and specificity by 64-detector CT alone were 90.0% and 97.5%, respectively; its positive and negative predictive values were 81.8% and 98.7% respectively. For MRCA, sensitivity was 60%, specificity, 100%, positive predictive value, 100% and negative predictive value, 92.2%. MRCA showed no false positives.


CONCLUSIONS
MDCT, especially 64-detector CT, is feasible for detecting CAV, whereas MRCA currently shows limited sensitivity.
Nunoda
Shinichi
S
Department of Medicine, Tokyo Women's Medical University Medical Center East, Tokyo, Japan. nunodagm@dnh.twmu.ac.jp
Machida
Haruhiko
H
Sekikawa
Akihiko
A
Shitakura
Kazunobu
K
Okajima
Kiyotaka
K
Kubo
Yutaka
Y
Ueno
Eiko
E
Otsuka
Kuniaki
K
D000293:Adolescent; D000328:Adult; D017023:Coronary Angiography; D003331:Coronary Vessels; D005260:Female; D016027:Heart Transplantation / Q000000981:diagnostic imaging*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014184:Transplantation, Homologous; D014652:Vascular Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000209:etiology