Feasibility of 64-slice gadolinium-enhanced cardiac CT for the evaluation of obstructive coronary artery disease.
OBJECTIVE
To assess the feasibility of gadolinium-enhanced 64-slice cardiac CT (CCT) for the diagnosis of obstructive coronary artery disease.


METHODS
Comparative prospective study.


METHODS
Outpatient Imaging Diagnostic Centre, Diagnóstico Maipú, Buenos Aires, Argentina.


METHODS
Twenty patients with suspected coronary artery disease.


METHODS
Gadolinium-enhanced 64-slice CCT was performed before invasive coronary angiography (ICA).


METHODS
The feasibility of gadolinium-enhanced 64-slice CCT for detection of obstructive coronary artery disease (>50% diameter reduction) was evaluated, using ICA as the 'gold standard'. Mean lumen attenuation, non-calcified and calcified plaques densities were correlated between gadolinium-enhanced CCT studies and iodine-enhanced CCT studies of a control group. Renal function was strictly monitored.


RESULTS
Gadolinium-enhanced CCT demonstrated adequate visualisation of 283/289 coronary segments that were evaluable by ICA, 31 of which had >50% luminal stenosis. In per-segment analysis, gadolinium-enhanced CCT showed a sensitivity of 90.3%, specificity of 96.8%, positive predictive value of 77.8% and negative predictive value of 98.8%. The agreement of coronary stenosis between multidetector CT (MDCT) and ICA was 94.1% (272/289). The mean lumen attenuation, non-calcified and calcified plaques densities in gadolinium-enhanced CCT studies were 140.1 Hounsfield units (HU), 51.1 HU and 523.6 HU, whereas in iodine-enhanced CCT studies the values were 354.1 HU, 101.0 HU and 778.5 HU, respectively (p < 0.001).


CONCLUSIONS
Gadolinium-enhanced CCT is a feasible alternative for patients with severe contraindications to iodinated contrast agents referred for MDCT coronary angiography.
Carrascosa
Patricia
P
Department of Radiology, Diagnóstico Maipú, Buenos Aires 1602, Argentina.
Capuñay
Carlos
C
Deviggiano
Alejandro
A
Bettinotti
Marcelo
M
Goldsmit
Alejandro
A
Tajer
Carlos
C
Carrascosa
Jorge
J
García
Mario J
MJ
D000368:Aged; D016022:Case-Control Studies; D003287:Contrast Media; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D005240:Feasibility Studies; D005260:Female; D005682:Gadolinium; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D005682:Gadolinium