title: Coronary vasospastic angina: assessment by multidetector CT coronary angiography.
abstract: OBJECTIVE
  We aimed to describe the imaging findings of multidetector CT coronary angiography (MDCTA) in cases of vasospastic angina (VA) and to determine the accuracy of MDCTA in the identification of VA as compared with invasive coronary angiography with an ergonovine provocation test (CAG with an EG test).
  
  
  METHODS
  Fifty-three patients with clinically suspected VA were enrolled in this study. Two radiologists analyzed the stenosis degree, presence or absence of plaque, plaque composition, and a remodeling index of the related-segment in CAG with an EG test, which were used as a gold standard. We evaluated the diagnostic performances of MDCTA by comparing the MDCTA findings with those of CAG with an EG test.
  
  
  RESULTS
  Among the 25 patients with positive CAG with an EG test, all 12 patients with significant stenosis showed no definite plaque with the negative arterial remodeling. Of the six patients with insignificant stenosis, three (50%) had non-calcified plaque (NCP), two (33%) had mixed plaque, and one (17%) had calcified plaque. When the criteria for significant stenosis with negative remodeling but no definite evidence of plaque as a characteristic finding of MDCTA were used, results showed sensitivities, specificities, positive predictive values (PPV), and negative predictive values (NPV) of 48%, 100%, 100%, and 68%, respectively.
  
  
  CONCLUSIONS
  Significant stenosis with negative remodeling, but no definite evidence of plaque, is the characteristic finding on MDCTA of VA. Cardiac MDCTA shows good diagnostic performance with high specificity and PPV as compared with CAG with an EG test.
authors.affiliation: Division of Cardiovascular Imaging, Department of Radiology, Cardiovascular Center Seoul National University Bundang Hospital, Gyeonggi-do 436-707, Korea.
authors.forename: Koung Mi
authors.initials: KM
authors.lastname: Kang
authors.forename: Sang Il
authors.initials: SI
authors.lastname: Choi
authors.forename: Eun Ju
authors.initials: EJ
authors.lastname: Chun
authors.forename: Jeong A
authors.initials: JA
authors.lastname: Kim
authors.forename: Tae-Jin
authors.initials: TJ
authors.lastname: Youn
authors.forename: Dong Ju
authors.initials: DJ
authors.lastname: Choi
mesh_terms: D000787:Angina Pectoris / Q000000981:diagnostic imaging*; D016009:Chi-Square Distribution; D015897:Comorbidity; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods*; D004562:Electrocardiography; D004874:Ergonovine; D005260:Female; D006801:Humans; D007479:Iopamidol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D010120:Oxytocics; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D010120:Oxytocics; C057937:iomeprol; D007479:Iopamidol; D004874:Ergonovine