Circulation. 2002;106:2051-2054
Published online before print September 30, 2002, doi: 10.1161/01.CIR.0000037222.58317.3D
Published online before print September 30, 2002, doi: 10.1161/01.CIR.0000037222.58317.3D
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(Circulation. 2002;106:2051.)
© 2002 American Heart Association, Inc.
Brief Rapid Communication |
Reliable Noninvasive Coronary Angiography With Fast Submillimeter Multislice Spiral Computed Tomography
From the Thoraxcenter, Departments of Cardiology (K.N., P.A.L., P.J.d.F.) and Radiology (K.N., F.C., R.R., P.M.T.P., P.J.d.F.), Erasmus Medical Center, Rotterdam, the Netherlands.
Correspondence to Koen Nieman, Erasmus MC, Thoraxcenter Bd 410, PO Box 2040, 3000CA, Rotterdam, The Netherlands. E-mail koennieman{at}hotmail.com
Background— Multislice spiral computed tomography (MSCT) is a promising technique for noninvasive coronary angiography, although clinical application has remained limited because of frequently incomplete interpretability, caused by motion artifacts and calcifications.
Methods and Results— In 59 patients (53 male, aged 58±12 years) with suspected obstructive coronary artery disease, ECG-gated MSCT angiography was performed with a 16-slice MSCT scanner (0.42-s rotation time, 12x0.75-mm detector collimation). Thirty-four patients were given additional ß-blockers (average heart rate: 56±6 min-1). After contrast injection, all data were acquired during an approximately 20-s breath hold. The left main (LM), left anterior descending (LAD), left circumflex (LCX), and right coronary artery (RCA), including 
2.0-mm side branches, were independently evaluated by two blinded observers and screened for 50% stenoses. The consensus reading was compared with quantitative coronary angiography. MSCT was successful in 58 patients. Eighty-six of the 231 evaluated branches were significantly diseased. Without exclusion of branches, the sensitivity, specificity and positive and negative predictive value to identify 50% obstructed branches was 95% (82/86), 86% (125/145), 80% (82/102), and 97% (125/129), respectively. The overall accuracy for the LM, LAD, RCA, and LCX was 100%, 91%, 86%, and 81%, respectively. No obstructed LM, LAD, or RCA branches remained undetected. Classification of patients as having no, single, or multivessel disease was accurate in 78% (45/58) of patients and no patients with significant obstructions were incorrectly excluded.
Conclusions— Improvements in MSCT technology, combined with heart rate control, allow reliable noninvasive detection of obstructive coronary artery disease.
Key Words: imaging • coronary disease • angiography • stenosis
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H. T. Abada, C. Larchez, B. Daoud, A. Sigal-Cinqualbre, and J.-F. Paul MDCT of the Coronary Arteries: Feasibility of Low-Dose CT with ECG-Pulsed Tube Current Modulation to Reduce Radiation Dose Am. J. Roentgenol., June 1, 2006; 186(6_Supplement_2): S387 - S390. [Abstract] [Full Text] [PDF]
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M. Gilard, J.-C. Cornily, P.-Y. Pennec, C. Joret, G. Le Gal, J. Mansourati, J.-J. Blanc, and J. Boschat Accuracy of Multislice Computed Tomography in the Preoperative Assessment of Coronary Disease in Patients With Aortic Valve Stenosis J. Am. Coll. Cardiol., May 16, 2006; 47(10): 2020 - 2024. [Abstract] [Full Text] [PDF]
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P. Zanzonico, L. N. Rothenberg, and H. W. Strauss Radiation Exposure of Computed Tomography and Direct Intracoronary Angiography: Risk Has its Reward J. Am. Coll. Cardiol., May 2, 2006; 47(9): 1846 - 1849. [Abstract] [Full Text] [PDF]
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D. R. Coles, M. A. Smail, I. S. Negus, P. Wilde, M. Oberhoff, K. R. Karsch, and A. Baumbach Comparison of Radiation Doses From Multislice Computed Tomography Coronary Angiography and Conventional Diagnostic Angiography J. Am. Coll. Cardiol., May 2, 2006; 47(9): 1840 - 1845. [Abstract] [Full Text] [PDF]
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M A S Cordeiro, J M Miller, A Schmidt, A C Lardo, B D Rosen, D E Bush, J A Brinker, D A Bluemke, E P Shapiro, and J A C Lima Non-invasive half millimetre 32 detector row computed tomography angiography accurately excludes significant stenoses in patients with advanced coronary artery disease and high calcium scores Heart, May 1, 2006; 92(5): 589 - 597. [Abstract] [Full Text] [PDF]
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F. Pugliese, F. Cademartiri, C. van Mieghem, W. B. Meijboom, P. Malagutti, N. R. A. Mollet, C. Martinoli, P. J. de Feyter, and G. P. Krestin Multidetector CT for visualization of coronary stents. RadioGraphics, May 1, 2006; 26(3): 887 - 904. [Abstract] [Full Text] [PDF]
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U. Hoffmann, F. Moselewski, K. Nieman, I.-K. Jang, M. Ferencik, A. M. Rahman, R. C. Cury, S. Abbara, H. Joneidi-Jafari, S. Achenbach, et al. Noninvasive Assessment of Plaque Morphology and Composition in Culprit and Stable Lesions in Acute Coronary Syndrome and Stable Lesions in Stable Angina by Multidetector Computed Tomography J. Am. Coll. Cardiol., April 18, 2006; 47(8): 1655 - 1662. [Abstract] [Full Text] [PDF]
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M. A.S. Cordeiro and J. A.C. Lima Atherosclerotic plaque characterization by multidetector row computed tomography angiography. J. Am. Coll. Cardiol., April 18, 2006; 47(8 Suppl): C40 - C47. [Abstract] [Full Text] [PDF]
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G. M. Feuchtner, W. Dichtl, G. J. Friedrich, M. Frick, H. Alber, T. Schachner, J. Bonatti, A. Mallouhi, T. Frede, O. Pachinger, et al. Multislice Computed Tomography for Detection of Patients With Aortic Valve Stenosis and Quantification of Severity J. Am. Coll. Cardiol., April 4, 2006; 47(7): 1410 - 1417. [Abstract] [Full Text] [PDF]
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C. Jahnke, I. Paetsch, S. Achenbach, B. Schnackenburg, R. Gebker, E. Fleck, and E. Nagel Coronary MR Imaging: Breath-hold Capability and Patterns, Coronary Artery Rest Periods, and {beta}-Blocker Use Radiology, April 1, 2006; 239(1): 71 - 78. [Abstract] [Full Text] [PDF]
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C. A.G. Van Mieghem, E. P. McFadden, P. J. de Feyter, N. Bruining, J. A. Schaar, N. R. Mollet, F. Cademartiri, D. Goedhart, S. de Winter, G. R. Granillo, et al. Noninvasive Detection of Subclinical Coronary Atherosclerosis Coupled With Assessment of Changes in Plaque Characteristics Using Novel Invasive Imaging Modalities: The Integrated Biomarker and Imaging Study (IBIS) J. Am. Coll. Cardiol., March 21, 2006; 47(6): 1134 - 1142. [Abstract] [Full Text] [PDF]
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 K. Sakakura, T. Yasu, Y. Kobayashi, T. Katayama, Y. Sugawara, H. Funayama, Y. Takagi, N. Ikeda, T. Ishida, Y. Tsuruya, et al. Noninvasive Tissue Characterization of Coronary Arterial Plaque by 16-Slice Computed Tomography in Acute Coronary Syndrome Angiology, March 1, 2006; 57(2): 155 - 160. [Abstract] [PDF]
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F. Cademartiri, N. R. Mollet, G. Runza, T. Baks, M. Midiri, E. P. McFadden, T. G. Flohr, B. Ohnesorge, P. J. de Feyter, and G. P. Krestin Improving Diagnostic Accuracy of MDCT Coronary Angiography in Patients with Mild Heart Rhythm Irregularities Using ECG Editing. Am. J. Roentgenol., March 1, 2006; 186(3): 634 - 638. [Abstract] [Full Text] [PDF]
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S. Y. Kim, J. B. Seo, K.-H. Do, J.-N. Heo, J. S. Lee, J.-W. Song, Y. H. Choe, T. H. Kim, H. S. Yong, S. I. Choi, et al. Coronary Artery Anomalies: Classification and ECG-gated Multi-Detector Row CT Findings with Angiographic Correlation. RadioGraphics, March 1, 2006; 26(2): 317 - 333. [Abstract] [Full Text] [PDF]
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