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(Circulation. 1999;99:1523.)
© 1999 American Heart Association, Inc.

Images in Cardiovascular Medicine

LAD Stenosis Detected by Subsecond Spiral CT

Teruhito Mochizuki, MD; Kenya Murase, PhD; Yasushi Koyama, MD; Hiroshi Higashino, MD; Junpei Ikezoe, MD

From the Department of Radiology, Ehime University School of Medicine (T.M., K.M., J.I.), and the Departments of Cardiology (Y.K.) and Radiology (H.H.), Ehime-Imabari Hospital, Japan.

Correspondence to Teruhito Mochizuki, MD, Department of Radiology, Ehime-University School of Medicine, Shitsukawa, Shigenobu-cho, Onsen-gun, Ehime-ken 791-0295 Japan. E-mail tmochi{at}m.ehime-u.ac.jp

A50-year-old man with angina pectoris was hospitalized for coronary angiography. He was diagnosed with angina pectoris from the typical symptom (angina on exercise), positive exercise ECG (depressed ST-T in leads I, aVL, and V₁ through V₃), and positive exercise ²⁰¹Tl single photon emission CT (decreased ²⁰¹Tl perfusion in anteroseptal wall on exercise and significant redistribution on the 4-hour delayed scan). The coronary angiogram (CAG) depicted left anterior descending coronary artery (LAD) stenoses (75% stenosis in segment 6 and 50% stenosis in segment 7, Figure). Plain CT depicts no calcification of the LAD, and contrast-enhancement CT depicts LAD stenoses concordant with the CAG (Figure).

View larger version (64K): [in this window] [in a new window]   Figure 1. CAG (left) and plain and contrast-enhancement CT (middle and right, respectively) of 50-year-old man with angina pectoris. Coronary angiogram depicts LAD stenoses (75% stenosis in segment 6 [arrow] and 50% stenosis in segment 7 [arrowhead]). Plain CT depicts left coronary arteries, and no calcification is observed. Contrast-enhancement CT depicts LAD stenoses concordant with CAG.

To demonstrate coronary arteries, we used 3-mm-thick, 2-mm-per-rotation table speed (0.8 second per rotation), and 0.1 pitch overlapping reconstruction. Because a half-scan helical reconstruction algorithm was applied, time resolution (full width–half maximal) to obtain one transaxial slice was 0.4 second. This protocol allowed clear images of the coronary artery with less motion artifact. Clear images were obtained mainly in the end-diastolic and end-systolic phases. This image (quality and resolution) supports the potential use of subsecond spiral CT in the evaluation of coronary artery disease.

Footnotes

The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.

Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke's Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.

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