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(Circulation. 2001;103:2535.)
© 2001 American Heart Association, Inc.
Brief Rapid Communications |
Detection of Coronary Artery Stenoses by Contrast-Enhanced, Retrospectively Electrocardiographically-Gated, Multislice Spiral Computed Tomography
From the Department of Internal Medicine II (S.A., T.G., D.R., H.D., W.M., W.G.D.), the Institute of Medical Physics (S.U., W.A.K.), and the Institute of Diagnostic Radiology (C.S., E.W., W.B., U.B.), University of Erlangen-Nürnberg, Germany.
Correspondence to Dr S. Achenbach, Medizinische Klinik II, Universität Erlangen, Östliche Stadtmauerstr 29, 91054 Erlangen, Germany. E-mail stephan.achenbach{at}rzmail.uni-erlangen.de
Background—Multislice spiral computed tomography (MSCT) with retrospectively ECG-gated image reconstruction permits coronary artery visualization. We investigated the method’s ability to identify high-grade coronary artery stenoses and occlusions.
Methods and
Results—A total of 64 consecutive
patients were studied by MSCT (4x1 mm cross-sections, 500-ms
rotation, table feed 1.5 mm/rotation, intravenous
contrast agent, retrospectively ECG-gated image reconstruction). All
coronary arteries and side branches with a luminal diameter
2.0 mm were assessed concerning evaluability and the presence of
high-grade stenoses (>70% diameter stenosis) or
occlusions. Results were compared with quantitative coronary
angiography. Of 256 coronary arteries (left main, left anterior
descending, left circumflex and right coronary artery,
including their respective side branches), 174 could be evaluated
(68%). In 19 patients (30%), all arteries were evaluable. Artifacts
caused by coronary motion were the most frequent reason for
unevaluable arteries. Overall, 32 of 58 high-grade stenoses and
occlusions were detected by MSCT (58%). In evaluable arteries, 32 of
35 lesions were detected, and the absence of stenosis was
correctly identified in 117 of 139 arteries (sensitivity, 91%;
specificity, 84%). If analysis was extended to all
stenoses with >50% diameter reduction, sensitivity was 85%
(40 of 47) and specificity was 76% (96 of
127).
Conclusions—MSCT with retrospective ECG gating permits the detection of coronary artery stenoses with high accuracy if image quality is sufficient, but its clinical use may presently be limited due to degraded image quality in a substantial number of cases, mainly due to rapid coronary motion.
Key Words: imaging • coronary disease • tomography
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R. Koos, A. H. Mahnken, A. M. Sinha, J. E. Wildberger, R. Hoffmann, and H. P. Kuhl Aortic Valve Calcification as a Marker for Aortic Stenosis Severity: Assessment on 16-MDCT Am. J. Roentgenol., December 1, 2004; 183(6): 1813 - 1818. [Abstract] [Full Text] [PDF]
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A F Kopp, A Kuttner, T Trabold, M Heuschmid, S Schroder, and C D Claussen Multislice CT in cardiac and coronary angiography Br. J. Radiol., December 1, 2004; 77(suppl_1): S87 - S97. [Abstract] [Full Text] [PDF]
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L. K. Hofmann, K. H. Zou, P. Costello, and U. J. Schoepf Electrocardiographically Gated 16-Section CT of the Thorax: Cardiac Motion Suppression Radiology, December 1, 2004; 233(3): 927 - 933. [Abstract] [Full Text] [PDF]
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F. Cademartiri, K. Nieman, A. van der Lugt, R. H. Raaijmakers, N. Mollet, P. M. T. Pattynama, P. J. de Feyter, and G. P. Krestin Intravenous Contrast Material Administration at 16-Detector Row Helical CT Coronary Angiography: Test Bolus versus Bolus-tracking Technique Radiology, December 1, 2004; 233(3): 817 - 823. [Abstract] [Full Text] [PDF]
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J. R. Davies, J. H. Rudd, and P. L. Weissberg Molecular and Metabolic Imaging of Atherosclerosis J. Nucl. Med., November 1, 2004; 45(11): 1898 - 1907. [Abstract] [Full Text] [PDF]
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U. Hoffmann, F. Moselewski, R. C. Cury, M. Ferencik, I.-k. Jang, L. J. Diaz, S. Abbara, T. J. Brady, and S. Achenbach Predictive Value of 16-Slice Multidetector Spiral Computed Tomography to Detect Significant Obstructive Coronary Artery Disease in Patients at High Risk for Coronary Artery Disease: Patient- Versus Segment-Based Analysis Circulation, October 26, 2004; 110(17): 2638 - 2643. [Abstract] [Full Text] [PDF]
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A. Kuettner, T. Trabold, S. Schroeder, A. Feyer, T. Beck, A. Brueckner, M. Heuschmid, C. Burgstahler, A. F. Kopp, and C. D. Claussen Noninvasive detection of coronary lesions using 16-detector multislice spiral computed tomography technology: Initial clinical results J. Am. Coll. Cardiol., September 15, 2004; 44(6): 1230 - 1237. [Abstract] [Full Text] [PDF]
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P.J. de Feyter and K. Nieman Noninvasive multi-slice computed tomography coronary angiography: An emerging clinical modality J. Am. Coll. Cardiol., September 15, 2004; 44(6): 1238 - 1240. [Full Text] [PDF]
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J. F. Viles-Gonzalez, M. Poon, J. Sanz, T. Rius, K. Nikolaou, Z. A. Fayad, V. Fuster, and J. J. Badimon In Vivo 16-Slice, Multidetector-Row Computed Tomography for the Assessment of Experimental Atherosclerosis: Comparison With Magnetic Resonance Imaging and Histopathology Circulation, September 14, 2004; 110(11): 1467 - 1472. [Abstract] [Full Text] [PDF]
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J. K. Willmann, D. Weishaupt, R. Kobza, F. R. Verdun, B. Seifert, B. Marincek, and T. Boehm Coronary Artery Bypass Grafts: ECG-gated Multi-Detector Row CT Angiography--Influence of Image Reconstruction Interval on Graft Visibility Radiology, August 1, 2004; 232(2): 568 - 577. [Abstract] [Full Text] [PDF]
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P. Schoenhagen, S. S. Halliburton, A. E. Stillman, S. A. Kuzmiak, S. E. Nissen, E. M. Tuzcu, and R. D. White Noninvasive Imaging of Coronary Arteries: Current and Future Role of Multi-Detector Row CT Radiology, July 1, 2004; 232(1): 7 - 17. [Abstract] [Full Text] [PDF]
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U. J. Schoepf, C. R. Becker, B. M. Ohnesorge, and E. K. Yucel CT of Coronary Artery Disease Radiology, July 1, 2004; 232(1): 18 - 37. [Abstract] [Full Text] [PDF]
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N. R. Mollet, F. Cademartiri, K. Nieman, F. Saia, P. A. Lemos, E. P. McFadden, P. M. T. Pattynama, P. W. Serruys, G. P. Krestin, and P. J. de Feyter Multislice spiral computed tomography coronary angiography in patients with stable angina pectoris J. Am. Coll. Cardiol., June 16, 2004; 43(12): 2265 - 2270. [Abstract] [Full Text] [PDF]
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E. Martuscelli, A. Romagnoli, A. D'Eliseo, C. Razzini, M. Tomassini, M. Sperandio, G. Simonetti, and F. Romeo Accuracy of thin-slice computed tomography in the detection of coronary stenoses Eur. Heart J., June 2, 2004; 25(12): 1043 - 1048. [Abstract] [Full Text] [PDF]
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U. Hoffmann, R. Millea, C. Enzweiler, M. Ferencik, S. Gulick, J. Titus, S. Achenbach, D. Kwait, D. Sosnovik, and T. J. Brady Acute Myocardial Infarction: Contrast-enhanced Multi-Detector Row CT in a Porcine Model Radiology, June 1, 2004; 231(3): 697 - 701. [Abstract] [Full Text] [PDF]
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S. J. Riederer Coronary Artery MR Angiography: Are We There Yet? Radiology, May 1, 2004; 231(2): 302 - 304. [Full Text] [PDF]
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H. S. Choi, B. W. Choi, K. O. Choe, D. Choi, K.-J. Yoo, M.-I. Kim, and J. Kim Pitfalls, Artifacts, and Remedies in Multi- Detector Row CT Coronary Angiography RadioGraphics, May 1, 2004; 24(3): 787 - 800. [Abstract] [Full Text] [PDF]
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B. Desjardins and E. A. Kazerooni ECG-Gated Cardiac CT Am. J. Roentgenol., April 1, 2004; 182(4): 993 - 1010. [Full Text] [PDF]
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A. Kuettner, A. F. Kopp, S. Schroeder, T. Rieger, J. Brunn, C. Meisner, M. Heuschmid, T. Trabold, C. Burgstahler, J. Martensen, et al. Diagnostic accuracy of multidetector computed tomography coronary angiography in patients with angiographically proven coronary artery disease J. Am. Coll. Cardiol., March 3, 2004; 43(5): 831 - 839. [Abstract] [Full Text] [PDF]
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