Copyright © 2002 by the European Society of Cardiology.
Non-invasive coronary angiography with high resolution multidetector-row computed tomography. Results in 102 patients
a Department of Diagnostic Radiology, Division of Cardiology, Eberhard-Karls-University Tuebingen, Germany
b Department of Internal Medicine, Division of Cardiology, Eberhard-Karls-University Tuebingen, Germany
c Department of Cardiology, Bristol Heart Institute, University of Bristol, U.K.
d Mayo Clinic, Jacksonville, Florida, U.S.A.
revised April 5, 2002; accepted April 10, 2002
Abstract
Aims A new generation of multidetector-row CT (MDCT) scanners allows complete coronary coverage using retrospective ECG gating and 1mm slices. The purpose of this study was to investigate the potential of high resolution MDCT angiography with retrospective gating for detection of coronary artery stenoses.
Methods and Results A total of 102 patients underwent both conventional and MDCT coronary angiography. After intravenous injection of a non-ionic contrast medium the entire heart was scanned within a single breath hold using 1mm slices. All MDCT data sets were reconstructed with retrospective gating at 20% to 80% in increments of 10% relative to the cardiac cycle. Two blinded independent reviewers analysed image quality for segments 1–4 (right coronary artery), 5–8 (left main, left anterior descending), and 11, 12 (left circumflex). These segments were evaluated for the presence or absence of significant (
50%) stenoses. The results were compared with those of invasive coronary angiography in a blinded fashion. Overall sensitivity for the detection of significant stenoses (50%) were 0·86 (reader 1) and 0·93 (reader 2), specificity 0·96 (reader 1) and 0·97 (reader 2), negative predictive value 0·98 (reader 1) and 0·99 (reader 2).
Conclusions High resolution MDCT angiography with retrospective gating permits the non-invasive detection of coronary artery stenoses with high accuracy if image quality is optimized for each of the three major coronary arteries. Copyright 2002 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved.
Key Words: Multidetector-row computed tomography (MDCT), coronary artery disease (CAD), computed tomography angiography (CTA), image reconstruction.
f1 Correspondence: Andreas F. Kopp, MD, Department of Diagnostic Radiology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany.
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