Detection of coronary artery stenoses by contrast-enhanced, retrospectively electrocardiographically-gated,...

Area of Science:

• Cardiovascular Imaging
• Radiology
• Medical Diagnostics

Background:

• Multislice spiral computed tomography (MSCT) enables coronary artery visualization.
• Retrospective ECG-gating is used for image reconstruction in MSCT.

Purpose of the Study:

• To investigate the ability of MSCT with retrospective ECG gating to identify high-grade coronary artery stenoses and occlusions.
• To compare MSCT findings with quantitative coronary angiography.

Main Methods:

• 64 patients underwent MSCT with specific parameters (4x1 mm slices, 500-ms rotation, 1.5 mm/rotation table feed).
• Intravenous contrast agent and retrospective ECG-gating were utilized.
• Coronary arteries and side branches (diameter >/=2.0 mm) were assessed for evaluability, stenosis (>70%), and occlusions.

Main Results:

• 174 out of 256 coronary arteries (68%) were evaluable; 30% of patients had all arteries evaluated.
• Coronary motion artifacts were the primary cause of unevaluable arteries.
• MSCT detected 58% of high-grade stenoses/occlusions (32/58); sensitivity was 91% and specificity 84% for stenosis in evaluable arteries.

Conclusions:

• MSCT with retrospective ECG gating can accurately detect coronary artery stenoses when image quality is adequate.
• Clinical use is currently limited by image quality issues, mainly from coronary motion.
• Further advancements are needed to overcome motion-related artifacts for improved diagnostic accuracy.