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[Noninvasive plaque imaging using contrast-enhanced cardiac computed tomography].
Gert Kerkhoff1, Axel Schmermund, Stephan Möhlenkamp
1Klinik für Innere Medizin I und Kardiologie, Alfried-Krupp-Krankenhaus Essen, Essen. gert.kerkhoff@krupp-krankenhaus.de
Herz
|October 22, 2003
Summary
Contrast-enhanced coronary CT angiography shows promise for visualizing coronary stenosis, offering about 90% accuracy. However, artifacts and motion limit its use, and further studies are needed to establish its clinical value for obstructive coronary artery disease.
Area of Science:
- Cardiovascular imaging
- Computed tomography
- Noninvasive angiography
Background:
- Advances in multislice spiral computed tomography (MSCT) and electron-beam computed tomography (EBT) have renewed interest in CT-based coronary angiography.
- Invasive coronary angiography remains the gold standard, but cardiac CT lumenography offers a noninvasive alternative.
Purpose of the Study:
- To describe the principles and potentials of contrast-enhanced coronary CT imaging.
- To summarize practical limitations of current CT coronary angiography equipment.
Main Methods:
- Cardiac CT lumenography for visualizing coronary stenosis.
- Assessment of coronary calcification and plaque burden using CT.
- Utilizing newer MSCT technology for lesion configuration differentiation.
Main Results:
- Cardiac CT lumenography achieves approximately 90% sensitivity and specificity for detecting flow-limiting coronary stenosis.
- CT enables reliable estimation of coronary calcification and plaque burden for cardiovascular risk assessment.
- Newer MSCT technology shows potential for differentiating noncalcified plaques, though data is limited.
Conclusions:
- Contrast-enhanced coronary CT angiography is a promising noninvasive tool for evaluating coronary artery disease.
- Limitations include artifacts from calcifications and motion, impacting diagnostic accuracy.
- Further prospective studies are required to establish the clinical value for excluding obstructive coronary artery disease and to prove the relevance of plaque characterization.