Clinical utility of computed tomography and magnetic resonance techniques for noninvasive coronary angiography

Matthew J Budoff1, Stephan Achenbach, Andre Duerinckx

  • 1Division of Cardiology, Saint John's Cardiovascular Research Center, Harbor-UCLA Medical Center Research and Education Institute, Torrance, California 90502, USA. Budoff@flash.net

Insights

Noninvasive coronary angiography methods like electron beam angiography (EBA) show promise for detecting coronary artery disease (CAD). While not a complete replacement for conventional angiography, these techniques offer safer, cost-effective patient options.

Area of Science:

  • Cardiovascular imaging
  • Medical diagnostics
  • Radiology

Background:

  • Conventional coronary angiography (CCA) is invasive and costly.
  • Noninvasive coronary angiography (NIC) methods are advancing.
  • NIC aims to augment or replace CCA for diagnosing coronary artery disease (CAD).

Purpose of the Study:

  • To review literature on noninvasive coronary angiography (NIC).
  • Focus on electron beam angiography (EBA), magnetic resonance angiography (MRA), and spiral computed tomography (CT).
  • Evaluate these methods for visualizing coronary artery obstructions.

Main Methods:

  • Conducted MEDLINE searches for NIC studies.
  • Included magnetic resonance imaging (MRI), multi-row detector spiral computed tomography (MDCT), and electron beam tomography (EBT).
  • Performed weighted analysis to determine sensitivity and specificity.

Main Results:

  • Electron beam angiography (EBA) showed 87% sensitivity and 91% specificity for obstructive CAD.
  • Multi-row detector spiral CT (MDCT) had 59% sensitivity and 89% specificity, improving with newer devices.
  • Magnetic resonance angiography (MRA) demonstrated 77% sensitivity and 71% specificity.

Conclusions:

  • Noninvasive coronary angiography (NIC) is evolving and not yet a universal alternative to CCA.
  • EBA, MDCT, and MRA are used clinically at specialized centers.
  • Selective NIC use can be cost-effective and safer for patients deciding on treatment.
Abstract

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