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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
[Non-invasive coronary angiography with 16 multidetector-row spiral computed tomography: a comparative study with
Rubén Leta1, Francesc Carreras, Xavier Alomar
1Sección de Imagen Cardíaca y Unidad de Hemodinámica, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. rleta@hsp.santpau.es
Insights
Sixteen-slice computed tomography coronary angiography is a reliable non-invasive tool for assessing coronary artery disease, particularly in proximal and medial segments. This diagnostic method shows high accuracy for significant coronary lesions.
Area of Science:
- Cardiovascular Imaging
- Radiology
- Medical Diagnostics
Background:
- Non-invasive coronary angiography using 16 multidetector-row spiral computed tomography (MDCT) is a developing diagnostic technique.
- The clinical reliability of 16-MDCT for coronary angiography requires further investigation.
Purpose of the Study:
- To evaluate the diagnostic accuracy of 16-MDCT coronary angiography.
- To compare the findings of 16-MDCT coronary angiography with invasive coronary angiography.
Main Methods:
- Thirty-one patients underwent both non-invasive 16-MDCT and invasive coronary angiography.
- Coronary artery segments were analyzed using a standardized anatomical model.
- Significant lesions were defined as >50% diameter reduction.
Main Results:
- 16-MDCT provided appropriate assessment in 88.4% of coronary segments.
- Sensitivity and specificity for significant lesions were 75% and 91%, respectively.
- Accuracy was highest in proximal (89% sensitivity, 93% specificity) and medial (87% sensitivity, 90% specificity) segments.
Conclusions:
- 16-MDCT coronary angiography is a powerful diagnostic tool for evaluating coronary arteries.
- The technique is particularly effective for assessing proximal and medial segments of major coronary arteries.
Introduction And Objectives:
Non-invasive coronary artery angiography by 16 multidetector-row spiral computed tomography is a novel diagnostic tool whose reliability is still unclear. The aim of our study was to compare this technique with invasive coronary angiography.
Patients And Method:
A total of 31 selected patients were examined with both angiographic methods. Non-invasive studies were performed with a helical computer tomography system (Toshiba Aquilion 16-slices). A contrast agent was injected into a peripheral vein, and cross-sectional images were reconstructed with a slice thickness of 0.5 mm or 1.0 mm. Findings from both techniques were analyzed according to a predetermined segmented anatomical model of the coronary artery. The detection and relevance of coronary artery lesions were evaluated, and lesions with a reduction in diameter of more than 50% were considered significant.
Results:
Non-invasive coronary angiography yielded an appropriate assessment in 88.4% of the coronary artery segments. The reasons that prevented correct segment evaluation were extensive coronary calcifications, inappropriate breath-hold, motion artefacts and small vessel size. Sensitivity and specificity for the detection of significant coronary lesions with the non-invasive method were 75% and 91%, respectively. Sensitivity and specificity for individual coronary artery segments were as follows: proximal, 89% and 93%; medial, 87% and 90%; distal, 50% and 90%; and secondary branches, 62% and 92%.
Conclusions:
Non-invasive coronary artery angiography with 16 multidetector-row computed tomography is a powerful diagnostic tool, especially for the evaluation of the proximal and medial segments of the major coronary arteries.
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