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Noninvasive coronary imaging and assessment of left ventricular function using 16-slice computed tomography
Joanne D Schuijf1, Jeroen J Bax, Liesbeth P Salm
1Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
The American Journal of Cardiology
|February 22, 2005
Summary
Sixteen-slice multislice computed tomography (MSCT) effectively detects coronary artery disease, including stenosis in stents and bypass grafts. This imaging technique also accurately assesses left ventricular ejection fraction, proving valuable for chest pain evaluation.
Area of Science:
- Cardiovascular Imaging
- Radiology
- Diagnostic Medicine
Background:
- Multislice computed tomography (MSCT) is emerging as a viable tool for noninvasive cardiac imaging.
- Previous studies suggest MSCT's potential for coronary angiography and left ventricular function analysis.
Purpose of the Study:
- To assess the diagnostic performance of 16-slice MSCT.
- To evaluate its ability to detect significant coronary artery disease (stenosis >/=50%).
- To analyze its accuracy in evaluating coronary stents, bypass grafts, and left ventricular ejection fraction.
Main Methods:
- Forty-five patients underwent 16-slice MSCT and conventional coronary angiography.
- MSCT evaluated native coronary segments, bypass grafts, and stents for stenosis.
- Left ventricular ejection fraction was calculated using MSCT and compared with 2D echocardiography.
Main Results:
- MSCT successfully evaluated 94% of native coronary segments, 85% of grafts, and 79% of stents.
- Overall sensitivity was 85%, specificity 89%, positive predictive value 71%, and negative predictive value 95%.
- MSCT showed high correlation with 2D echocardiography for ejection fraction (r=0.96, p<0.001).
Conclusions:
- Sixteen-slice MSCT is a feasible noninvasive method for evaluating coronary artery disease in patients with chest pain.
- It demonstrates good performance in detecting significant coronary stenoses, graft disease, and stent issues.
- MSCT provides reliable assessment of global left ventricular function.