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Coronary artery stenosis quantification using multislice computed tomography.

Marc Dewey1, Wolfgang Rutsch, Dirk Schnapauff

  • 1Department of Radiology, Charité, Medical School, Freie Universität und Humboldt-Universität zu Berlin, Berlin, Germany. marc.dewey@charite.de

Investigative Radiology
|January 16, 2007
PubMed
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Multislice computed tomography (MSCT) shows moderate correlation for quantifying coronary artery stenoses compared to conventional coronary angiography. Current accuracy and reliability limit routine clinical use, but future improvements may enhance its potential.

Area of Science:

  • Cardiovascular Imaging
  • Medical Diagnostics
  • Radiology

Background:

  • Noninvasive detection of coronary artery stenoses is crucial for cardiovascular disease management.
  • Multislice computed tomography (MSCT) offers a potential noninvasive method for stenosis assessment.
  • Conventional coronary angiography remains the gold standard for stenosis quantification.

Purpose of the Study:

  • To evaluate the agreement, correlation, and reliability of MSCT in quantifying coronary artery stenoses.
  • To compare MSCT findings with quantitative coronary angiography (QCA) as the reference standard.

Main Methods:

  • Analysis of 118 coronary artery stenoses in 62 patients using 16-detector row MSCT.
  • Stenosis degree quantified by MSCT and QCA using diameter measurements.

Related Experiment Videos

  • Bland-Altman analysis for agreement and correlation coefficients for reliability.

    • Main Results:

    • Moderate correlation (R=0.51) between MSCT and QCA for stenosis quantification.
    • Large limits of agreement for MSCT (+/-27.6%) and interobserver reliability (+/-24.8%).
    • Improved correlation (R=0.80) and smaller limits of agreement (+/-17.3%) for stenoses in vessels >= 3.5 mm.

    Conclusions:

    • Current MSCT accuracy and reliability are insufficient for routine clinical application in stenosis quantification.
    • MSCT demonstrated potential for future accurate and reliable coronary artery stenosis quantification with improved resolution.
    • MSCT can correctly classify stenoses as low-grade (<75%) or high-grade (>=75%) in 62% of cases.