Coronary artery disease cannot be reliably evaluated by 16-slice multidetector spiral computed tomography

Area of Science:

• Cardiovascular Imaging
• Medical Diagnostics
• Radiology

Background:

• Selective coronary angiography is standard for coronary artery disease evaluation.
• This method carries a risk of rare but serious complications.
• Alternative imaging modalities are sought to improve patient safety.

Purpose of the Study:

• To investigate if 16-slice multidetector spiral computed tomography (MDCT) can substitute for selective angiography.
• To evaluate MDCT's efficacy in assessing coronary artery disease in patients with prior coronary artery bypass grafting.

Main Methods:

• A comparative study involving 45 patients who underwent coronary artery bypass grafting.
• Patients were examined with both 16-slice MDCT and conventional selective angiography on the same day.
• Interpreters were blinded to the results of the parallel imaging modality.

Main Results:

• MDCT detected significant pathology (stenosis >/=50% or occlusion) in larger coronary segments with a mean sensitivity of 87% and specificity of 21%.
• MDCT failed to identify three out of ten left main stem stenoses.
• The sensitivity and specificity varied significantly across different coronary segments.

Conclusions:

• Sixteen-slice MDCT is not a suitable routine replacement for selective angiography in evaluating coronary artery disease.
• Further advancements in CT technology may be needed for reliable assessment in post-bypass patients.