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

Kristian Bartnes1, Trude Sildnes, Amjid Iqbal

  • 1Department of Cardiothoracic and Vascular Surgery, University Hospital North Norway, Tromsø, Norway. kristian.bartnes@unn.no

Scandinavian Cardiovascular Journal : SCJ
|May 10, 2007
PubMed

Insights

Sixteen-slice multidetector spiral computed tomography (MDCT) cannot replace selective angiography for evaluating coronary artery disease in bypass graft patients. MDCT showed poor specificity and missed critical left main stem stenoses.

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.
Abstract

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