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In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
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Angiographically uncertain left main coronary artery narrowings: correlation with multidetector computed tomography

Robert Dragu1, Arthur Kerner, Luis Gruberg

  • 1Division of Invasive Cardiology, Rambam Health Care Campus and the Bruce Rappaport Faculty of Medicine, The Technion-Israel Institute of Technology, Haifa, Israel.

The International Journal of Cardiovascular Imaging
|January 1, 2008
PubMed

Insights

Multidetector computed tomography (MDCT) accurately assesses left main coronary artery (LMCA) stenosis, correlating well with intravascular ultrasound (IVUS). MDCT offers a valuable non-invasive tool for evaluating uncertain LMCA disease.

Area of Science:

  • Cardiovascular Imaging
  • Radiology
  • Interventional Cardiology

Background:

  • Left main coronary artery (LMCA) stenosis assessment via angiography is often unreliable.
  • Intravascular ultrasound (IVUS) is currently used to determine the significance of uncertain LMCA stenosis.
  • Multidetector computed tomography (MDCT) offers a potential non-invasive alternative for LMCA stenosis evaluation.

Purpose of the Study:

  • To prospectively evaluate the ability of MDCT to assess LMCA luminal and plaque dimensions.
  • To characterize atherosclerotic plaque in the LMCA using MDCT.
  • To compare MDCT findings with IVUS and quantitative coronary angiography (QCA) in patients with angiographically uncertain LMCA stenosis.

Main Methods:

  • Twenty patients with uncertain LMCA stenosis underwent evaluation with IVUS, QCA, and 16-slice MDCT.
  • Key parameters assessed included minimal lumen diameter (MLD), minimal lumen area (MLA), lumen area stenosis (LAS), and plaque burden (PB).

Main Results:

  • MDCT showed high correlation with IVUS for MLA (r=0.93) and PB (r=0.94).
  • Strong correlations were also observed between MDCT and IVUS for LAS (r=0.83).
  • MDCT demonstrated high sensitivity for identifying non-calcified (100%) and calcified (75%) plaques.

Conclusions:

  • MDCT demonstrates a high degree of correlation with IVUS in assessing LMCA stenosis severity and plaque characteristics.
  • MDCT serves as a valuable non-invasive tool for the assessment, decision-making, and follow-up of patients with uncertain LMCA disease.
Abstract

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