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Updated: Jun 24, 2026
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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
Invasive versus noninvasive evaluation of coronary artery disease
Joanne D Schuijf1, Jacob M van Werkhoven, Gabija Pundziute
1Department of Cardiology, Leiden University Medical Center, the Netherlands.
JACC. Cardiovascular Imaging
|April 10, 2009
Summary
Multidetector computed tomography (MDCT) can detect coronary atherosclerosis even when myocardial perfusion imaging (MPI) shows normal blood flow. MDCT identifies non-flow-limiting plaque, offering a more comprehensive view of coronary artery disease.
Area of Science:
- Cardiovascular Imaging
- Radiology
- Diagnostic Cardiology
Background:
- Myocardial perfusion imaging (MPI) abnormalities correlate with significant stenosis on multidetector computed tomography (MDCT) coronary angiography.
- MDCT may detect atherosclerotic lesions even with normal MPI findings.
Purpose of the Study:
- To compare diagnostic information from noninvasive MDCT and MPI for coronary artery disease.
- To validate findings against invasive coronary angiography and intravascular ultrasound (IVUS).
Main Methods:
- MDCT, MPI, and conventional coronary angiography performed in 70 patients.
- IVUS performed in 53 patients for quantitative assessment of plaque burden and minimal luminal area.
- Quantitative coronary angiography (QCA) used for stenosis quantification.
Main Results:
- MDCT identified significant stenosis in 88% of patients with abnormal MPI.
- MDCT showed 96% sensitivity and 67% specificity for detecting stenoses >50% diameter narrowing compared to QCA.
- MDCT detected coronary atherosclerosis in 84% of patients with normal MPI, with substantial plaque burden noted on IVUS even without flow limitation.
Conclusions:
- MDCT can reveal significant plaque burden irrespective of myocardial perfusion status.
- MDCT detects non-flow-limiting atherosclerotic lesions, which are not false positives.
- MDCT provides a more comprehensive assessment of coronary atherosclerosis than MPI alone.
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