EXPRESS PUBLICATIONS
Diagnostic accuracy of noninvasive coronary imaging using 16-detector slice spiral computed tomography with 188 ms temporal resolution
Axel Kuettner, MD*,
Torsten Beck, MD ,
Tanja Drosch, MS*,
Klaus Kettering, MD,
Martin Heuschmid, MD*,
Christof Burgstahler, MD,
Claus D. Claussen, MD*,
Andreas F. Kopp, MD* and
Stephen Schroeder, MD,*
* Department for Radiology, Division of Diagnostic Radiology
Department for Internal Medicine, Division of Cardiology,
Eberhard-Karls-University of Tuebingen, Tuebingen, Germany.
Manuscript received May 7, 2004;
revised manuscript received September 3, 2004,
accepted October 21, 2004.
* Reprint requests and correspondence: Dr. Stephen Schroeder, Department of Cardiology, Eberhard-Karls-University Tuebingen, Otfried-Mueller-Str. 10, 72076 Tuebingen, Germany. (Email: Stephen.Schroeder{at}med.uni-tuebingen.de).
OBJECTIVES: The aim of our study was to evaluate the diagnostic accuracy of 16-multi-detector spiral computed tomography (MDCT) with 188 ms temporal resolution.
BACKGROUND: Because of rapid technical innovations, MDCT coronary imaging has significantly improved in the last five years. Recent results indicate a high diagnostic accuracy, especially in patients with clinical suspicion of coronary artery disease
(CAD).
METHODS: A total of 72 consecutive patients (30 women, 42 men, age 64 ± 10 years) scheduled for invasive coronary angiography (ICA) because of suspected CAD were additionally studied by MDCT (Sensation 16 Speed 4D, Siemens, Forchheim, Germany). Thirty-seven of 72 patients (51%) received an additional beta-blockade before MDCT because of heart rates >65 beats/min. The MDCT scans were analyzed regarding the presence of coronary artery lesions. Results were compared with ICA.
RESULTS: All 72 scans showed diagnostic image quality (heart rate: 64.1 ± 9.2 beats/min, calcium mass: 86 ± 156 mg). Thirteen coronary segments were evaluated in each patient. Sixty-two of 936 (6.6%) segments showed a nondiagnostic image quality. All segments were included in the analysis. A total of 117 relevant lesions (diameter stenosis >50%) were detected using ICA, and 96 of 117 (82%) were detected by MDCT. Sensitivity, specificity, and positive and negative predictive values for the whole study group were as follows: 82%, 98%, 87%, and 97%, respectively. The correct clinical diagnosis of presence or absence of significant CAD was obtained in 65 of 72 (90%) patients. All stenoses were detected by MDCT in 52 of 72 (72%) patients.
CONCLUSIONS: Our results indicate a high diagnostic accuracy of 16-slice MDCT with improved temporal resolution.
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Abbreviations and Acronyms
| | CAD = coronary artery disease | | CVD = cardiovascular disease | | ICA = invasive coronary angiography | | IQS = image quality score | | LAD = left anterior descending coronary artery | | LCx = left circumflex artery | | LM = left main (segment 5) | | MDCT = multi-detector spiral computed tomography | | RCA = right coronary artery |
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