Noninvasive detection of coronary lesions using 16-detector multislice spiral computed tomography technology
Initial clinical results
Axel Kuettner, MD*,*,
Tobias Trabold, MD*,
Stephen Schroeder, MD ,
Anja Feyer, MS*,
Torsten Beck, MD,
Ariane Brueckner, MD*,
Martin Heuschmid, MD*,
Christof Burgstahler, MD,
Andreas F. Kopp, MD* and
Claus D. Claussen, MD*
* Department for Radiology, Diagnostic Radiology
Department for Internal Medicine, Division of Cardiology, Eberhard-Karls-University of Tuebingen, Tuebingen, Germany
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Figure 1 A 45-year-old female patient with cardiovascular risk factors (hyperlipidemia, 30 pack years of smoking) and atypical angina. Conventional coronary angiography (c) excludes coronary artery disease. The entire coronary tree is well visualized at computed tomography angiography. Excellent image quality of the displayed coronary tree with no calcifications present (Agatston score 0). The volume rendering technique images (a) suggest a significant lesion of the small caliber septal branch (arrow). However, maximum intensity projections and curved maximum intensity projection images (b) of the left main, right coronary artery (e), the left anterior descending coronary artery (d), and of the septal branch as well as the circumflex coronary artery (f) show only slight tapering of the vessel without a significant lesion.
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Figure 2 A 58-year-old male patient with two-vessel disease. Note the excellent image quality as well as the absence of calcifications at the site of obstruction. (a) High-grade ostial lesion (multislice spiral computed tomography [MSCT]). (b) Tandem lesion in proximal right coronary artery (MSCT). (c) Catheter correlation of the ostial lesion. (d) Tandem lesion in catheter correlation.
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Figure 3 A 57-year-old male patient with known two-vessel disease and prior multiple right circumflex artery and left anterior descending coronary artery percutaneous transluminal coronary angioplasties. With a favorable Agatston score (39) and a heart rate below 65 beats/min, an excellent image quality is obtained, which is displayed in the maximum intensity projection image (a). Severe left anterior descending coronary artery lesion is visualized by multislice spiral computed tomography; the arrows indicate the begin and end of the lesion. (b) Corresponding conventional coronary angiography image; the arrows also indicate beginning and end of the lesion.
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