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Detection of Transplant Coronary Artery Disease Using Multidetector Computed Tomography With Adaptative Multisegment Reconstruction

Gardar Sigurdsson, MD^_*, Patricia Carrascosa, MD, Mohammad H. Yamani, MD^_*, Neil L. Greenberg, PhD^_*, Sergio Perrone, MD, Gustavo Lev, MD, Milind Y. Desai, MD^_* and Mario J. Garcia, MD^_*,_*

^_* Cleveland Clinic Foundation, Cleveland, Ohio
Diagnostico Maipu, San Isidro, Buenos Aires, Argentina
Organ Transplant Division, Favaloro Foundation, Buenos Aires, Argentina

View larger version (160K): [in a new window]   Figure 1 Volume-rendered contrast-enhanced multidetector computed tomographic image obtained from a heart transplant patient with an average heart rate of 106 beats/min.

View larger version (12K): [in a new window]   Figure 2 Bland-Altman analysis comparing stenosis determined by invasive coronary angiography (CA) and multidetector computed tomographic (MDCT) angiography (CTA). The points that lie on the 2 diagonal lines (1 going upward and 1 going downward) correspond to 1 method identifying no (0%) stenosis, whereas the other method is detecting a stenosis.

View larger version (73K): [in a new window]   Figure 3 Right coronary artery with evidence of diffuse vasculopathy. Both invasive angiography (A) and multidetector computed tomography (MDCT) (B and C) show moderate stenosis of the lumen in the proximal segment. Diffuse thickening of the vessel wall is noted in the MDCT maximum-intensity projection (A) and cross-sectional (C) images (arrows).

View larger version (81K): [in a new window]   Figure 4 Small calcified atherosclerotic plaque seen in the left main coronary artery (arrow) by multidetector computed tomography (A) in a patient with minimal angiographic irregularities (B).

View larger version (92K): [in a new window]   Figure 5 Left anterior descending artery showing distal vessel narrowing (arrows) by multidetector computed tomography (A) and invasive angiography (B).