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The utility of multi-detector row spiral CT for detection of coronary artery stenoses

Authors
 Jae-Youn Moon  ;  Namsik Chung  ;  Byoung Wook Choi  ;  Kyu Ok Choe  ;  Hye Sun Seo  ;  Young-Guk Ko  ;  Seok-Min Kang  ;  Jong-Won Ha  ;  Se-Joong Rim  ;  Yangsoo Jang  ;  Won-Heum Shim  ;  Seung-Yun Cho 
Citation
 YONSEI MEDICAL JOURNAL, Vol.46(1) : 86-94, 2005 
Journal Title
 YONSEI MEDICAL JOURNAL 
ISSN
 0513-5796 
Issue Date
2005
MeSH
Aged ; Coronary Stenosis/diagnostic imaging* ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Reproducibility of Results ; Sensitivity and Specificity ; Tomography, Spiral Computed*/standards
Keywords
Coronary artery stenoses ; computed tomography ; imaging ; stent ; MDCT
Abstract
Contrast-enhanced multi-detector row spiral computed tomography (MDCT) was introduced as a promising noninvasive method for vascular imaging. This study examined the accuracy of this technique for detecting significant coronary artery stenoses. Both MDCT(Sensation 16, Siemens, Germany, 12 × 0.75 mm collimation and 0.42 sec rotation speed, 120 kV, 500 effective mA, and 2.7 mm/rotation table-feed) and invasive coronary angiography (CAG) were performed on 61 patients (mean age 59.2 ± 10, 44 men) who were suspected of having coronary artery disease. All patients were treated with atenolol (25 - 50 mg) prior to imaging and the heart rate was maintained below 65 beats per minutes during image acquisition. The images were reconstructed in the diastole around TI - 400 ms with a 0.5 mm increment and a 1.0 mm thickness. All coronary arteries with a diameter of 2.0 mm or more were assessed for the presence of a stenosis (> 50% luminal narrowing). Two independent radiologists who were unaware of the results of the invasive CAG evaluated the MDCT data, and the results were compared with those from the invasive CAG (interval 1- 27, mean 11 days). An evaluation of the CT coronary angiogram (CTCA) was possible in 58 of the 61 patients (95%). Image acquisition of the major coronary arteries including the left main trunk was available in 229 out of 244 arteries. Invasive CAG showed that 35 out of 58 patients had significant coronary artery stenoses by. patient analysis of those who could be evaluated showed that CT coronary angiography correctly classified 30 out of 35 patients as having at least 1 coronary stenosis (sensitivity 85.7%, specificity 91.3%, positive predictive value 93.8%, negative predictive value 80.8%). By analyzing each coronary artery, CAG found 62 stenotic coronary arteries in the 229 coronary arteries that could be evaluated. MDCT correctly detected 50 out of 62 stenotic coronary arteries and an absence of stenosis was correctly identified in 156 out of 167 normal coronary arteries (sensitivity 80.6%, specificity 93.4%, positive predictive value 81.9%, negative predictive value 92.8%). The non-invasive technique of MDCT for examining the coronary artery appears to be a useful method for detecting coronary artery stenoses with a high accuracy particularly with the proximal portion and large arteries.
Files in This Item:
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DOI
10.3349/ymj.2005.46.1.86
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Min(강석민) ORCID logo https://orcid.org/0000-0001-9856-9227
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Moon, Jae Youn(문재연)
Seo, Hye Sun(서혜선)
Shim, Won Heum(심원흠)
Rim, Se Joong(임세중) ORCID logo https://orcid.org/0000-0002-7631-5581
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Chung, Nam Sik(정남식)
Cho, Seung Yun(조승연)
Choe, Kyu Ok(최규옥)
Choi, Byoung Wook(최병욱) ORCID logo https://orcid.org/0000-0002-8873-5444
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/147686
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