摘要
The aim of our study was to evaluate the diagnostic accuracy of 16-multi-detector spiral computed tomography(MDCT)with 188 ms temporal resolution. 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). 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. 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. Our results indicate a high diagnostic accuracy of 16-slice MDCT with improved temporal resolution.
The aim of our study was to evaluate the diagnostic accuracy of 16-multi-detector spiral computed tomography(MDCT)with 188 ms temporal resolution. 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). 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. 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. Our results indicate a high diagnostic accuracy of 16-slice MDCT with improved temporal resolution.
