AIMS: Multislice spiral computed tomography (MSCT) is a promising non-invasive method to diagnose coronary artery disease (CAD). As no detailed comparative evaluation in consecutive patients referred for evaluation of CAD has been reported, this prospective study evaluating 2384 coronary segments in 149 consecutive patients was performed. METHODS AND RESULTS: The coronary artery tree was analysed in 16 segments both for coronary angiography (CA) and MSCT; a luminal narrowing > or = 50% based on visual assessment was considered significant. By MSCT, 77% of 2110 angiographically assessable segments could be evaluated, 94% per patient in proximal and 70% in distal segments (P<0.001). Sensitivity of MSCT to detect significant stenoses was 30% in all, but only 10% in peripheral segments. The main limitations were calcifications in 34% of segments and motion artefacts in 24% of patients. Overall diagnostic sensitivity for the presence of significant CAD was 86% but specificity was only 49%. CONCLUSION: When compared with invasive CA, 16-slice MSCT is of limited diagnostic value for the diagnosis of CAD in consecutive patients. Despite a clinically useful sensitivity for the overall diagnosis of significant CAD, specificity is low. Thus, relevant decisions regarding the need of and suitability for possible revascularization procedures cannot be based on MSCT findings alone.
AIMS: Multislice spiral computed tomography (MSCT) is a promising non-invasive method to diagnose coronary artery disease (CAD). As no detailed comparative evaluation in consecutive patients referred for evaluation of CAD has been reported, this prospective study evaluating 2384 coronary segments in 149 consecutive patients was performed. METHODS AND RESULTS: The coronary artery tree was analysed in 16 segments both for coronary angiography (CA) and MSCT; a luminal narrowing > or = 50% based on visual assessment was considered significant. By MSCT, 77% of 2110 angiographically assessable segments could be evaluated, 94% per patient in proximal and 70% in distal segments (P<0.001). Sensitivity of MSCT to detect significant stenoses was 30% in all, but only 10% in peripheral segments. The main limitations were calcifications in 34% of segments and motion artefacts in 24% of patients. Overall diagnostic sensitivity for the presence of significant CAD was 86% but specificity was only 49%. CONCLUSION: When compared with invasive CA, 16-slice MSCT is of limited diagnostic value for the diagnosis of CAD in consecutive patients. Despite a clinically useful sensitivity for the overall diagnosis of significant CAD, specificity is low. Thus, relevant decisions regarding the need of and suitability for possible revascularization procedures cannot be based on MSCT findings alone.
Authors: Marco A S Cordeiro; Albert C Lardo; Marcelo S V Brito; Miguel A Rosário Neto; Maria H A Siqueira; José R Parga; Luiz F Avila; José A F Ramires; João A C Lima; Carlos E Rochitte Journal: Int J Cardiovasc Imaging Date: 2006-03-15 Impact factor: 2.357
Authors: Duncan R Coles; Peter Wilde; Martin Oberhoff; Chris A Rogers; Karl R Karsch; Andreas Baumbach Journal: Int J Cardiovasc Imaging Date: 2006-12-13 Impact factor: 2.357
Authors: Riccardo Marano; Francesco De Cobelli; Irene Floriani; Christoph Becker; Christopher Herzog; Maurizio Centonze; Giovanni Morana; Gian Franco Gualdi; Guido Ligabue; Gianluca Pontone; Carlo Catalano; Dante Chiappino; Massimo Midiri; Giovanni Simonetti; Filippo Marchisio; Lucio Olivetti; Rossella Fattori; Lorenzo Bonomo; Alessandro Del Maschio Journal: Eur Radiol Date: 2008-12-17 Impact factor: 5.315
Authors: Maciej Krupiński; Małgorzata Urbańczyk-Zawadzka; Bartosz Laskowicz; Małgorzata Irzyk; Robert Banyś; Piotr Klimeczek; Katarzyna Gruszczyńska; Jan Baron Journal: Eur Radiol Date: 2014-06-04 Impact factor: 5.315