Author + information
- Received June 25, 2003
- Revision received April 13, 2004
- Accepted May 25, 2004
- Published online September 15, 2004.
- 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*
- ↵*Reprint requests and correspondence:
Dr. Axel Kuettner, Department of Diagnostic Radiology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
Objectives The aim of our study was to evaluate the feasibility of detecting coronary artery lesions using a new computed tomography (CT) scanner with 16 detectors and faster gantry rotation.
Background Computed tomography angiography of the coronaries permits assessment of the coronaries; however, image quality is still impaired by motion artifacts and calcifications.
Methods Sixty patients scheduled for conventional coronary angiography (CCA) were additionally studied by multislice spiral computed tomography (MSCT).Calcium scores and a contrast-enhanced visualization of the coronaries were performed and analyzed regarding evaluability, presence of coronary artery lesions, and correct clinical diagnosis.
Results Calcium scoring was successful in all patients; 58 of 60 patients had a diagnostic contrast-enhanced scan. Mean calcium score was 506 ± 743 Agatston score equivalent (ASE); 13 of 58 (22%) patients had an ASE ≥1,000, 46 of 58 (78%) patients <1,000. In 763 coronary segments, CCA detected a total of 75 lesions ≥50%. The MSCT correctly assessed 54 of these. Twenty-one lesions were missed or incorrectly underestimated. Sensitivity was 72%, specificity 97%. When restricting analysis to patients with an ASE <1,000, 40 significant lesions ≥50% were seen on CCA, and MSCT correctly detected 39 lesions (sensitivity 98%, specificity 98%). Regardless of any threshold, the correct clinical diagnosis could be obtained in 58 of 60 (97%) of all patients.
Conclusions In individuals with low-to-moderate amounts of coronary artery calcium, 16-detector CT coronary angiography has high sensitivity and specificity for the diagnosis of significant coronary artery stenosis.
- Received June 25, 2003.
- Revision received April 13, 2004.
- Accepted May 25, 2004.
- American College of Cardiology Foundation