Author + information
- Received December 28, 2006
- Revision received April 18, 2007
- Accepted April 24, 2007
- Published online August 21, 2007.
- Annick C. Weustink, MD⁎,†,
- Willem B. Meijboom, MD⁎,†,
- Nico R. Mollet, MD, PhD⁎,†,
- Masato Otsuka, MD⁎,
- Fransesca Pugliese, MD⁎,†,
- Carlos van Mieghem, MD⁎,†,
- Roberto Malago, MD†,
- Niels van Pelt, MD⁎,†,
- Marcel L. Dijkshoorn, BSc†,
- Filippo Cademartiri, MD, PhD⁎,†,
- Gabriel P. Krestin, MD, PhD† and
- Pim J. de Feyter, MD, PhD⁎,†,⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. Pim J. de Feyter Department of Cardiology and Radiology, Thoraxcenter, Room Ba 589, ’s Gravendijkwal 230, 3000 CA Rotterdam, the Netherlands.
Objectives Our objective was to prospectively evaluate the diagnostic performance of the high-speed dual-source computed tomography scanner (DSCT), with an increased temporal resolution (83 ms), for the detection of significant coronary lesions (≥50% lumen diameter reduction) in a clinically wide range of patients.
Background Cardiac motion artifacts may decrease coronary image quality with use of earlier computed tomography scanners that have a limited temporal resolution.
Methods We prospectively studied 100 symptomatic patients (79 men, 21 women, mean age 61 ± 11 years) with atypical (18%) or typical (55%) angina pectoris, or unstable coronary artery disease (27%) scheduled for conventional coronary angiography. Mean scan time was 8.58 ± 1.52 s. Mean heart rate was 68 ± 11 beats/min. Quantitative coronary angiography was used as the standard of reference. Irrespective of image quality or vessel size, all segments were included for analysis.
Results Invasive coronary angiography demonstrated no significant disease in 23%, single-vessel disease in 31%, and multivessel disease in 46% of patients; 1,489 coronary segments, containing 220 significant (14.8%) stenoses, were available for analysis. Sensitivity, specificity, and positive and negative predictive values of DSCT coronary angiography for the detection of significant lesions on a segment-by-segment analysis were 95% (95% confidence interval [CI] 90 to 97), 95% (95% CI 93 to 96), 75% (95% CI 69 to 80), 99% (95% CI 98 to 99), respectively, and on a patient-based analysis 99% (95% CI 92 to 100), 87% (95% CI 65 to 97), 96% (95% CI 89 to 99), and 95% (95% CI 74 to 100), respectively.
Conclusions Noninvasive DSCT coronary angiography is highly sensitive to detect and to reliably rule out the presence of a significant coronary stenosis in patients presenting with atypical or typical angina pectoris, or unstable coronary artery disease.
- Received December 28, 2006.
- Revision received April 18, 2007.
- Accepted April 24, 2007.
- American College of Cardiology Foundation