Background. Multidetector computed tomography coronary angiography (MDCT-CA) is a non-invasive technique that clearly shows coronary anatomy and correctly identifies plaque location and morphology. In this study we assessed diagnostic accuracy of MDCT-CA in detectiong significant stenosis in patients with clinically relevant coronary tree disease. Methods. Fifty patients (38 males, 12 females, mean age 60.9 ± 9.2 years) with atypical chest pain, stable or unstable angina pectoris, or non-ST-elevation myocardial infarction underwent MDCT-CA (Brilliance 40, Philips Medical Systems, Cleveland, OH, USA) within 3 days before diagnostic conventional coronary angiography. Inclusion criteria were sinus rhythm, heart rate <70 b/min, and ability to hold breath for more than 12 s. Exclusion criteria were known intolerance to contrast medium, serum creatinine >2 mg/dl, pregnancy, respiratory insufficiency, unstable clinical conditions, and severe heart failure. Beta-blockers were administered if heart rate was >70 b/min. To synchronize arrival of the contrast bolus (Iomeron 400, Bracco, Milan) in the coronary arteries with the start of the scan the bolus-tracking technique was used. Diagnostic accuracy was evaluated per segment, per vessel, and per patient. Results. Mean heart rate during examination was 61.9 ± 6.2 b/min; 618 segments were evaluated. The assessment was impaired by respiratory artifacts only in 1 patient (2%). MDCT-CA showed good sensitivity, specificity, and positive and negative predictive values in detecting significant coronary artery stenosis (94, 94, 91, and 96% per segment; 91, 97, 95, and 92% per vessel; 100, 100, 100, and 100% per-patient, respectively). Conclusions. Forty-slice MDCT-CA showed a good diagnostic capability in detecting significant coronary artery stenosis in patients referred to our institution for suspected or known significant coronary artery disease.

RUNZA G, RIZZO M, EVOLA S, ALAIMO V, NOVO G, CORRADO E, et al. (2007). Approccio diagnostico non invasivo con tomografia computerizzata multidetettore a 40 strati per lo studio della malattia aterosclerotica coronarica. GIORNALE ITALIANO DI CARDIOLOGIA, 8(8), 508-518.

Approccio diagnostico non invasivo con tomografia computerizzata multidetettore a 40 strati per lo studio della malattia aterosclerotica coronarica

RUNZA, Giuseppe;EVOLA, Salvatore;NOVO, Giuseppina;CORRADO, Egle;TRIOLO, Oreste Fabio;GENNARO, Francesca;HOFFMANN, Enrico;MIDIRI, Massimo;NOVO, Salvatore
2007-01-01

Abstract

Background. Multidetector computed tomography coronary angiography (MDCT-CA) is a non-invasive technique that clearly shows coronary anatomy and correctly identifies plaque location and morphology. In this study we assessed diagnostic accuracy of MDCT-CA in detectiong significant stenosis in patients with clinically relevant coronary tree disease. Methods. Fifty patients (38 males, 12 females, mean age 60.9 ± 9.2 years) with atypical chest pain, stable or unstable angina pectoris, or non-ST-elevation myocardial infarction underwent MDCT-CA (Brilliance 40, Philips Medical Systems, Cleveland, OH, USA) within 3 days before diagnostic conventional coronary angiography. Inclusion criteria were sinus rhythm, heart rate <70 b/min, and ability to hold breath for more than 12 s. Exclusion criteria were known intolerance to contrast medium, serum creatinine >2 mg/dl, pregnancy, respiratory insufficiency, unstable clinical conditions, and severe heart failure. Beta-blockers were administered if heart rate was >70 b/min. To synchronize arrival of the contrast bolus (Iomeron 400, Bracco, Milan) in the coronary arteries with the start of the scan the bolus-tracking technique was used. Diagnostic accuracy was evaluated per segment, per vessel, and per patient. Results. Mean heart rate during examination was 61.9 ± 6.2 b/min; 618 segments were evaluated. The assessment was impaired by respiratory artifacts only in 1 patient (2%). MDCT-CA showed good sensitivity, specificity, and positive and negative predictive values in detecting significant coronary artery stenosis (94, 94, 91, and 96% per segment; 91, 97, 95, and 92% per vessel; 100, 100, 100, and 100% per-patient, respectively). Conclusions. Forty-slice MDCT-CA showed a good diagnostic capability in detecting significant coronary artery stenosis in patients referred to our institution for suspected or known significant coronary artery disease.
2007
RUNZA G, RIZZO M, EVOLA S, ALAIMO V, NOVO G, CORRADO E, et al. (2007). Approccio diagnostico non invasivo con tomografia computerizzata multidetettore a 40 strati per lo studio della malattia aterosclerotica coronarica. GIORNALE ITALIANO DI CARDIOLOGIA, 8(8), 508-518.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10447/2519
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