Bj. Rensing et al., Intravenous coronary angiography by electron beam computed tomography - A clinical evaluation, CIRCULATION, 98(23), 1998, pp. 2509-2512
Citations number
9
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Background-Noninvasive detection of coronary stenoses with electron beam CT
(EBCT) after intravenous injection of contrast medium has recently emerged
, We sought to determine the diagnostic accuracy of EBCT angiography in the
clinical setting using conventional coronary angiography as the "gold stan
dard."
Methods and Results-Thirty-seven patients (30 men) were investigated. After
intravenous injection of 150 mL of contrast medium, 40 to 60 consecutive t
ransaxial tomograms, covering the proximal and middle parts of the coronary
arteries, were obtained with ECG triggering at end diastole during breath-
holding. Three-dimensional reconstructions of the proximal and middle parts
of the arteries were compared with the conventional angiograms. Of the 259
proximal and middle coronary segments, 211 (81%) were analyzable by EBCT,
Of the left anterior descending coronary artery CLAD) segments, 95% were as
sessable. Right coronary artery (RCA) and left circumflex artery (LCx) segm
ents were assessable in 66% and 76%, respectively. Overall sensitivity and
specificity to detect a >50% diameter stenosis were 77% and 94%, respective
ly. This was 82% and 92% for the LAD, 60% and 97% for the RCA, and 83% and
89% for the LCx tall figures based on assessable lesions).
Conclusions-Intravenous EBCT coronary angiography is a promising coronary i
maging technique. The technique is not yet robust enough to be an alternati
ve to conventional coronary angiography. It can detect and rule out signifi
cant coronary artery disease of the left main proximal and mid portions of
the LAD with good accuracy.