Fm. Prigent et Rm. Steingart, CLINICAL-VALUE OF ELECTRON-BEAM COMPUTED-TOMOGRAPHY IN THE DIAGNOSIS AND PROGNOSIS OF CORONARY-ARTERY DISEASE, Current opinion in cardiology, 12(6), 1997, pp. 561-565
Electron-beam computed tomography (EBCT) is a relatively new imaging m
odality that provides transaxial cardiac images with excellent spatial
and temporal resolution. At present EBCT is used primarily to detect
and quantify the extent of coronary calcification. In autopsy studies,
increasing areas of classification are associated with the increasing
likelihood of more advanced atherosclerosis, but the relationship is
not linear, with large confidence limits, and EBCT may underestimate t
he total plaque burden. Compared with angiography, EBCT has a high sen
sitivity to detect coronary classification and a high negative predict
ive value to rule out a significant stenosis. But it may miss atherosc
lerotic plaque, including unstable plaque. Recent studies have aimed a
t improving the characterization of individual plaques by EBCT. Despit
e validation against autopsy and angiography, the clinical utility of
EBCT still is not well defined. Additional data on reproducibility and
better consensus on criteria for abnormality for coronary calcificati
on are advised.