Diagnostic Performance of Multislice CT Coronary Angiography in the Assessment of Significant Coronary Artery Disease

  • Ali Mohammadzadeh Department of Radiology, Rejaee Cardiovascular Research Center, Tehran University of Medical Sciences; Tehran, Iran.
  • Abbas Arjmand Shabestari Department of Radiology, Modarres Hospital, Shahid Beheshti University of Medical Sciences;Advanced Diagnostic and Interventional Research Center(ADIR), Tehran, Iran.
  • Maryam Mohammadzadeh Mail Department of Radiology, Guilan University of Medical Sciences, Rasht, Iran.
  • Mohammad Ali Mohammadzadeh Department of Vascular Surgery, Guilan University of Medical Sciences, Rasht, Iran.
  • Sakineh Kadivar Department of Ophthalmology, Guilan University of Medical Sciences, Rasht, Iran.
  • Vahid Mohammadzadeh Department of Internal Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Hamid Heidari Guilan Road Trauma Research Center, Poursina Hospital, Rasht, Iran.
Keywords:
Coronary angiography, Coronary artery disease, Sensitivity and Specificity

Abstract

The use of noninvasive assessment tools such as multi-slice CT coronary angiography (MSCT-CA-CA) is recently considered mainly because it offers safety, patient convenience, and faster performance. The aim of the present study was to determine the ability of MSCT-CA-CA for the detection of significant stenoses in the coronary arteries, in comparison to conventional invasive coronary angiography (ICA). A total of 58 consecutive patients who were candidate for coronary angiography, with the diagnosis of acute coronary syndrome, from September 2006 to March 2006 were entered into the study. They underwent both coronary MSCT-CA-CA and ICA. The findings of each coronary segment were compared to MSCT-CA-CA in comparison with ICA. Based on artery analysis, sensitivity and specificity of MSCT-CA for the detection of involvement in RCA were 90.0% and 92.8%, in LAD were 71.8% and 92.9% and in LCX were 67.9% and 92.6%, respectively. On a per-segment basis, the sensitivity of MSCT-CA in the detection of injured segments ranged between 33.3% (for segment 11) and 100% (for segments 1, 2 and 12). Also, specificity ranged from 63.6% (for segment 15) and 98.1% (for segment 6). The presence of hypertension, hyperlipidemia, and smoking led to the reduction of the specificity and accuracy of MSCT-CA, whereas history of diabetes mellitus could increase the specificity and accuracy of this tool. MSCT-CA has high diagnostic performance in the assessment of significant coronary artery disease. Risk factors for coronary artery disease may influence this performance.

References

Anders K, Baum U, Schmid M, Ropers D, Schmid A, Pohle K, Daniel WG, Bautz W, Achenbach S. Coronary artery bypass graft (CABG) patency: assessment with high-resolution submillimeter 16-slice multidetector-row computed tomography (MDCT) versus coronary angiography. Eur J Radiol 2006;57(3):336-44.

Shabestari AA, Abdi S, Akhlaghpoor S, Azadi M, Baharjoo H, Pajouh MD, Emami Z, Esfahani F, Firouzi I, Hashemian M, Kouhi M, Mozafari M, Nazeri I, Roshani M, Salevatipour B, et al. Diagnostic performance of 64-channel multislice computed tomography in assessment of significant coronary artery disease in symptomatic subjects. Am J Cardiol 2007;99(12):1656-61.

Bax JJ, Schuijf JD. Which role for multislice computed tomography in clinical cardiology? Am Heart J 2005;149(6):960-1.

Hoffmann U, Moselewski F, Cury RC, Ferencik M, Jang IK, Diaz LJ, Abbara S, Brady TJ, Achenbach S. Predictive value of 16-slice multidetector spiral computed tomography to detect significant obstructive coronary artery disease in patients at high risk for coronary artery disease: patient-versus segment-based analysis. Circulation 2004;110(17):2638-43.

Achenbach S, Ropers D, Hoffmann U, MacNeill B, Baum U, Pohle K, Brady TJ, Pomerantsev E, Ludwig J, Flachskampf FA, Wicky S, Jang IK, Daniel WG. Assessment of coronary remodeling in stenotic and nonstenotic coronary atherosclerotic lesions by multidetector spiral computed tomography. J Am Coll Cardiol 2004;43(5):842-7.

Kuettner A, Beck T, Drosch T, Kettering K, Heuschmid M, Burgstahler C, Claussen CD, Kopp AF, Schroeder S. Diagnostic accuracy of noninvasive coronary imaging using 16-detector slice spiral computed tomography with 188 ms temporal resolution. J Am Coll Cardiol 2005;45(1):123-7.

Mollet NR, Cademartiri F, Krestin GP, McFadden EP, Arampatzis CA, Serruys PW, de Feyter PJ. Improved diagnostic accuracy with 16-row multi-slice computed tomography coronary angiography. J Am Coll Cardiol 2005;45(1):128-32.

Stein PD, Yaekoub AY, Matta F, Sostman HD. 64-slice CT for diagnosis of coronary artery disease: a systematic review. Am J Med 2008;121(8):715-25.

Pugliese F, Mollet NR, Runza G, van Mieghem C, Meijboom WB, Malagutti P, Baks T, Krestin GP, deFeyter PJ, Cademartiri F. Diagnostic accuracy of non-invasive 64- slice CT coronary angiography in patients with stable angina pectoris. Eur Radiol 2006;16(3):575-82.

Herzog C, Zwerner PL, Doll JR, Nielsen CD, Nguyen SA, Savino G, Vogl TJ, Costello P, Schoepf UJ. Significant coronary artery stenosis: comparison on per-patient and per-vessel or per-segment basis at 64-section CT angiography. Radiology 2007;244(1):112-20.

Nikolaou K, Knez A, Rist C, Wintersperger BJ, Leber A, Johnson T, Reiser MF, Becker CR. Accuracy of 64-MDCT in the diagnosis of ischemic heart disease. AJR Am J Roentgenol 2006;187(1):111-7.

Leber AW, Knez A, von Ziegler F, Becker A, Nikolaou K, Paul S, Wintersperger B, Reiser M, Becker CR, Steinbeck G, Boekstegers P. Quantification of obstructive and nonobstructive coronary lesions by 64-slice computed tomography: a comparative study with quantitative coronary angiography and intravascular ultrasound. J Am Coll Cardiol 2005;46(1):147-54.

Schlosser T, Mohrs OK, Magedanz A, Nowak B, Voigtländer T, Barkhausen J, Schmermund A. Noninvasive coronary angiography using 64-detector-row computed tomography in patients with a low to moderate pretest probability of significant coronary artery disease. Acta Radiol 2007;48(3):300-7.

Oncel D, Oncel G, Tastan A, Tamci B. Detection of significant coronary artery stenosis with 64-section MDCT angiography. Eur J Radiol. 2007;62(3):394-405.

Ong TK, Chin SP, Liew CK, Chan WL, Seyfarth MT, Liew HB, Rapaee A, Fong YY, Ang CK, Sim KH. Accuracy of 64-row multidetector computed tomography in detecting coronary artery disease in 134 symptomatic patients: influence of calcification. Am Heart J 2006;151(6):1323.e1-6.

Aviram G, Finkelstein A, Herz I, Lessick J, Miller H, Graif M, Keren G. Clinical value of 16-slice multi-detector CT compared to invasive coronary angiography. Int J Cardiovasc Intervent 2005;7(1):21-8.

Bordeleau E, Lamonde A, Prenovault J, Belblidia A, Coté G, Lespérance J, Soulez G, Chartrand-Lefebvre C. Accuracy and rate of coronary artery segment visualization with CT angiography for the non-invasive detection of coronary artery stenoses. Int J Cardiovasc Imaging 2007;23(6):771-80.

Raff GL, Gallagher MJ, O'Neill WW, Goldstein JA. Diagnostic accuracy of noninvasive coronary angiography using 64-slice spiral computed tomography. J Am Coll Cardiol 2005;46(3):552-7.

Mollet NR, Cademartiri F, van Mieghem CA, Runza G, McFadden EP, Baks T, Serruys PW, Krestin GP, de Feyter PJ. High-resolution spiral computed tomography coronary angiography in patients referred for diagnostic conventional coronary angiography. Circulation 2005;112(15):2318-23.

Ehara M, Surmely JF, Kawai M, Katoh O, Matsubara T, Terashima M, Tsuchikane E, Kinoshita Y, Suzuki T, Ito T, Takeda Y, Nasu K, Tanaka N, Murata A, Suzuki Y, et al. Diagnostic accuracy of 64-slice computed tomography for detecting angiographically significant coronary artery stenosis in an unselected consecutive patient population: comparison with conventional invasive angiography. Circ J 2006;70(5):564-71.

Brodoefel H, Reimann A, Burgstahler C, Schumacher F, Herberts T, Tsiflikas I, Schroeder S, Claussen CD, Kopp AF, Heuschmid M. Noninvasive coronary angiography using 64-slice spiral computed tomography in an unselected patient collective: effect of heart rate, heart rate variability and coronary calcifications on image quality and diagnostic accuracy. Eur J Radiol 2008;66(1):134-41.

Meijboom WB, Weustink AC, Pugliese F, van Mieghem CA, Mollet NR, van Pelt N, Cademartiri F, Nieman K, Vourvouri E, Regar E, Krestin GP, de Feyter PJ. Comparison of diagnostic accuracy of 64-slice computed tomography coronary angiography in women versus men with angina pectoris. Am J Cardiol 2007;100(10):1532-7.

How to Cite
1.
Mohammadzadeh A, Arjmand Shabestari A, Mohammadzadeh M, Mohammadzadeh MA, Kadivar S, Mohammadzadeh V, Heidari H. Diagnostic Performance of Multislice CT Coronary Angiography in the Assessment of Significant Coronary Artery Disease. Acta Med Iran. 50(1):31-36.
QRcode
Section
Articles