We sought to compare the diagnostic value of multi-slice computed tomography(MSCT)coronary angiography(CA)to detect significant stenoses(< 50%lumen diameter reduction)-with that of invasive CA. The latest 16-row MS...We sought to compare the diagnostic value of multi-slice computed tomography(MSCT)coronary angiography(CA)to detect significant stenoses(< 50%lumen diameter reduction)-with that of invasive CA. The latest 16-row MSCT scanner has a faster rotation time(375 ms)and permits scanning with a higher X-ray tube current(500 to 600 mA)during MSCT CA when compared with previous scanners. We studied 51 patients(37 men, mean age 58.9±10.0 years)with stable angina or atypical chest pain. Patients with pre-scan heart rates < 70 beats/min received oral beta-blockade. The heart was scanned after intravenous injection of 100 ml contrast(iodine content, 400 mg/ml). Mean scan time was 18.9±1.0 s. The MSCT scans were analyzed by two observers unaware of the results of invasive angiography, and all available coronary branches< 2 mm were included. Invasive CA demonstrated normal arteries in 16%(8 of 51), non-significant disease in 21%(11 of 51), single-vessel disease in 37%(19 of 51), and multivessel disease in 26%(13 of 51)of patients. There were 64 significant lesions. Sensitivity, specificity, and positive and negative predictive values for detection of significant lesions on a segment-based analysis were 95%(61 of 64, 95%confidence interval [CI] 86 to 99), 98%(537 of 546, 95%CI 96 to 99), 87%(61 of 70, 95%CI 76 to 98), and 99%(537 of 540, 95%CI 98 to 99), respectively. All patients with angiographically normal coronary arteries or significant lesions were correctly identified. Three of 11 patients with < 50%lesions were incorrectly classified as having single-vessel disease. The 16-row MSCT CA reliably detects significant coronary stenoses in patients with atypical chest pain or stable angina pectoris.展开更多
文摘We sought to compare the diagnostic value of multi-slice computed tomography(MSCT)coronary angiography(CA)to detect significant stenoses(< 50%lumen diameter reduction)-with that of invasive CA. The latest 16-row MSCT scanner has a faster rotation time(375 ms)and permits scanning with a higher X-ray tube current(500 to 600 mA)during MSCT CA when compared with previous scanners. We studied 51 patients(37 men, mean age 58.9±10.0 years)with stable angina or atypical chest pain. Patients with pre-scan heart rates < 70 beats/min received oral beta-blockade. The heart was scanned after intravenous injection of 100 ml contrast(iodine content, 400 mg/ml). Mean scan time was 18.9±1.0 s. The MSCT scans were analyzed by two observers unaware of the results of invasive angiography, and all available coronary branches< 2 mm were included. Invasive CA demonstrated normal arteries in 16%(8 of 51), non-significant disease in 21%(11 of 51), single-vessel disease in 37%(19 of 51), and multivessel disease in 26%(13 of 51)of patients. There were 64 significant lesions. Sensitivity, specificity, and positive and negative predictive values for detection of significant lesions on a segment-based analysis were 95%(61 of 64, 95%confidence interval [CI] 86 to 99), 98%(537 of 546, 95%CI 96 to 99), 87%(61 of 70, 95%CI 76 to 98), and 99%(537 of 540, 95%CI 98 to 99), respectively. All patients with angiographically normal coronary arteries or significant lesions were correctly identified. Three of 11 patients with < 50%lesions were incorrectly classified as having single-vessel disease. The 16-row MSCT CA reliably detects significant coronary stenoses in patients with atypical chest pain or stable angina pectoris.
