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Abstract
Background: Multislice CT is a recent development in the
spiral CT that allows ECG-gated complete coronary coverage in
a reasonable time.
Objectives: To investigate the ability of MSCT coronary
angiography, using the 4 and 8-slice CT scanners to detect
high-grade coronary artery stenosis and occlusion and to
evaluate the vascular conduits in patients with previous CABG
operations.
Methods: A total number of 45 consecutive patients
scheduled for elective conventional coronary angiography for
known or suspected CAD were enrolled for retrospective ECGgated
MSCT angiography (intravenous contrast agent, 4 / 8 x
1.25-mm slice thickness, 500 ms tube rotation) including 10
patients who had coronary stents and 13 patients who had
had coronary artery bypass grafts. Findings of CT angiography
were compared to those of conventional angiograms.
Evaluation was performed on a per segment basis, using the
results of selective coronary angiography as the gold standard.
Results: Our study revealed an overall sensitivity of 83%,
specificity of 93%, PPV of 80.6%, NPV of 93.5 % and accuracy
of 90% for detection of significant stenosis (≥50%) or occlusion.
Conclusion: CT angiography permits non-invasive
coronary imaging, particularly at the proximal coronary
segments. However, because of the limited temporal & spatial
resolutions and the various artifacts associated with data
creation & reformation, post-processing methods, and image
interpretation, MSCT angiography is not ready to replace
conventional coronary angiography at this time. In view of the
high NPV, patients without significant CAD would be selected
accurately at CT, and hence, avoiding the unnecessary
invasive coronary angiography.
Key words: Coronary artery disease (CAD) – multislice
computed tomography (MSCT) – Computed tomography
angiography (CTA).