Coronary CT angiography with dual source computed tomography in 170 patients
Introduction
In an aging society, there is an increased prevalence of coronary artery disease (CAD) [1]. Therefore, an early detection of CAD is getting more important. The potential of coronary CT angiography (CTA) with a high negative predictive value to exclude CAD has been shown in several previous studies using multi-detector CT (MDCT) [2], [3], [4], [5], [6], [7], [8] or dual source CT (DSCT) [9], [10], [11], [12], [13], [14], [15]. In preliminary studies the recently introduced DSCT offered an encouraging diagnostic accuracy and it has been shown to provide stable image quality, even for higher heart rates [9], [10], [11], [12], [13], [14], [15]. These initial results suggest that this technique might ultimately broaden the indication for CTA and be applied to patients with a higher risk for CAD.
Thus, the aim of the present study was to evaluate the reproducibility of the above results in a large, completely unselected and consecutive group of patients scheduled for invasive coronary angiography (ICA).
Section snippets
Material and methods
170 consecutive patients (124 men, 46 women; mean age: 64 ± 9 years) scheduled for invasive coronary angiography were additionally examined with DSCT. Elevated serum creatinine levels >1.5 mg/dl, unstable angina, thyroid disease, pregnancy or allergic reactions to iodinated contrast agents were determined as exclusion criteria. The local Ethics Committee approved the study protocol, and all patients gave informed consent to participate in this study.
120 of 170 patients (71%) were on daily
Results
The patients’ characteristics are listed in Table 1. DSCT and ICA were performed in all 170 patients without problems. In 101 of 170 patients, there was a known CAD and they were scheduled for ICA because of suspected restenosis. Prevalence for CAD was 82%. Mean heart rate during the scan was 64 ± 12 beats/min. 45 of 170 patients (26%) were not in sinus rhythm during the scan.
The mean calcium score (in Agatston score equivalent) was 686 ± 976 (median 236, range 0–4950) and the mean calcium mass was
Discussion
The challenge for early four- and sixteen-slice MDCT have been the small diameter of the coronary segments and their rapid movement throughout the coronary cycle. Consequently, the main cause of low image quality and the restricted diagnostic accuracy have been residual motion artifacts [17], [18], [19]. With an increased temporal and spatial resolution 64-detector row CT proved in several studies an acceptable image quality and a high diagnostic accuracy despite of still remaining limitations
Conclusion
Coronary DSCT angiography proved to have a robust image quality and provide a high accuracy in excluding CAD even in an unselected consecutive group of patients with a higher prevalence for CAD. Therefore results of preliminary studies as well as potency of coronary DSCT angiography as a non-invasive tool in cardiac imaging could be confirmed.
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2021, European Journal of Radiology OpenRadiation dose and diagnostic accuracy of high-pitch dual-source coronary angiography in the evaluation of coronary artery stenoses
2016, Diagnostic and Interventional ImagingCitation Excerpt :Our study demonstrated that if heart rate and BMI was increased, the amount of contrast medium and ED values was increased. When we compare the number of patients in our study with the literature; Lell et al., 25 patients, in 2009 [27], Tsiflikas et al., 170 patients, in 2010 [28], Achenbach et al., 50 patients, in 2010 [29], Yi-ning et al., 75 patients, in 2010 [30] researched the radiation dose, image quality and prospective triggered method with dual source CT systems. When compared with other studies, 186 patients included in our study is sufficient in terms of numbers.
Multicenter evaluation of coronary dual-source CT angiography in patients with intermediate risk of coronary artery stenoses (MEDIC): Study design and rationale
2014, Journal of Cardiovascular Computed TomographyCitation Excerpt :Dual-source CT (DSCT) allows imaging of the coronary arteries with better temporal resolution compared with 64-slice CT and may therefore be better suited to identify coronary artery stenoses in patients with elevated heart rates. In smaller trials performed without systematic use of β-blockers, sensitivities of 90% to 96% and specificities of 92% to 98% were reported for the detection of coronary artery stenoses on a per-segment level.6–10 The maximum number of patients included in these trials was 170, and no large trial that assesses the accuracy of DSCT for the detection of coronary artery stenoses has so far been performed.