RESUMEN
Technological advances in multidetector computed tomography (MDCT) like second-generation dual source scanners have made it possible to evaluate myocardial perfusion as well as the anatomy of the coronary arteries in patients with suspected coronary disease; until recently, this application was confined to other imaging modalities. In this brief communication, we report a cardiac CT imaging protocol that combines CT coronary angiography with the analysis of ventricular function, perfusion, and myocardial viability in a single examination, thereby enabling a comprehensive assessment of coronary disease.
Asunto(s)
Enfermedad de la Arteria Coronaria/diagnóstico , Tomografía Computarizada por Rayos X , Adenosina , Angiografía Coronaria/métodos , Prueba de Esfuerzo/métodos , Humanos , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: The purpose of this study was to evaluate the diagnostic performance of coronary CT angiography (coronary CTA) using prospective ECG triggering (PT) for the detection of significant coronary artery stenosis compared to invasive coronary angiography (ICA). METHODS: A total of 20 patients underwent coronary CTA with PT using a 128-slice CT scanner (Definition AS+, Siemens) and ICA. All coronary CTA studies were evaluated for significant coronary artery stenoses (>or=50% luminal narrowing) by 2 observers in consensus using the AHA-15-segment model. Findings in CTA were compared to those in ICA. RESULTS: Coronary CTA using PT had 88% sensitivity in comparison to 100% with ICA, 95% to 88% specificity, 80% to 92% positive predictive value and 97% to 100% negative predictive value for diagnosing significant coronary artery stenosis on per segment per patient analysis, respectively. Mean effective radiation dose-equivalent of CTA was 2.6+/-1 mSv. CONCLUSION: Coronary CTA using PT enables non-invasive diagnosis of significant coronary artery stenosis with high diagnostic accuracy in comparison to ICA and is associated with comparably low radiation exposure.
