الفهرس | Only 14 pages are availabe for public view |
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). |