Document Detail

Accuracy of 16-detector multislice spiral computed tomography in the initial evaluation of dilated cardiomyopathy.
MedLine Citation:
PMID:  16987628     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Multislice Computed Tomography (MSCT) recently proved its accuracy in the detection of coronary artery disease (CAD). It can also give information about left ventricular function and venous network anatomy. We here sought to validate a MSCT-based strategy in the initial evaluation of patients with dilated cardiomyopathy (DCM). METHODS: 36 patients with DCM underwent cardiac MSCT before conventional coronary angiography with ventriculography. We analysed arterial calcium score (Agatston score equivalent: ASE), coronary stenosis, left ventricular parameters and venous network. RESULTS: The sensitivity of a MSCT-based strategy in detecting significant CAD was 100% and the specificity 80%. The positive and negative predictive values were respectively 67% and 100%. For ASE <1.000 (75% of patients), MSCT detected all non-CAD patients without one (motion artifacts), enabling conventional angiography to be avoided in 21/27 patients (77.7%). For ASE > or =1000, MSCT enabled conventional angiography to be avoided in only 2/9 patients (22.2%). The ventricle was assessable in 83.4% (30 patients) on MSCT. Correlation coefficient Rs with ventriculography were 0.78 (p<0.0001), 0.77 (p<0.0001) and 0.82 (p<0.0001) respectively for end-diastolic volume, end-systolic volume and EF. The venous network was assessable in all patients both on MSCT and angiography. CONCLUSION: In patients undergoing an initial evaluation of DCM, MSCT appears to be an effective alternative to conventional angiography. The following attitude may be proposed: when ASE >1.000, conventional coronary angiography is mandatory due to MSCT's poor interest in such cases; when ASE <1.000, a contrast-enhanced MSCT may, when normal, replace coronary angiography.
Jean-Christophe Cornily; Martine Gilard; Grégoire Le Gal; Pierre-Yves Pennec; Ulric Vinsonneau; Jean-Jacques Blanc; Jacques Mansourati; Jacques Boschat
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Validation Studies     Date:  2006-09-20
Journal Detail:
Title:  European journal of radiology     Volume:  61     ISSN:  0720-048X     ISO Abbreviation:  Eur J Radiol     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-01-08     Completed Date:  2007-03-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106411     Medline TA:  Eur J Radiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  84-90     Citation Subset:  IM    
Department of Cardiology, Brest University Hospital, France.
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MeSH Terms
Cardiomyopathy, Dilated / radiography*
Coronary Angiography
Equipment Design
Equipment Failure Analysis
Middle Aged
Pilot Projects
Radiographic Image Enhancement / instrumentation*,  methods
Radiographic Image Interpretation, Computer-Assisted / instrumentation*,  methods
Reproducibility of Results
Sensitivity and Specificity
Tomography, Spiral Computed / instrumentation*,  methods

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