Document Detail


Feasibility of gadolinium-diethylene triamine pentaacetic acid enhanced multidetector computed tomography for the evaluation of coronary artery disease.
MedLine Citation:
PMID:  19083885     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Multidetector computed tomography (MDCT) has been proposed as a noninvasive method for the diagnosis of obstructive coronary artery disease (CAD). In patients with high risk of iodinated contrast adverse effects such as acute allergic-type reactions, the use of gadolinium could be an alternative. OBJECTIVE: We sought to evaluate the feasibility of gadolinium-enhanced MDCT for the diagnosis of obstructive CAD. METHODS: Twenty patients (mean age, 61 years; range, 50-73 years) referred for X-ray coronary angiography were studied by both gadolinium and iodine-enhanced 16-row MDCT coronary angiography. The degree of enhancement and the accuracy for detection of obstructive CAD (>50% diameter reduction) were evaluated with X-ray coronary angiography as the standard. Renal nephrotoxicity was strictly monitored. RESULTS: Gadolinium- and iodine-enhanced MDCT showed adequate visualization of the coronary arteries in 310 of the 312 coronary artery segments that were available by X-ray angiography, respectively. The average density of the coronary arteries in both iodine and gadolinium CT scans was 253.65 Hounsfield unit (HU) and 135.20 HU, respectively. In a per-coronary segment analysis, gadolinium- and iodine-enhanced MDCT showed sensitivities of 89% vs 84%, specificities of 96% vs 95%, and negative predictive values of 97% vs 96%, respectively. In a per-patient analysis, both gadolinium- and iodine-enhanced MDCT showed sensitivities of 92.85% vs specificities of 83.33%. Intermethod agreement between gadolinium- and iodine-enhanced MDCT (kappa) was 0.95 (P < 0.0001). CONCLUSION: Our preliminary results indicate lower attenuation with gadolinium but similar diagnostic accuracy for the detection of obstructive CAD when compared with iodine-enhanced MDCT. Therefore, gadolinium is a feasible alternative contrast agent for patients with iodine contrast allergy referred for MDCT coronary angiography.
Authors:
Patricia Carrascosa; Carlos Capuñay; Marcelo Bettinotti; Alejandro Goldsmit; Alejandro Deviggiano; Jorge Carrascosa; Mario J García
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article     Date:  2007-07-04
Journal Detail:
Title:  Journal of cardiovascular computed tomography     Volume:  1     ISSN:  1876-861X     ISO Abbreviation:  -     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2008-12-16     Completed Date:  2009-03-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101308347     Medline TA:  J Cardiovasc Comput Tomogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  86-94     Citation Subset:  IM    
Affiliation:
Department of Radiology, Diagnóstico Maipú, Buenos Aires, Argentina. investigacion@diagnosticomaipu.com.ar
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MeSH Terms
Descriptor/Qualifier:
Aged
Contrast Media
Coronary Angiography / methods*
Coronary Artery Disease / radiography*
Feasibility Studies
Female
Gadolinium DTPA / diagnostic use*
Humans
Iodine / diagnostic use*
Middle Aged
Reproducibility of Results
Sensitivity and Specificity
Tomography, X-Ray Computed / methods*
Chemical
Reg. No./Substance:
0/Contrast Media; 7553-56-2/Iodine; 80529-93-7/Gadolinium DTPA
Comments/Corrections
Comment In:
J Cardiovasc Comput Tomogr. 2007 Oct;1(2):95-6   [PMID:  19083886 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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