| Feasibility of gadolinium-diethylene triamine pentaacetic acid enhanced multidetector computed tomography for the evaluation of coronary artery disease. | |
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MedLine Citation:
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PMID: 19083885 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Patricia Carrascosa; Carlos Capuñay; Marcelo Bettinotti; Alejandro Goldsmit; Alejandro Deviggiano; Jorge Carrascosa; Mario J García |
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Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article Date: 2007-07-04 |
Journal Detail:
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Title: Journal of cardiovascular computed tomography Volume: 1 ISSN: 1876-861X ISO Abbreviation: - Publication Date: 2007 Oct |
Date Detail:
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Created Date: 2008-12-16 Completed Date: 2009-03-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101308347 Medline TA: J Cardiovasc Comput Tomogr Country: United States |
Other Details:
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Languages: eng Pagination: 86-94 Citation Subset: IM |
Affiliation:
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Department of Radiology, Diagnóstico Maipú, Buenos Aires, Argentina. investigacion@diagnosticomaipu.com.ar |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Contrast Media; 7553-56-2/Iodine; 80529-93-7/Gadolinium DTPA |
| Comments/Corrections | |
Comment In:
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J Cardiovasc Comput Tomogr. 2007 Oct;1(2):95-6
[PMID:
19083886
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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