| Role of 16-multidetector computed tomography in the assessment of coronary artery stenoses: A prospective study of consecutive patients. | |
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MedLine Citation:
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PMID: 18650996 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND: Recent studies have demonstrated a high sensitivity (S) of 16-multidetector computed tomography (16-MDCT) for the detection of significant coronary artery stenoses. Whether these results are applicable to clinical practice is unclear. Therefore, the aim of the present study was to compare 16-MDCT angiography with conventional coronary angiography (CCA) for the detection of significant coronary artery stenoses in a consecutive series of patients. METHOD: A total of 93 consecutive patients (mean [+/- SD] age 59+/-9 years), in whom CCA was performed for stable angina pectoris, underwent 16-MDCT angiography (16x0.75 mm, table feed 6.5 mm/s, rotation time 0.42 s; Sensation 16, Siemens Medical Solutions, Germany) the day before performing CCA. Patients with diabetes mellitus, serum creatinine level higher than 132.6 mumol/L and/or acute coronary syndromes were excluded. Two observers blinded to CCA results evaluated MDCT angiograms according to standard criteria. Segment-based (13 segments per patient) and patient-based (at least one stenosis greater than 50% lumen diameter reduction) analyses were performed. RESULTS: A total of 1209 segments were analyzed. Of these segments, 173 (14%) were excluded due to poor image quality or massive calcification. In 86 segments, CCA revealed significant coronary artery stenosis (greater than 50% diameter reduction). However, 16-MDCT detected only 47 of these, resulting in a S of 55% and a specificity (SP) of 97% (positive predictive value 64%; negative predictive value 96%). On a patient-based analysis, the S increased to 89%, whereas the SP still remained high (87%). CONCLUSION: In this relatively large consecutive cohort, S for the detection of significant coronary artery stenoses was moderate on a segment-based analysis but increased on a patient-based analysis using 16-MDCT. In contrast, SP was high in both analyses, supporting the use of 16-MDCT for the exclusion of significant coronary artery stenoses. Further improvement of spatial and temporal resolution in MDCT technology may lead to a lower exclusion rate and higher S. |
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Authors:
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Thomas Postel; Matthias Frick; Gudrun Feuchtner; Hannes Alber; Ralf Zwick; Alois Suessenbacher; Ammar Mallouhi; Guy Friedrich; Otmar Pachinger; Dieter Zur Nedden; Franz Weidinger |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Experimental and clinical cardiology Volume: 12 ISSN: 1205-6626 ISO Abbreviation: Exp Clin Cardiol Publication Date: 2007 |
Date Detail:
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Created Date: 2008-07-24 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9715903 Medline TA: Exp Clin Cardiol Country: Canada |
Other Details:
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Languages: eng Pagination: 149-52 Citation Subset: - |
Affiliation:
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Division of Cardiology; |
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