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Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-13968

Scheffel, H; Alkadhi, H; Plass, A; Vachenauer, R; Desbiolles, L; Gaemperli, O; Schepis, T; Frauenfelder, T; Schertler, T; Husmann, L; Grünenfelder, J; Genoni, M; Kaufmann, P A; Marincek, B; Leschka, S (2006). Accuracy of dual-source CT coronary angiography: first experience in a high pre-test probability population without heart rate control. European Radiology, 16(12):2739-2747.

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Abstract

The aim of this study was to assess the diagnostic accuracy of dual-source computed tomography (DSCT) for evaluation of coronary artery disease (CAD) in a population with extensive coronary calcifications without heart rate control. Thirty patients (24 male, 6 female, mean age 63.1+/-11.3 years) with a high pre-test probability of CAD underwent DSCT coronary angiography and invasive coronary angiography (ICA) within 14+/-9 days. No beta-blockers were administered prior to the scan. Two readers independently assessed image quality of all coronary segments with a diameter > or =1.5 mm using a four-point score (1: excellent to 4: not assessable) and qualitatively assessed significant stenoses as narrowing of the luminal diameter >50%. Causes of false-positive (FP) and false-negative (FN) ratings were assigned to calcifications or motion artifacts. ICA was considered the standard of reference. Mean body mass index was 28.3+/-3.9 kg/m2 (range 22.4-36.3 kg/m2), mean heart rate during CT was 70.3+/-14.2 bpm (range 47-102 bpm), and mean Agatston score was 821+/-904 (range 0-3,110). Image quality was diagnostic (scores 1-3) in 98.6% (414/420) of segments (mean image quality score 1.68+/-0.75); six segments in three patients were considered not assessable (1.4%). DSCT correctly identified 54 of 56 significant coronary stenoses. Severe calcifications accounted for false ratings in nine segments (eight FP/one FN) and motion artifacts in two segments (one FP/one FN). Overall sensitivity, specificity, positive and negative predictive value for evaluating CAD were 96.4, 97.5, 85.7, and 99.4%, respectively. First experience indicates that DSCT coronary angiography provides high diagnostic accuracy for assessment of CAD in a high pre-test probability population with extensive coronary calcifications and without heart rate control.

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Nuclear Medicine
04 Faculty of Medicine > Center for Integrative Human Physiology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Diagnostic and Interventional Radiology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiovascular Surgery
DDC:570 Life sciences; biology
610 Medicine & health
Language:English
Date:December 2006
Deposited On:18 Mar 2009 15:18
Last Modified:28 Nov 2013 00:33
Publisher:Springer
ISSN:0938-7994
Additional Information:The original publication is available at www.springerlink.com Free full text article
Publisher DOI:10.1007/s00330-006-0474-0
PubMed ID:17031451
Citations:Web of Science®. Times Cited: 249
Google Scholar™
Scopus®. Citation Count: 341

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