Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-3604
Scheffel, H; Alkadhi, H; Leschka, S; Plass, A; Desbiolles, L; Guber, I; Krauss, T; Grünenfelder, J; Genoni, M; Luescher, T F; Marincek, B; Stolzmann, P (2008). Low-dose CT coronary angiography in the step-and-shoot mode: diagnostic performance. Heart, 94(9):1132-1137.
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OBJECTIVE: To investigate the performance of low-dose, dual-source computed tomography (DSCT) coronary angiography in the step-and-shoot (SAS) mode for the diagnosis of significant coronary artery stenoses in comparison with conventional coronary angiography (CCA). DESIGN, SETTING AND PATIENTS: Prospective, single-centre study conducted in a referral centre enrolling 120 patients (71 men, mean (SD) age 68 (9) years, mean (SD) body mass index 26.2 (3.2) kg/m2). All study participants underwent DSCT in the SAS mode and CCA within 14 days. Twenty-seven patients were given intravenous beta blockers for heart rate reduction before CT. Patients were excluded if a target heart rate <or=70 bpm could not be achieved by beta blockers or when the patients were in non-sinus rhythm. Two blinded readers independently evaluated coronary artery segments for assessability and for the presence of significant (>50%) stenoses. Sensitivity, specificity, negative (NPV) and positive predictive values (PPV) were determined, with CCA being the standard of reference. Radiation dose values were calculated. RESULTS: DSCT coronary angiography in the SAS mode was successfully performed in all 120 patients. Mean (SD) heart rate during scanning was 59 (6) bpm (range 44-69). 1773/1803 coronary segments (98%) were depicted with a diagnostic image quality in 109/120 patients (91%). The overall patient-based sensitivity, specificity, PPV and NPV for the diagnosis of significant stenoses were 100%, 93%, 94% and 100%, respectively. The mean (SD) effective dose of the CT protocol was 2.5 (0.8) mSv (range 1.2-4.4). CONCLUSIONS: DSCT coronary angiography in the SAS mode allows, in selected patients with a regular heart rate, the accurate diagnosis of significant coronary stenoses at a low radiation dose.
|Item Type:||Journal Article, refereed, original work|
|Communities & Collections:||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:||610 Medicine & health|
|Deposited On:||29 Sep 2008 15:25|
|Last Modified:||28 Nov 2013 01:35|
|Publisher:||BMJ Publishing Group|
|Citations:||Web of Science®. Times cited: 169|
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