Publikation

Low-dose CT coronary angiography for the prediction of myocardial ischaemia

Wissenschaftlicher Artikel/Review - 01.01.2010

Bereiche
PubMed
DOI

Zitation
Stolzmann P, Marincek B, Boesiger P, Grünenfelder J, Leschka S, Kozerke S, Plass A, Baumueller S, Azemaj N, Scheffel H, Donati O, Alkadhi H. Low-dose CT coronary angiography for the prediction of myocardial ischaemia. Eur Radiol 2010; 20:56-64.
Art
Wissenschaftlicher Artikel/Review (Englisch)
Zeitschrift
Eur Radiol 2010; 20
Veröffentlichungsdatum
01.01.2010
eISSN (Online)
1432-1084
Seiten
56-64
Kurzbeschreibung/Zielsetzung

The purpose of this study was to prospectively determine the accuracy of low-dose computed tomography coronary angiography (CTCA) for the diagnosis of functionally relevant coronary artery disease (CAD) using cardiac magnetic resonance (CMR) as a standard of reference. Forty-one consecutive patients (age 64 +/- 10 years) underwent k-space and time broad-use linear acquisition speed-up technique accelerated CMR (1.5 T) and dual-source CTCA using prospective electrocardiography gating within 1 day. CTCA lesions were analysed and diameter stenoses of more than 50% and more than 75% were compared with CMR findings taken as the reference standard for assessing the functional relevance of CAD. CMR revealed perfusion defects in 21/41 patients (51%). A total of 569 coronary segments were analysed with low-dose CTCA. The image quality of low-dose CTCA was diagnostic in 566/569 segments (99.5%) in 39/41 patients (95%). Low-dose CTCA revealed stenoses of more than 50% in 58/123 coronary arteries (47.2%) in 24/41 patients (59%) and more than 75% stenoses in 46/123 coronary arteries (37.4%) in 23/41 patients (56%). Using a greater than 50% diameter stenosis, low-dose CTCA yielded the following per artery sensitivity, specificity, positive and negative predictive values, and accuracy for the detection of perfusion defects: 89%, 79%, 72%, 92% and 83%, respectively. Low-dose CTCA is reliable for ruling out functionally relevant CAD, but is a poor predictor of myocardial ischaemia.