Predictive Value of Noninvasive Coronary Angiography With Multidetector Computed Tomography to Detect Significant Coronary Stenosis Before Valve Surgery

2006 ◽  
Vol 97 (10) ◽  
pp. 1506-1510 ◽  
Author(s):  
Patricia Reant ◽  
Sebastien Brunot ◽  
Stephane Lafitte ◽  
Karim Serri ◽  
Lionel Leroux ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Angiography ◽  
Multidetector Computed Tomography ◽  
Predictive Value ◽  
Coronary Stenosis ◽  
Valve Surgery ◽  
Noninvasive Coronary Angiography ◽  
Significant Coronary Stenosis

scholarly journals The Functional Severity Assessment of Coronary Stenosis Using Coronary Computed Tomography Angiography-Based Myocardial Mass at Risk and Minimal Lumen Diameter

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Kenji Sadamatsu ◽  
Kazuhiro Nagaoka ◽  
Yasuaki Koga ◽  
Kotaro Kagiyama ◽  
Kohei Muramatsu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Angiography ◽  
Computed Tomography Angiography ◽  
Predictive Value ◽  
Coronary Stenosis ◽  
Coronary Computed Tomography Angiography ◽  
Quantitative Coronary Angiography ◽  
Myocardial Mass ◽  
Coronary Computed Tomography ◽  
Minimal Lumen Diameter

Background. We investigated whether or not the addition of myocardial mass at risk (MMAR) to quantitative coronary angiography was useful for diagnosing functionally significant coronary stenosis in the daily practice. Methods. We retrospectively enrolled 111 consecutive patients with 149 lesions who underwent clinically indicated coronary computed tomography angiography and subsequent elective coronary angiography with fractional flow reserve (FFR) measurement. MMAR was calculated using a workstation-based software program with ordinary thin slice images acquired for the computed tomography, and the minimal lumen diameter (MLD) and the diameter stenosis were measured with quantitative coronary angiography. Results. The MLD and MMAR were significantly correlated with the FFR, and the MMAR-to-MLD ratio (MMAR/MLD) showed a good correlation. The area under the receiver operating characteristic curve (AUC) of MMAR/MLD for FFR ≤ 0.8 was 0.746, and the sensitivity, specificity, positive predictive value, and negative predictive value were 60%, 83%, 68%, and 77%, respectively, at a cut-off value of 29.5 ml/mm. The addition of MMAR/MLD to diameter stenosis thus made it possible to further discriminate lesions with FFR ≤ 0.8 (AUC = 0.750). For the proximal left coronary artery lesions, in particular, MMAR/MLD showed a better correlation with the FFR, and the AUC of MMAR/MLD for FFR ≤ 0.8 was 0.919 at a cut-off value of 31.7 ml/mm. Conclusions. The index of MMAR/MLD correlated well with the physiological severity of coronary stenosis and showed good accuracy for detecting functional significance. The MMAR/MLD might be a useful parameter to consider when deciding the indication for revascularization.

New Approach to Noninvasive Coronary Angiography by Multidetector Computed Tomography

2007 ◽  
Vol 31 (3) ◽  
pp. 441-443 ◽  
Author(s):  
Patricia Carrascosa ◽  
Pablo Garcia Merletti ◽  
Carlos Capu??ay ◽  
Alejandro Goldsmit ◽  
Marcelo Bettinotti ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Angiography ◽  
Multidetector Computed Tomography ◽  
New Approach ◽  
Noninvasive Coronary Angiography

Limitations of 64-detector-row computed tomography coronary angiography: Calcium and motion but not short experience

2009 ◽  
Vol 50 (2) ◽  
pp. 174-180 ◽  
Author(s):  
H. Mir-Akbari ◽  
J. Ripsweden ◽  
J. Jensen ◽  
P. Pichler ◽  
C. Sylvén ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Heart Rate ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Predictive Value ◽  
Coronary Stenosis ◽  
Diagnostic Performance ◽  
Motion Artifacts ◽  
Artery Disease

Background: Recently, 64-detector-row computed tomography coronary angiography (CTA) has been introduced for the noninvasive diagnosis of coronary artery disease. Purpose: To evaluate the diagnostic capacity and limitations of a newly established CTA service. Material and Methods: In 101 outpatients with suspected coronary artery disease, 64-detector-row CTA (VCT Lightspeed 64; GE Healthcare, Milwaukee, Wisc., USA) was performed before invasive coronary angiography (ICA). The presence of >50% diameter coronary stenosis on CTA was rated by two radiologists recently trained in CTA, and separately by an experienced colleague. Diagnostic performance of CTA was calculated on segment, vessel, and patient levels, using ICA as a reference. Segments with a proximal reference diameter <2 mm or with stents were not analyzed. Results: In 51 of 101 patients and 121 of 1280 segments, ICA detected coronary stenosis. In 274 of 1280 (21%) segments, CTA had non-diagnostic image quality, the main reasons being severe calcifications (49%), motion artifacts associated with high or irregular heart rate (45%), and low contrast opacification (14%). Significantly more women (43%) had non-diagnostic scans compared to men (20%). A heart rate above 60 beats per minute was associated with significantly more non-diagnostic patients (38% vs. 18%). In the 1006 diagnostic segments, CTA had a sensitivity of 78%, specificity of 95%, positive predictive value (PPV) of 54%, and negative predictive value (NPV) of 98% for detecting significant coronary stenosis. In 29 patients, CTA was non-diagnostic. In the remaining 72 patients, sensitivity was 100%, specificity 65%, PPV 79%, and NPV 100%. The use of a more experienced CTA reader did not improve diagnostic performance. Conclusion: CTA had a very high negative predictive value, but the number of non-diagnostic scans was high, especially in women. The main limitations were motion artifacts and vessel calcifications, while short experience in CTA did not influence the interpretation.

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