Evaluation of Diagnostic Performance of MDCT Coronary Angiography in Comparison with Conventional Coronary Angiography

Background: Coronary artery disease is now becoming increasingly prevalent than before especially in younger age groups. We in the current study tried to evaluate the potential of 128 slice MDCT coronary angiography for the detection of stenotic coronary lesions by comparing the results of computed tomographic coronary angiography to a gold standard set by Conventional coronary angiography. Methods: A total of n=30 patients with clinically suspected Coronary artery disease. They were evaluated with 128 Slice CT Scanner (PHILIPS INGENUITY) and conventional coronary angiography. All patients were examined with a 128 slice MDCT scanner (Philips Ingenuity 128 slice Netherlands) using standard cardiac CT protocol. Gantry rotation time was 400 ms with a half sector acquisition protocol and multisector reconstruction permitting an effective temporal resolution between 50 and 200 ms depending on patient heart rate. Results: In the n=30 Patients included in the study with CCA, the n=450 coronary segments included in the study were found to contain a total number of n=138 stenoses among them non-significant stenoses. The accuracy of MDCT detection of coronary stenoses greater than 50% diameter of vessel lumen is about 94.78. When raising the threshold for stenosis from 50% to 70% of the vessel lumen, so that only hemodynamic relevant stenoses enter the evaluation, the sensitivity decreases from 88%. The MDCT detection in the patient group with heart rates below 60 beats per minute higher values for sensitivity 93% and specificity 97% were observed, compared to sensitivity 87% and specificity 93% of the patient group with heart rates above 60 beats per minute. Conclusion:The present study revealed that a high negative predictive value (98.08%)suggests that 128- Slice MDCT coronary angiography is a good screening modality for evaluation of patients with mild to intermediate-risk factors who might otherwise require invasive angiography.

Electrocardiogram-gated 16-multidetector computed tomographic angiography of the coronary arteries in dogs

The aims of this study were to assess if ECG-gated 16-multidetector CT (MDCT) provides sufficient temporal and spatial resolution to evaluate canine coronary arteries and provide a detailed description of their anatomy. A total of 24 dogs were included. Images were reviewed to assess: (1) coronary artery opacification and dominance; (2) choice of optimal R-R ECG reconstruction interval for both left coronary artery (LCA) and right coronary artery (RCA); (3) branching patterns of the left main coronary artery (LMCA); and (4) diameter and length of the LCA and RCA and classification of their branches by adapting a previously described segmental coding system. The degree of opacification of the coronary arteries was subjectively judged as excellent or good in five and 19 dogs, respectively. All hearts showed a left coronary dominance. The best R-R reconstruction interval for both LCA and RCA arteries was 75 per cent. Seven different subtypes of LMCA branching patterns were noted. The rami circumflexus and interventricularis paraconalis were divided into three angiographic segments, and the ramus septi interventricularis and the RCA in two and three segments, respectively. ECG-gated 16-MDCT coronary angiography provides adequate resolution to assist the basic anatomy of the main coronary artery branches.