| Objective: To evaluate the feasibility of detecting coronary artery disease and ability of identifying stenosis by intravenous contrast agent coronary angiography with retrospectively ECG-gated multislic spiral CT scan. Method: Thirty patients in sinus rhythm were performd by MSCT 1 to 3 days before quantitative coronary angiography(QCA). Contrast agent was injected intravenously at 3.0ml/s, delay time was 15s, scanning with GE MSCT, in inspiration (breathhold 30s or so), cross-sectional images were reconstructed using retrospectively ECG-gating to obtain image acquisition windows. All coronary arteries and side branch with a luminal diameter ≥ 2mm were assessed concerning evaluability and the presence of significant stenosis(≥ 50% diameter stenosis) or occlusion. The results were compared with QCA. Result: In 253 coronary arteries (left main, left anterior descending, left circunflex and right coronary artery), 218 could evaluated (86.2%). In 11 patients (36.7%), all erteries could be evaluated. Sensitivity of dectect ≥50% stenosis is 82.6%; specificity is 97.9%; positive predictive value(PPV) is 82.6%; negative predictive value(NPV) is 97.9%; The sensitivity and specificity for high grade stenoses (≥75%) is 83.3% and 98.1% inspectively. Totle sensitivity (including unevaluable vessels in MSCT) is 68.4%. Coronary artery diameters in MSCT showed close correlation to QCA in the proximal RCA, LM and LAD. Conclusion: MSCT with retrospectively ECG-gating permits the detection of significant coronary arteries stonesis with high accuracy if image quality is satisfactory. Although, presently its clinical use may be limited due to the rapid coronary motion, it still is a prospective method of dignosing coronary artery disease(CAD). |
PDF Full Text Request