Abstract
This case report describes the use of retrospectively ECG-gated multislice spiral computed tomography (MSCT) for evaluation of lesion severity in a patient with relevant left main stenosis by visual analysis of the coronary angiogram. For further diagnostic evaluation the patient underwent intravascular ultrasound (IVUS) imaging, which showed a maximal 30% area stenosis, and MSCT, which demonstrated a maximal 48% area stenosis. MSCT was useful in this case to defer cardiac surgery and might be used as a noninvasive alternative to IVUS imaging in case of doubtful lesion severity.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Mintz GS, Painter JA, Pichard AD, et al. Atherosclerosis in angiographically ‘normal’ coronary artery reference segments: an intravascular ultrasound study with clinical correlations. J Am Coll Cardiol 1995; 25: 1479–1485.
Nieman K, Rensing BJ, van Guens RJ, et al. Usefulness of multislice computed tomography for detecting obstructive coronary artery disease. Am J Cardiol 2002; 89(8): 913–918.
Achenbach S, Giesler T, Ropers D, et al. Detection of coronary artery stenosis by contrast-enhanced, retrospectively electrocardiographically gated, multislice spiral computed tomography. Circulation 2001; 103: 2535–2538.
Galbraith JE, Murphy ML, de Soyza N. Coronary angiogram interpretation. Interobserver variability. JAMA 1978; 240: 2053–2056.
Zir LM, Miller SW, Dinsmore RE, Gilbert JP, Harthorne JW. Interobserver variability in coronary angiography. Circulation 1976; 53: 627–632.
De Franco A. Understanding the pathophysiology of the arterial wall: which method should we use? Intra-vascular ultrasound. Eur Heart J Supplements 2002; 4(Suppl F): F29–F40.
Knez A, Becker CR, Leber A, et al. Usefulness of multislice spiral computed tomography angiography for determination of coronary artery stenosis. Am J Cardiol 2001; 88: 1191–1194.
Schroeder S, Kopp AF, Ohnesorge B, et al. Accuracy and reliability of quantitative measurements in coronary arteries by multi-slice computed tomography: experimental and initial clinical results. Clin Radiol 2001; 56(6): 466–474.
Nieman K, Outkerk M, Rensing BJ, et al. Coronary angiography with multi-slice computed tomography. Lancet 2001; 357(9256): 599–603.
Schröder S, Kopp AF, Baumbach A, et al. Noninvasive detection and evaluation of atherosclerotic plaque with multislice computed tomography. J Am Coll Cardiol 2001; 37: 1430–1435.
Flohr T, Bruder H, Stierstorfer K, Simon J, Schaller S, Ohnesorge B. New technical developments in Multislice CT, Part 2: Sub-Millimeter 16–Slice Scanning and increased Gantry rotation speed for Cardiac Imaging. Fortschr Röntgenstr 2002; 174: 1022–1027.
Nieman K, Cademartiri F, Lemos PA, Raaijmakers R, Pattynama PM, de Feyter PJ. Reliable noninvasive coronary angiography with fast submillimeter multislice spiral computed tomography. Circulation 2002; 106(16): 2051–2054.
Schroeder S, Kopp AF, Baumbach A, et al. Noninvasive detection of coronary lesions by multislice computed tomography: results of the New Age pilot trial. Catheter Cardiovasc Interv 2001; 53(3): 352–358.
Kopp AF, Ohnesorge B, Flohr T. High temporal resolution ECG-gated multi-slice spiral CT: a new method for 3D and 4D cardiac imaging. Cardiovasc Intervent Radiol 1999; 22: S184.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Koos, R., Mahnken, A.H., Sinha, AM. et al. ECG-gated multislice spiral computed tomography to clarify lesion severity in a case of left main stenosis. Int J Cardiovasc Imaging 19, 349–353 (2003). https://doi.org/10.1023/A:1025468722596
Issue Date:
DOI: https://doi.org/10.1023/A:1025468722596