Skip to main content
SpringerLink
Log in

Coronary artery imaging during preoperative CT staging: preliminary experience with 64-slice multidetector CT in 99 consecutive patients

  • Cardiac
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

The purpose of this study was to evaluate the clinical feasibility of coronary artery imaging during routine preoperative 64-slice MDCT scans of the chest. Ninety-nine consecutive patients in sinus rhythm underwent a biphasic multidetector-row spiral CT examination of the chest without the administration of beta-blockers, including an ECG-gated acquisition over the cardiac cavities, followed by a non-gated examination of the upper third of the thorax. Data were reconstructed to evaluate coronary arteries and to obtain presurgical staging of the underlying disease. The percentage of assessable segments ranged from 65.4% (972/1,485) when considering all coronary artery segments to 88% (613/693) for the proximal and mid segments, reaching 98% (387/396) for proximal coronary artery segments. The 387 interpretable proximal segments included 97 (97%) LM, 99 (100%) LAD, 96 (97%) LCX and 95 (96%) RCA with a mean attenuation of 280.70±52.93 HU. The mean percentage of assessable segments was significantly higher in patients with a heart rate ≤80 bpm (n=48) than in patients with a heart rate greater than 80 bpm (n=35) (80±11% vs. 72±13%; P=0.0008). Diagnostic image quality was achieved in all patients for preoperative staging of the underlying disorder. The mean estimated effective dose was 12.06±3.25 mSv for ECG-gated scans and 13.88±3.49 mSv for complete chest examinations. Proximal and mid-coronary artery segments can be adequately evaluated during presurgical CT examinations of the chest obtained with 64-slice MDCT without the administration of β-blockers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Freeman WK, Gibbons RJ, Shub C (1989) Preoperative assessment of the cardiac patient undergoing non cardiac procedures. Mayo Clin Proc 64:1105–1117

    PubMed  CAS  Google Scholar 

  2. Von Knorring JV (1981) Postoperative myocardial infarction: a prospective study in a risk group of surgical patients. Surgery 90:55–60

    Google Scholar 

  3. Steen PA, Tinker JH, Tarhan S (1978) Myocardial reinfarction after anesthesia and surgery. JAMA 239:2566–2570

    Article  PubMed  CAS  Google Scholar 

  4. Tarhan S, Moffitt EA, Taylor WF, Guiliani ER (1972) Myocardial infarction after general anesthesia. JAMA 220:1451–1454

    Article  PubMed  CAS  Google Scholar 

  5. Burke JR, Duarte IC, Thourani VH, Miller JI (2003) Preoperative risk assessment for marginal patients requiring pulmonary resection. Ann Thorac Surg 76:1767–1773

    Article  PubMed  Google Scholar 

  6. Achenbach S, Giesler T, Ropers D et al (2001) Detection of coronary artery stenoses by contrast-enhanced, retrospectively electrocardiographically-gated, multislice spiral computed tomography. Circulation 103:2535–2538

    PubMed  CAS  Google Scholar 

  7. Knez A, Becker CR, Leber A et al (2001) Usefulness of multislice computed tomography angiography for determination of coronary artery stenoses. Am J Cardiol 88:1191–1194

    Article  PubMed  CAS  Google Scholar 

  8. Nieman K, Rensing BJ, van Geuns RJ et al (2002) Usefulness of multislice computed tomography for detecting obstructive coronary artery disease. Am J Cardiol 89:913–918

    Article  PubMed  Google Scholar 

  9. Nieman K, Rensing BJ, van Geums RJM et al (2002) Non-invasive coronary angiography with multislice spiral CT: the impact of the heart rate. Heart 88:470–474

    Article  PubMed  CAS  Google Scholar 

  10. Nieman K, Cademartiri F, Lemos PA, Raaijmakers R, Pattynama PM, Reyter PJ (2002) Reliable non-invasive coronary angiography with fast submillimeter multislice spiral computed tomography. Circulation 106:2051–2054

    Article  PubMed  Google Scholar 

  11. Ropers D, Baum U, Pohle K, Anders K, Ulzheimer S, Ohnesorge B, Schlundt C, Bautz W, Daniel WG, Achenbach S (2003) Detection of coronary artery stenoses with thin-slice multidetector row spiral computed tomography and multiplanar reconstruction. Circulation 107:664–666

    Article  PubMed  Google Scholar 

  12. Mollet NR, Cademartiri F, Krestin G, McFadden EP, Arampatzis CA, Serruys PW, de Feyter PJ (2005) Improved diagnostic accuracy with 16-row multislice computed tomography coronary angiography. J Am Coll Cardiol 45:128–132

    Article  PubMed  Google Scholar 

  13. Heuschmid M, Kuettner A, Schroeder S, Trabold T, Feyer A, Seemann M, Kuzo R, Claussen CD, Kopp AF (2005) ECG-gated 16-MDCT of the coronary arteries: assessment of image quality and accuracy in detectiong stenoses. AJR 184:1413–1419

    PubMed  Google Scholar 

  14. Hoffmann MHK, Shi H, Manzke R, Schmid F, De Vries L, Grass M, Brambs HJ, Aschoff AJ (2005) Noninvasive coronary angiography with 16-detector row CT: effect of heart rate. Radiology 234:86–97

    PubMed  Google Scholar 

  15. Leber AW, Knez A, von Ziegler F, Becker A, Nikolaou K, Paul S, Wintersperger B, Reiser M, Becker C, Steinbeck G, Boekstegers P (2005) Quantification of obstructive and nonobstructive coronary lesions by 64-slice computed tomography. A comparative study with quantitative coronary angiography and intravascular ultrasound. J Am Coll Cardiol 46:147–154

    Article  PubMed  Google Scholar 

  16. Raff GL, Gallagher MJ, O’Neill WW, Goldstein JA (2005) Diagnostic accuracy of non-invasive coronary angiography using 64-slice spiral computed tomography. J Am Coll Cardiol 46 (in press)

  17. Leschka S, Alkadhi H, Plass A, Desbiolles L, Grünelfelder J, Marincek B, Wildermuth S (2005) Accuracy of MSCT coronary angiography with 64-slice technology: first experience. Eur Heart J 26:1482–1487

    Article  PubMed  Google Scholar 

  18. Salem R, Remy-Jardin M, Delhaye D, Khalil C, Teisseire A, Delannoy-Deken V, Duhamel A, Remy J (2005) Integrated cardiothoracic imaging with ECG-gated 64-slice multidetector-row CT: preliminary experience in 133 patients. Eur Radiol (accepted for publication)

  19. Delhaye D, Remy-Jardin M, Salem R, Teisseire A, Khalil C, Delannoy-Deken V, Duhamel A, Remy J (2005) Coronary imaging quality in routine ECG-gated multidetector CT examinations of the entire thorax: preliminary experience with a 64-slice CT system. Radiology (submitted for publication)

  20. Lembcke A, Dohmen PM, Dewey M, Klessen C, Elgeti T, Hermann KG, Konertz W, Hamm B, Kivelitz DE (2005) Multislice computed tomography for preoperative evaluation of right ventricular volumes and function: comparison with magnetic resonance imaging. Ann Thorac Surg 79:1344–1351

    Article  PubMed  Google Scholar 

  21. Koch K, Oellig F, Oberholzer K, Bender P, Kunz P, Mildenberger P, Hake U, Kreitner KF, Thelen M (2005) Assessment of right ventricular function by 16-detector-row CT: comparison with magnetic resonance imaging. Eur Radiol 15:312–318

    Article  PubMed  CAS  Google Scholar 

  22. Jakobs TF, Becker CR, Ohnesorge B, Flohr T, Suess C, Schoepf UJ, Reiser MF (2002) Multislice helical CT of the heart with retrospective ECG gating: reduction of radiation exposure by ECG-controlled tube current modulation. Eur Radiol 12:1081–1086

    Article  PubMed  Google Scholar 

  23. Flohr T, Ohnesorge B (2001) Heart rate adaptive optimization of spatial and temporal resolution for electrocardiogram-gated multislice spiral CT of the heart. J Comput Assist Tomogr 25:907–923

    Article  PubMed  CAS  Google Scholar 

  24. Flohr T, Stierstorfrer K, Raupach R, Ulzheimer S, Bruder H (2004) Performance evaluation of a 64-slice CT system with z-flying focal spot. Rofö 176:1803–1810

    PubMed  CAS  Google Scholar 

  25. Hertzog C, Abolmaali N, Balzer JO, Baunach S, Ackerman H, Dogan S, Britten MB, Vogl TJ (2002) Heart-rate-adapted image reconstruction in multidetector-row cardiac CT: influence of physiological and technical prerequisite on image quality. Eur Radiol 12:2670–2678

    Google Scholar 

  26. National Heart Lung and Blood Institute Obesity Education Initiative Expert Panel (1998) Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report. National Heart, Lung and Blood Institute, Rockville, Maryland

  27. American Heart Association Committee Report (1979) A reporting system on patients evaluated for coronary artery disease. Circulation 51:7–34

    Google Scholar 

  28. Schroeder S, Kopp AF, Kuettner A et al (2002) Influence of heart rate on vessel visibility in non-invasive coronary angiography using new multislice computed tomography: experience in 94 patients. Clin Imaging 26:106–111

    Article  PubMed  Google Scholar 

  29. Zhang SZ, Hu XH, Zhang QW, Huang WX (2005) Evaluation of computed tomography coronary angiography in patients with a high heart rate using 16-slice spiral computed tomography with 0.37-s gantry rotation time. Eur Radiol 15:1105–1109

    Article  PubMed  Google Scholar 

  30. Hamoir XL, Flohr T, Hamoir V, Labaki L, Tricquet JY, Duhamel A, Kirsch J (2005) Coronary arteries: assessment of image quality and optimal reconstruction window in retrospective ECG-gated multislice CT at 375 ms gantry rotation time. Eur Radiol 15:296–304

    Article  PubMed  Google Scholar 

  31. Pugliese F, Mollet NRA, Runza G, van Mieghem C, Meijboom WB, Malagutti P, Baks T, Krestin GP, deFeyter PJ, Cademartiri F (2005) Diagnostic accuracy of non-invasive 64-slice CT coronary angiography in patients with stable angina pectoris. Eur Radiol (early paper internet)

  32. Wintersperger BJ, Nikolaou K (2005) Basics of cardiac MDCT: techniques and contrast application. Eur Radiol 15(suppl 2):B2–B9

    PubMed  Google Scholar 

  33. White CS, Kuo D, Kelemen M, Jain V, Musk A, Zaidi E, Read K, Sliker C, Prasad R (2005) Chest pain evaluation in the emergency department: can MDCT provide a comprehensive evaluation? AJR 185:533–540

    PubMed  Google Scholar 

  34. Coche E, Vlassznbroeck A, Roelants V, D’Hoore W, Verschuren F, Goncette L, Maldague B (2005) Evaluation of biventricular ejection fraction with ECG-gated 16-slice CT: preliminary findings in acute pulmonary embolism in comparison with radionuclide ventriculography. Eur Radiol 15:1432–1440

    Article  PubMed  Google Scholar 

  35. Kim TH, Ryu YH, Hur J, Kim SJ, Choi BW, Kim Y, Kim HJ (2005) Evaluation of right ventricular volume and mass using retrospective ECG-gated cardiac multidetector computed tomography: comparison with first-pass radionuclide angiography. Eur Radiol 15:1987–1993

    Article  PubMed  Google Scholar 

  36. Delhaye D, Remy-Jardin M, Teisseire A, Hossein-Foucher C, Leroy S, Duhamel A, Remy J (2006) Estimation of right ventricular ejection fraction by multidetector row CT: comparison with equilibrium radionuclide scintigraphy. AJR (in press)

Download references

Author information

Authors and Affiliations

  1. Department of Thoracic Imaging, Hospital Calmette, University Center of Lille, Boulevard Jules Leclerc, 59037, Lille cedex, France

    Damien Delhaye, Martine Remy-Jardin, Céline Rozel & Jacques Remy

  2. Department of Thoracic Surgery, Hospital Calmette, University Center of Lille, Boulevard Jules Leclerc, 59037, Lille cedex, France

    Catherine Dusson & Alain Wurtz

  3. Department of Medical Statistics, University of Lille, Place de Verdun, 59037, Lille cedex, France

    Valérie Delannoy-Deken & Alain Duhamel

Authors
  1. Damien Delhaye
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Martine Remy-Jardin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Céline Rozel
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Catherine Dusson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Alain Wurtz
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Valérie Delannoy-Deken
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Alain Duhamel
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Jacques Remy
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Martine Remy-Jardin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Delhaye, D., Remy-Jardin, M., Rozel, C. et al. Coronary artery imaging during preoperative CT staging: preliminary experience with 64-slice multidetector CT in 99 consecutive patients. Eur Radiol 17, 591–602 (2007). https://doi.org/10.1007/s00330-006-0423-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-006-0423-y

Keywords

Search

Navigation