Skip to main content

Advertisement

SpringerLink
Log in

Influence of intra-coronary enhancement on diagnostic accuracy with 64-slice CT coronary angiography

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

Abstract

We assessed the effect of intra-coronary attenuation on diagnostic accuracy using 64-slice computed tomography coronary angiography (CT-CA). We enrolled 170 patients with suspected coronary artery disease who underwent conventional coronary angiography (CA) and 64-slice CT-CA (100 ml of Iomeprol 400 mg I/ml at 4 ml/s). The study population was divided into two groups (85 patients each based on median attenuation of 326 HU) based on mean arterial attenuation; group 1 with low attenuation and group 2 with high attenuation. Diagnostic accuracy for the detection of significant coronary artery stenosis was determined for both groups using CA as reference standard. Overall, 163 significant stenoses were detected in 1,030 assessable coronary artery segments in group 1 compared with 160 significant stenoses in 1,020 assessable segments in group 2. The average intra-coronary attenuation was significantly (P < 0.05) higher for group 2 (388 ± 46 HU) compared with group 1 (291 ± 33 HU). The corresponding sensitivity and specificity values for detection of significant coronary artery stenosis were higher for group 2 (96.3% and 97.6%, respectively) than for group 1 (82.8% and 93.2%, respectively) and were more marked in distal coronary segments than in proximal segments. Higher intra-coronary attenuation on CT-CA results in greater diagnostic accuracy for detection of coronary artery stenosis.

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

Similar content being viewed by others

References

  1. Cademartiri F, Nieman K, van der Lugt A et al (2004) IV contrast administration for CT coronary angiography on a 16-multidetector-row helical CT scanner: test bolus vs. bolus tracking. Radiology 233:817–823

    Article  PubMed  Google Scholar 

  2. Cury RC, Pomerantsev EV, Ferencik M et al (2005) Comparison of the degree of coronary stenoses by multidetector computed tomography versus by quantitative coronary angiography. Am J Cardiol 96:784–787

    Article  PubMed  Google Scholar 

  3. Erdogan N, Akar N, Vural M et al (2006) Diagnostic value of 16-slice multidetector computed tomography in symptomatic patients with suspected significant obstructive coronary artery disease. Heart Vessels 21:278–284

    Article  PubMed  Google Scholar 

  4. Garcia MJ, Lessick J, Hoffmann MH; CATSCAN Study Investigators (2006) Accuracy of 16-row multidetector computed tomography for the assessment of coronary artery stenosis. JAMA 296:403–411

    Article  PubMed  CAS  Google Scholar 

  5. Reant P, Brunot S, Lafitte S et al (2006) Predictive value of noninvasive coronary angiography with multidetector computed tomography to detect significant coronary stenosis before valve surgery. Am J Cardiol 97:1506–1510

    Article  PubMed  Google Scholar 

  6. Nikolaou K, Rist C, Wintersperger BJ et al (2006) Clinical value of MDCT in the diagnosis of coronary artery disease in patients with a low pretest likelihood of significant disease. AJR Am J Roentgenol 186:1659–1668

    Article  PubMed  Google Scholar 

  7. Gaspar T, Halon D, Rubinshtein R, Peled N (2005) Clinical applications and future trends in cardiac CTA. Eur Radiol 15(Suppl 4):D10–D14

    PubMed  Google Scholar 

  8. Cury RC, Ferencik M, Achenbach S et al (2006) Accuracy of 16-slice multi-detector CT to quantify the degree of coronary artery stenosis: assessment of cross-sectional and longitudinal vessel reconstructions. Eur J Radiol 57:345–350

    Article  PubMed  Google Scholar 

  9. Leber AW, Knez A, von Ziegler F et al (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 

  10. Nikolaou K, Knez A, Rist C, Wintersperger BJ, Leber A, Johnson T, Reiser MF, Becker CR (2006) Accuracy of 64-MDCT in the diagnosis of ischemic heart disease. AJR Am J Roentgenol 187:111–117

    Article  PubMed  Google Scholar 

  11. Sheth TN, Rieber J, Mooyaart EA et al (2006) Usefulness of coronary computed tomographic angiography to assess suitability for revascularization in patients with significant coronary artery disease and angina pectoris. Am J Cardiol 98:1198–1201

    Article  PubMed  Google Scholar 

  12. Ehara M, Surmely JF, Kawai M et al (2006) Diagnostic accuracy of 64-slice computed tomography for detecting angiographically significant coronary artery stenosis in an unselected consecutive patient population: comparison with conventional invasive angiography. Circ J 70:564–571

    Article  PubMed  Google Scholar 

  13. Muhlenbruch G, Seyfarth T, Soo CS, Pregalathan N, Mahnken AH (2007) Diagnostic value of 64-slice multi-detector row cardiac CTA in symptomatic patients. Eur Radiol 17:603–609

    Article  PubMed  Google Scholar 

  14. Busch S, Johnson TR, Nikolaou K et al (2007) Visual and automatic grading of coronary artery stenoses with 64-slice CT angiography in reference to invasive angiography. Eur Radiol 17:1445–1451

    Article  PubMed  Google Scholar 

  15. Cademartiri F, Mollet NR, van der Lugt A et al (2005) Intravenous contrast material administration at helical 16-detector row CT coronary angiography: effect of iodine concentration on vascular attenuation. Radiology 236:661–665

    Article  PubMed  Google Scholar 

  16. Rist C, Nikolaou K, Kirchin MA et al (2006) Contrast bolus optimization for cardiac 16-slice computed tomography: comparison of contrast medium formulations containing 300 and 400 milligrams of iodine per milliliter. Invest Radiol 41:460–467

    Article  PubMed  Google Scholar 

  17. Cademartiri F, de Monye C, Pugliese F et al (2006) High iodine concentration contrast material for noninvasive multislice computed tomography coronary angiography: iopromide 370 versus iomeprol 400. Invest Radiol 41:349–353

    Article  PubMed  Google Scholar 

  18. Cademartiri F, Mollet NR, Lemos PA et al (2006) Higher intracoronary attenuation improves diagnostic accuracy in MDCT coronary angiography. AJR Am J Roentgenol 187:W430–W433

    Article  PubMed  Google Scholar 

  19. Scheffel H, Alkhadhi H, Plass A, Vachenhauer R, Desbiolles L, Gaemperli O, Schepis T, Fraunefelder T, Schertler T, Husmann L, Grunenfelder J, Genoni M, Kaufmann PA, Marincek B, Leschka S (2006) Accuracy of dual-source CT coronary angiography: First experience in a high pre-test probability population without heart rate control. Eur Radiol 16:2739–2747

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology and Cardiology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy

    Filippo Cademartiri, Erica Maffei, Anselmo Alessandro Palumbo, Annachiara Aldrovandi, Michele Fusaro, Luigi Vignali & Alberto Menozzi

  2. Department of Radiology and Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands

    Filippo Cademartiri, Anselmo Alessandro Palumbo, W. Bob Meiijboom, Nico R. A. Mollet & Gabriel P. Krestin

  3. Department of Radiology, University of Verona, Verona, Italy

    Roberto Malagò

  4. Department of Radiology, University of Palermo, Palermo, Italy

    Ludovico La Grutta & Massimo Midiri

  5. Cardiovascular Rehabilitation Unit, Don Gnocchi ONLUS, Parma, Italy

    Valerio Brambilla & Paolo Coruzzi

  6. Worldwide Medical & Regulatory Affairs, Bracco Imaging SpA, Milan, Italy

    Miles A. Kirchin

  7. Non-invasive Cardiovascular Imaging Unit, Department of Radiology, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci, 14, 43100, Parma, Italy

    Filippo Cademartiri

Authors
  1. Filippo Cademartiri
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Erica Maffei
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anselmo Alessandro Palumbo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Roberto Malagò
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ludovico La Grutta
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. W. Bob Meiijboom
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Annachiara Aldrovandi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Michele Fusaro
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Luigi Vignali
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Alberto Menozzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Valerio Brambilla
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Paolo Coruzzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Massimo Midiri
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Miles A. Kirchin
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Nico R. A. Mollet
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Gabriel P. Krestin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Filippo Cademartiri.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cademartiri, F., Maffei, E., Palumbo, A.A. et al. Influence of intra-coronary enhancement on diagnostic accuracy with 64-slice CT coronary angiography. Eur Radiol 18, 576–583 (2008). https://doi.org/10.1007/s00330-007-0773-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-007-0773-0

Keywords

Search

Navigation