Accuracy and Efficiency of a Novel Diagnostic Method for Non-invasive Coronary Angiography Using 64-slice Multi-slice Computed Tomography
Osaka University Medical School, Osaka, Japan
T. Kuroda, S. Sumitsuji, K. Tsujii, J. Kotani, K. Tachibana, K. Yamasaki, S. Nanto
Background: 64-slice multi-slice computed tomography (MSCT) has facilitated increasingly accurate non-invasive coronary angiography. However, the efficiency of diagnosing coronary artery disease by this modality depends largely on the imaging technology employed. ˇ°Curved MPRˇ± imaging method, the current gold standard, unmercifully demands time and efforts on the observer. We therefore introduced ˇ°Sliding slab MIPˇ± method, a novel diagnostic method for non-invasive coronary angiography, and evaluated its diagnostic accuracy and efficiency.
Methods: 30 consecutive patients undergoing MSCT and subsequent elective invasive coronary angiography (ICA) were studied. Patients were excluded for post CABG, post coronary stenting and severe coronary calcification, but not for mild or moderate coronary calcification. MSCT angiogram lesions were visualized on a three-dimensional ˇ°Sliding slab MIPˇ± ZIOSOFT NG1 workstation and analyzed quantitatively. Results were compared with the following ICA for significant coronary stenoses (over 75 % luminal narrowing) by segment.
Results: All MSCT scans showed diagnostic image quality. The average time caused for screening coronary arteries per patient on this workstation was 382 ∓ 125 sec. Of the 405 segments studied, sensitivity, specificity, positive and negative predictive values for the presence of significant stenoses on ICA were 96.7 %, 94.8 %, 76.6 % and 99.4 %, respectively.
Conclusion: The results indicate high time-efficiency and quantitative accuracy of the ˇ°Sliding slab MIPˇ± method in imaging non-invasive coronary angiography in a broad spectrum of patients.
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