Chikako Nishida MD, PRESENTER: Nothing to Disclose

Abstract: HTML Purpose: To investigate significance of incidental detection of coronary artery calcification in symptomatic patient population by non-gated multi-detector CT (MDCT). Methods and Materials: Between 1999 and 2002, 716 patients with suspected ischemic heart disease underwent thallium nuclear medicine scan. Of the patients, non-gated MDCT without contrast enhancement was performed for 55 patients. A median interval time between thallium scan and MDCT was 22 days. There were 37 men and 18 women, with a median age of 70 years (range; 49-83). In this retrospective analysis, patients with a history of myocardial infarction or coronary arterial intervention were not included. Calcification of coronary arteries detected on MDCT was correlated with ischemic changes on thallium exercise stress test. This analysis was examined both per patient and per coronary arterial territory. Results: Coronary artery calcification per patient was detected in 10 (63 %) of 16 patients with myocardial ischemia, while coronary artery calcification was detected in 11 (28 %) of the remaining 39 patients without ischemic changes. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of coronary artery calcification for the detection of myocardial ischemia were 63%, 72%, 48%, 82%, respectively. The detection of coronary artery calcification on MDCT was significantly correlated with myocardial ischemia (p < 0.05). In the analysis per coronary arterial territory, arterial calcification was noted in 12 (50 %) of 24 territories with myocardial ischemia, while calcification was noted in 22 (16%) of the remaining 141 territories without ischemia. Sensitivity, specificity, PPV and NPV of coronary artery calcification on MDCT were 50%, 84%, 35%, 90%, respectively. The detection of calcification of a major branch of coronary artery on MDCT was significantly correlated with ischemia at the arterial territory (p <0.001). Conclusion: Coronary arterial calcification on MDCT was significantly correlated with myocardial ischemia detected on thallium exercise stress test. Although the sensitivity and PPV of the finding are low, specificity and NPV are substantially high. Thus, the risk for ischemic heart disease is low enough for patients without coronary arterial calcification on non-gated MDCT.       Questions about this event email: nisida@nara.med.kindai.ac.jp

Nishida MD, C, Coronary Artery Calcification in Symptomatic Patients on Non-Gated Multi-Detector CT: Correlation with Thallium Exercise Stress Test.  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3101342.html