Patricia Marina Carrascosa MD, Presenter: Nothing to Disclose

Gustavo Lev, Abstract Co-Author: Nothing to Disclose

Carlos Capuñay MD, Abstract Co-Author: Nothing to Disclose

Marina Ulla MD, Abstract Co-Author: Nothing to Disclose

Jorge Manuel Carrascosa MD, Abstract Co-Author: Nothing to Disclose

Mario Garcia MD, Abstract Co-Author: Nothing to Disclose

To determine the role of MSCT in the evaluation of coronary arteries of heart transplant patients in comparison with digital angiography (DA) and intravascular ultrasound (IVUS).

Nineteen heart transplant patients were evaluated by DA and MSCT. Fifteen of them were also evaluated by IVUS. The diagnostic accuracy of MSCT in comparison with DA was determined. Stenosis > 50% were considered as a true-positive finding at DA. Those CT segments considered as a true-negative finding by DA (stenosis < 50%) were compare with IVUS to stablish intimal proliferation. CTs were performed in a 16-row scanner with 1mm collimation; 0.5mm reconstruction interval. An enhanced acquisition was performed with administration of 100ml of iodinated contrast using a power injector. IVUS were carried out with an Ultra Cross 3.2F, 30-MhZ coronary imaging catheter, (Boston Scientific Corporation). Previously, all patients received a bolus of 70 IU/Kg of unfractioned heparin and 0.2 mg of nitroglycerin intra-arterially. Cross-sectional images from both methods were matched via distance (10mm) from the ostium up to the vessel reach the diameter of 1.5mm. The analysis of the segments was done by two independent readers. Statistical analysis: the sensitivity, specificity, positive predictive value and negative predictive value were calculated using the exact binomial method.

MSCT vs DA: there were 4 segments non evaluable due to motion artifacts. There were 20 true-positive, 294 true-negative, 2 false-positive and 3 false-negative findings. The sensitivity was 87.0% (65.3, 96.6), specificity 99.3% (97.3, 99.9), positive predictive value 90.9% (69.4, 98.4) and negative predictive value 99.0% (96.8, 99.7). MSCT vs IVUS: there were 51 true-positive, 151 true-negative, 20 false-positive and 5 false-negative findings. The sensitivity was 91.1% (79.6, 96.7), specificity 88.3% (82.3, 92.5), positive predictive value 71.8% (59.7, 81.6) and negative predictive value 96.8% (92.3, 98.8).

MSCT is a non-invasive method useful in the evaluation of coronary arteries in heart transplant patients giving information about the lumen and the wall of the arteries allowing to detect the graft vascular disease.

Carrascosa, P, Lev, G, Capuñay, C, Ulla, M, Carrascosa, J, Garcia, M, Coronary Artery Evaluation of Heart Transplant Patients by MSCT.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4412456.html