Benjamin Cocheteux MD, Presenter: Nothing to Disclose

Philippe Jean Cluzel MD, PhD, Abstract Co-Author: Nothing to Disclose

Redha Boutekadjirt MD, Abstract Co-Author: Nothing to Disclose

Reynald Izzillo MD, Abstract Co-Author: Nothing to Disclose

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

Philippe Andre Grenier MD, PhD, Abstract Co-Author: Nothing to Disclose

To evaluate the diagnostic accuracy of contrast-enhanced coronary CT angiography for the detection of relevant coronary lesions with a diameter stenosis ≥ 50% using a 40-slice CT scanner.

100 patients were prospectively enrolled in this study. Coronary CT scans were performed with a 40-slice CT scanner (Brilliance 40, Philips Medical System). Imaging parameters were 120 kV, 650-800 mAs, rotation time 0.42 sec, 40x0.625 mm, pitch O.2, reconstruction increment 0.3 mm. Non ionic contrast of 100 mL with a 5 mL/sec and a 70 mL 0.9 % NaCl bolus chaser were administered. No beta blocker was used. Each study was divided in 10 phases of the R-R interval in order to determine in which of them there was less cardiac motion. A 3D voxel-based approach with cardiac phase weighting was used for reconstruction. Stenosis evaluation were done by two radiologists using axial slices and curved MPR images blinded to the results of conventional coronary angiography performed 2-7 days of CT examination. Each coronary artery segment was evaluated according to the 17 segments model of the American College of Cardiology and the American Heart Association.

All scans showed diagnostic image quality. Ninety nine of 1700 segments (5.3%) showed a nondiagnostic image quality. Sensitivity, specificity, and positive and negative predictive values for the whole study group were as follows: 93%, 98%, 92%, and 97%, respectively. The correct clinical diagnosis of presence or absence of significant CAD was obtained in 97 of 100 (97%) patients.

Our results indicate a high diagnostic accuracy of 40-slice MDCT with increased number of slices and improved algorithm of reconstruction.

Cocheteux, B, Cluzel, P, Boutekadjirt, R, Izzillo, R, Auguste, M, Grenier, P, Prospective Assessment of Coronary Artery Stenoses with ECG-gated 40-slice Spiral CT.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4419267.html