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Accuracy of dual-source computed tomography coronary angiography: evaluation with a standardised protocol for cardiac surgeons

Plass, Andre ; Azemaj, Naim ; Scheffel, Hans ; Desbiolles, Lotus ; Alkadhi, Hatem ; Genoni, Michele ; Falk, Volkmar ; Grunenfelder, Jurg

In: European Journal of Cardio-Thoracic Surgery, 2009, vol. 36, no. 6, p. 1011-1017

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    Titel
    • Accuracy of dual-source computed tomography coronary angiography: evaluation with a standardised protocol for cardiac surgeons
    Autor
    • Plass, Andre. Clinic for Cardiovascular Surgery, University Hospital Zurich, Raemistr. 100, 8091 Zurich, Switzerland
    • Azemaj, Naim. Clinic for Cardiovascular Surgery, University Hospital Zurich, Raemistr. 100, 8091 Zurich, Switzerland
    • Scheffel, Hans. Institute of Diagnostic Radiology, University Hospital Zurich, Zurich, Switzerland
    • Desbiolles, Lotus. Institute of Diagnostic Radiology, University Hospital Zurich, Zurich, Switzerland
    • Alkadhi, Hatem. Institute of Diagnostic Radiology, University Hospital Zurich, Zurich, Switzerland
    • Genoni, Michele. Clinic for Cardiovascular Surgery, University Hospital Zurich, Raemistr. 100, 8091 Zurich, Switzerland
    • Falk, Volkmar. Clinic for Cardiovascular Surgery, University Hospital Zurich, Raemistr. 100, 8091 Zurich, Switzerland
    • Grunenfelder, Jurg. Clinic for Cardiovascular Surgery, University Hospital Zurich, Raemistr. 100, 8091 Zurich, Switzerland
    Dokumententyp
    • Postprint
    Sprache
    • Englisch
    Veröffentlicht in
    • European Journal of Cardio-Thoracic Surgery, 2009, vol. 36, no. 6, p. 1011-1017. Elsevier Science B.V.
    Andere elektronische Ausgabe
    OAI-PMH-ID
    • oai:doc.rero.ch:298241
    Summary
    Background: This study assesses the accuracy of the new dual-source computed tomography (DSCT) for detection of coronary artery disease (CAD) compared with invasive coronary angiography (ICA) with a specifically designed data presentation protocol for cardiac surgeons. Methods: Forty patients (30 males/10 females) underwent ICA and DSCT. Best-quality images were prepared by radiologists. Evaluation of 12 segments of significant coronary stenosis was done by two cardiac surgeons with a data presentation protocol including different coronary views in two-/three-dimensional (2D/3D) images. No beta-blockers were administered prior to DSCT. Results: ICA revealed CAD in 21 patients and valvular disease but no CAD in 19 patients. In DSCT, 20/21 patients were diagnosed with CAD (at least one significant stenosis per patient). In 11/21 patients, all 12 segments were assessed correctly; in 7/21 patients one segment and in 3/21 patients two segments were evaluated incorrectly. Of all 21 patients with CAD, 239/252 segments (95%) were correctly evaluated. In 18/19 patients without CAD, DSCT correctly ruled-out the ICA results in 226/228 segments (99%). In total, 465/480 segments were correctly assessed (97%). Of 480 segments, only six were considered not assessable. DSCT assessments of the segments showed a sensitivity of 91%, specificity of 99%, a positive predictive value of 92% and a negative predictive value of 99%. Conclusions: The accuracy of DSCT coronary angiography especially for exclusion of CAD is promising. The introduced data presentation protocol allows for the independent evaluation by cardiac surgeons after pre-arrangement from the radiologists