Detection of coronary artery calcifications predicting coronary heart disease: comparison of fluoroscopy and spiral CT

Abstract

The aim of this study was to evaluate the clinical relevance of coronary artery calcifications detected by spiral CT, congruence with fluoroscopy (FS) and coronary angiography, and comparison with studies reporting on application of double-helical CT and ultrafast CT. Forty patients underwent spiral CT (2-mm slice thickness, table feed 3 mm/s), coronary angiography, and FS (performed in the usual manner). Stenosis and calcifications were evaluated semiquantitatively. Nineteen patients suffering from a stenosis >/= 75 % were verified at coronary angiography. All had coronary artery calcification on spiral CT. Fluoroscopy did not detect 8 of 19 patients with a stenosis >/= 75 % (1 vessel: n = 1; 2 vessels: n = 3; 3 vessels: n = 4). In spiral CT sensitivity was 100 % and specificity was 33 % (FS: 58 and 48 %). Positive predictive value was 83 % for spiral CT (FS: 50 %), and negative predictive value was 100 % (FS: 56 %). A significant linear increase in the calcification score was found for increasing maximal stenosis (p < 0.005). Spiral CT is more sensitive than FS in the recognition of hemodynamic relevant stenoses using the detection of coronary artery calcifications. Statistical parameters are comparable to ultrafast-CT. Spiral CT is a suitable non-invasive diagnostic technique in coronary heart disease. Coronary calcifications found incidentally in symptomatic patients at chest CT should be reported to the referring physician for further cardiological workup.

The accuracy of 1- and 3-mm slices in coronary calcium scoring using multi-slice CT in vitro and in vivo

“…Coronary artery calcifications are known to be a constituent of atherosclerosis [1][2][3][4]. As several studies proved the number of coronary calcification to be correlated with the risk of severe cardiac events, detection and quantification of coronary calcifications can be a useful diagnostic tool in the workup of patients with suspected coronary artery disease [5,6].…”

Evaluation of automated attenuation-based tube current adaptation for coronary calcium scoring in MDCT in a cohort of 262 patients

“…Coronary artery calcifications are known to be a constituent of atherosclerosis [1,2]. As several studies have proved the amount of coronary calcification to be correlated with the risk for severe cardiac events, detection and quantification of coronary calcifications can be a useful diagnostic tool in the workup of patients with suspected coronary artery disease (CAD) [3][4][5][6].…”

New developments in the detection of vulnerable plaque

“…With synchronous recording of the ECG, the whole heart can be imaged continuously with thin slices and high spatial resolution in less than 30 seconds. The quality of image appears adequate for precise calcium scoring and CT angiography of the coronary arteries [56]. Although MRI has some other advantages with respect to coronary artery imaging, ultra-fast CT is turning into a real opportunity.…”