Initial experience with 64-slice cardiac CT: non-invasive visualization of coronary artery bypass grafts

Abstract

State-of-the-art 64-slice CT coronary angiography demonstrates high diagnostic accuracy in the assessment of arterial and venous bypass graft stenoses.

Transitioning from 16-slice to 64-slice multidetector computed tomography for the assessment of coronary artery disease: Are we really making progress?

“…The efficacy of 16-and 64-slice MDCT in examining vein and arterial graft stenosis (more than 50% luminal narrowing) has been evaluated (70)(71)(72)(73) (Figure 4). As with graft patency, 64-slice MDCT was capable of assessing stenosis in 98% of all vein and arterial grafts.…”

“…This is despite the fact that two of seven studies using 64-slice technology included patients with irregular or elevated heart rates (71,72). The increased accuracy and 'real-world' applicability of 64-slice MDCT suggests that it may be used clinically in the assessment of bypass graft patency and stenosis immediately following surgery and consistently afterwards.…”

“…Analysis of distal anastamotic sites was particularly difficult due to small vessel size and the presence of metallic clip-related artefacts. The 64-slice MDCT was capable of assessing between 94% and 98% of distal anastamotic sites (60,72). Metallic clip-related artefacts prevented the analysis of only 2% to 3% of bypass grafts with 64-slice MDCT (63,72).…”

“…The 64-slice MDCT was capable of assessing between 94% and 98% of distal anastamotic sites (60,72). Metallic clip-related artefacts prevented the analysis of only 2% to 3% of bypass grafts with 64-slice MDCT (63,72). Unfortunately, only two studies have explicitly examined the ability of 64-slice MDCT in assessing distal anastamosis sites.…”

“…The presence of atrial fibrillation usually serves as an exclusion criteria in most MDCT analyses. More recently, studies using MDCT (71,72) have included patients with atrial fibrillation and have maintained excellent diagnostic accuracy, likely attributable to the increased temporal resolution associated with 64-slice technology.…”