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CT coronary angiography

Publication
Philips CT Clinical Science Philips Healthcare • USA

Coronary CT-flow quantification supplements morphological stenosis analysis

Bovenschulte H, Krug B, Schneider T, Schwabe H, Kabbasch C, Bangard C, Hellmich M, Michels G, Maintz D, Lackner K.

* Originally published in the April 2013 issue of the European Journal of Radiology.
Background
Our rationale was to evaluate whether a 64-slice CT scanner allows accurate measurement of computed tomographic (CT) changes in coronary artery flow profiles and whether CT flow measurements are suitable for classifying the significance and hemodynamic relevance of a stenosis and thereby supplement as a functional parameter for morphological stenosis analysis.

Methods
A total of 50 patients prospectively underwent computed tomography coronary angiography (coronary CTA) in a multidetector CT scanner (Brilliance CT 64-channel, Philips) ± one day before or after invasive coronary angiography (ICA). Immediately thereafter, two radiologists reviewed the imaging data to detect any vessel segments with morphology poorly evaluable by coronary CTA. A locally constant cyclical measurement was acquired in these coronary arteries in breath-hold technique during the passage of a 50 ml bolus of contrast media. For analysis, time-density curves of the bolus passage were registered in the coronary artery and the aorta (internal reference), the up-slopes were determined and correlated with each other. The results were compared with the ICA findings.

Results
47 of 50 CT flow measurements were evaluable. A good correlation was found between the degrees of stenosis and slope ratios in aorta and coronary artery (R²=0.92). The threshold corridor was 0.55-0.77 for distinguishing hemodynamically (≥70%) from non-hemodynamically relevant stenoses.

Conclusions
CT-based coronary artery flow measurements (CTFM) correlate well with the angiographically determined degree of stenosis and can elevate by non-invasive means the diagnostic accuracy of coronary CTA. From both a clinically diagnostic and scientific standpoint, CTFM proves a suitable method for quantifying coronary blood flow.
For more information about this publication, check out the PubMed listing for this article.


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Publication
Brilliance 64-channel
aorta, Cardiac, contrast, coronary angiography, coronary arteries, stenosis, Vascular
 

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