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Feasibility of 64-slice gadolinium-enhanced cardiac CT for evaluating obstructive CAD

Publication
CT Marketing Philips Healthcare

Carrascosa P, Capuñay C, Deviggiano A, Bettinotti M, Goldsmit A, Tajer C, Carrascosa J, García MJ.

Department of Radiology, Diagnostico Maipu, Buenos Aires, Argentina
investigacion@diagnosticomaipu.com.ar


* Originally published online on April 20, 2010 in Heart
.

Objective
To assess the feasibility of gadolinium-enhanced 64-slice cardiac CT (CCT) for the diagnosis of obstructive coronary artery disease.

Design
Comparative prospective study.

Setting
Outpatient Imaging Diagnostic Centre, Diagnóstico Maipú, Buenos Aires, Argentina.

Patients

Twenty patients with suspected coronary artery disease. Interventions Gadolinium-enhanced 64-slice CCT was performed before invasive coronary angiography (ICA).

Main outcome measures
The feasibility of gadolinium-enhanced 64-slice CCT for detection of obstructive coronary artery disease (> 50% diameter reduction) was evaluated, using ICA as the "gold standard." Mean lumen attenuation, non-calcified and calcified plaques densities were correlated between gadolinium-enhanced CCT studies and iodine-enhanced CCT studies of a control group. Renal function was strictly monitored.

Results
Gadolinium-enhanced CCT demonstrated adequate visualisation of 283/289 coronary segments that were evaluable by ICA, 31 of which had > 50% luminal stenosis. In per-segment analysis, gadolinium-enhanced CCT showed a sensitivity of 90.3%, specificity of 96.8%, positive predictive value of 77.8% and negative predictive value of 98.8%. The agreement of coronary stenosis between multidetector CT (MDCT) and ICA was 94.1% (272/289). The mean lumen attenuation, non-calcified and calcified plaques densities in gadolinium-enhanced CCT studies were 140.1 Hounsfield units (HU), 51.1 HU and 523.6 HU, whereas in iodine-enhanced CCT studies the values were 354.1 HU, 101.0 HU and 778.5 HU, respectively (p < 0.001).

Conclusion
Gadolinium-enhanced CCT is a feasible alternative for patients with severe contraindications to iodinated contrast agents referred for MDCT coronary angiography.
For more information about this publication, check out the PubMed listing for this article.


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Publication
Brilliance 64-channel
calcification, Cardiac, contrast-enhanced, coronary angiography, coronary arteries, coronary artery disease, gadolineum, kidney/renal, plaque, stenosis, Vascular
 

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