Approccio diagnostico non invasivo con tomografia computerizzata multidetettore a 40 strati per lo studio della malattia aterosclerotica coronarica

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Abstract

Background. Multidetector computed tomography coronary angiography (MDCT-CA) is a non-invasivetechnique that clearly shows coronary anatomy and correctly identifies plaque location and morphology.In this study we assessed diagnostic accuracy of MDCT-CA in detectiong significant stenosisin patients with clinically relevant coronary tree disease.Methods. Fifty patients (38 males, 12 females, mean age 60.9 ± 9.2 years) with atypical chest pain,stable or unstable angina pectoris, or non-ST-elevation myocardial infarction underwent MDCT-CA(Brilliance 40, Philips Medical Systems, Cleveland, OH, USA) within 3 days before diagnostic conventionalcoronary angiography. Inclusion criteria were sinus rhythm, heart rate <70 b/min, and abilityto hold breath for more than 12 s. Exclusion criteria were known intolerance to contrast medium,serum creatinine >2 mg/dl, pregnancy, respiratory insufficiency, unstable clinical conditions, and severeheart failure. Beta-blockers were administered if heart rate was >70 b/min. To synchronize arrivalof the contrast bolus (Iomeron 400, Bracco, Milan) in the coronary arteries with the start of thescan the bolus-tracking technique was used. Diagnostic accuracy was evaluated per segment, per vessel,and per patient.Results. Mean heart rate during examination was 61.9 ± 6.2 b/min; 618 segments were evaluated.The assessment was impaired by respiratory artifacts only in 1 patient (2%). MDCT-CA showed goodsensitivity, specificity, and positive and negative predictive values in detecting significant coronaryartery stenosis (94, 94, 91, and 96% per segment; 91, 97, 95, and 92% per vessel; 100, 100, 100, and100% per-patient, respectively).Conclusions. Forty-slice MDCT-CA showed a good diagnostic capability in detecting significantcoronary artery stenosis in patients referred to our institution for suspected or known significantcoronary artery disease.
Lingua originaleEnglish
pagine (da-a)508-518
Numero di pagine11
RivistaGiornale Italiano di Cardiologia
Volume8
Stato di pubblicazionePublished - 2007

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