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Volume 4 No. 2, April 2009 |
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ECG-Gated Multi-Detector Row Computed Tomography (MDCT) Coronary Angiography versus Coronary Angiography in Assessment of Patients with Acute Chest Pain Abeer S. Ghobashy
Radiodiagnosis Department, Faculty of Medicine, Tanta University,
Egypt
Background/Aim: Numerous studies have now shown that cardiac CT
accurately evaluate the coronary artery diseases such as; stenosis,
occlusions and plaque formation. The aim of the present study is to
evaluate the accuracy of electrocardiography (ECG)-gated
multi-detector row spiral computed tomography (MDCT) in assessing
the coronary arteries and correlating the data with coronary
angiographic findings. Patients & Methods: We studied
retrospectively 60 patients (42 males and 18 females) who had
consecutively undergone multi-detector row CT, as well as invasive
coronary angiography, mean patient age was 56 years, patients' heart
rate was around 60 bpm. All CT scans were obtained by a
multi-detector row scanner. Patients with heart rates higher than 65
bpm had previously received a short- lasting beta-blocker to obtain
rates of about 60 bpm. Results: In this study we found that
hyperlipidemia was the highest risk factor seen (80%) ; followed by
current smoking (76.7%), then hypertension (66.7%), increased BMI
(55.0%), history of CAD (26.7%); while Diabetes was the least risk
factor (23.3%). In our study with focus on the three main branches
for transverse scanning, the following visibilities were noted: LCA:
96 % (less than or equal to 60bpm), 86.6% (more than 60bpm); RCA:
80% (less than or equal to 60bpm), 69 % (more than 60 bpm); LCX:
63.3% (less than or equal to 60bpm), 55% (more than 60bpm).
Regarding to the atherosclerotic plaques were found at the
transverse scanning with a sensitivity of (67.7 %); 3D and VE
reformation showed sensitivity of 60 % and 66 % respectively,
whereas the sensitivity of MPR amounted to 66.7 %. Conclusion:
Multi-detector row CT angiography potentially has a diagnostic role
in acute chest pain; it has the advantage of vessel wall and plaque
depiction in addition to its ability to enable assessment of luminal
dimensions. The assessment of size and composition of coronary
arterial lesions and the associated changes in vessel architecture
may have important clinical implications. |
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