MDCT Highly Accurate for Diagnosing Coronary Artery Disease in Patients With Zero to Moderate Coronary Calcification

In patients with no or moderate coronary calcification, 16-slice MDCT allows the reliable detection of coronary artery stenosis with high diagnostic accuracy, say researchers from Tuebingen University Hospital in Germany. Coronary artery stenosis is the narrowing of coronary arteries due to the build-up of calcified plaques.

The study included 37 patients, 28 of whom had a calcium score of less than 1,000 (no calcification to moderate calcification). The researchers found that 16-MDCT was very accurate in diagnosing these patients, having a sensitivity and specificity of 93% and 94%, respectively.

When the remaining nine who had a calcium score of 1,000 or greater (severe calcification) were added, the overall sensitivity and specificity dropped to 59% and 87%, respectively. “Severe coronary calcification reduces reliable visualization of the coronary arteries and may mask vascular stenosis, but 16-MDCT has improved the visualization of coronary arteries so that those with no or moderate coronary calcification can be diagnosed accurately,” said Martin Heuschmid, MD, lead author of the study.

According to the researchers, coronary artery lesions are usually diagnosed by coronary angiography. “Coronary angiography, though, is an invasive examination with certain risks for the patients. MDCT could help to circumvent those drawbacks. However, in patients with severe coronary calcification, conventional coronary angiography may still be necessary to diagnose or exclude high-grade stenosis of the coronary tree,” said Dr. Heuschmid.

The study appears in the May 2005 issue of the American Journal of Roentgenology.