Heart 2000;84:489-493 ( November )

Cardiovascular medicine

Contrast enhanced electron beam computed tomography to analyse the coronary arteries in patients after acute myocardial infarction S Achenbach, D Ropers, M Regenfus, G Muschiol, W G Daniel, W Moshage

Department of Internal Medicine II, University of Erlangen-Nürnberg, Östliche Stadtmauerstr 29, D-91054 Erlangen, Germany

Correspondence to: Dr Achenbach email: stephan.achenbach{at}rzmail.uni-erlangen.de

Accepted 17 May 2000

OBJECTIVETo evaluate the accuracy of contrast enhanced electron beam computed tomography (EBCT) after acute myocardial infarction in determining patency of the infarct related artery and detecting high grade stenoses and occlusions in the coronary vessels.
DESIGNCase study using blinded comparison with invasive coronary angiography.
PATIENTS36 patients (mean age 53 years) 4-70 days after acute myocardial infarction.
INTERVENTIONSThe patients were studied by EBCT and invasive coronary angiography. For EBCT, 50 axial images of the heart (3 mm slice thickness) were acquired. They were triggered by the ECG during breath holding, after intravenous injection of contrast agent. The original images, surface reconstructions, and maximum intensity projections were evaluated for the presence of high grade stenoses and occlusions of the coronary arteries.
MAIN OUTCOME MEASURESEBCT results were compared with invasive coronary angiography.
RESULTSOf a total of 144 coronary arteries (left main, left anterior descending, left circumflex, and right coronary artery in 36 patients), 29 (20%) were unevaluable by EBCT. In the remaining arteries, 33 of 36 high grade lesions were correctly detected (92% sensitivity). Specificity was also 92% (73/79). Patency of the infarct related artery was correctly detected in 15 of 16 cases (94%). Five of the 14 occluded infarct related arteries (35%) were mistaken as stenotic but patent, and six could not be assessed.
CONCLUSIONSEBCT is very accurate in detecting significant coronary artery lesions in patients after acute myocardial infarction, but differentiation between occluded and patent infarct related arteries is currently unreliable.


Keywords: electron beam CT; coronary angiography; myocardial infarction; computed tomography

---

© 2000 by Heart
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Niinuma, H., George, R. T., Arbab-Zadeh, A., Lima, J. A.C., Henrikson, C. A. (2008). Imaging of pulmonary veins during catheter ablation for atrial fibrillation: the role of multi-slice computed tomography. Europace 10: iii14-iii21 [Abstract] [Full Text]  
• Budoff, M. J., Achenbach, S., Blumenthal, R. S., Carr, J. J., Goldin, J. G., Greenland, P., Guerci, A. D., Lima, J. A.C., Rader, D. J., Rubin, G. D., Shaw, L. J., Wiegers, S. E. (2006). Assessment of Coronary Artery Disease by Cardiac Computed Tomography: A Scientific Statement From the American Heart Association Committee on Cardiovascular Imaging and Intervention, Council on Cardiovascular Radiology and Intervention, and Committee on Cardiac Imaging, Council on Clinical Cardiology. Circulation 114: 1761-1791 [Full Text]  
• Fishman, E. K., Ney, D. R., Heath, D. G., Corl, F. M., Horton, K. M., Johnson, P. T. (2006). Volume rendering versus maximum intensity projection in CT angiography: what works best, when, and why.. RadioGraphics 26: 905-922 [Abstract] [Full Text]  
• Lu, B., Zhuang, N., Mao, S.-S., Child, J., Carson, S., Budoff, M. J. (2004). Baseline Heart Rate-adjusted Electrocardiographic Triggering for Coronary Artery Electron-Beam CT Angiography. Radiology 233: 590-595 [Abstract] [Full Text]  
• Budoff, M. J., Achenbach, S., Duerinckx, A. (2003). Clinical utility of computed tomography and magnetic resonance techniques for noninvasive coronary angiography. J Am Coll Cardiol 42: 1867-1878 [Abstract] [Full Text]  
• van Ooijen, P. M. A., Ho, K. Y., Dorgelo, J., Oudkerk, M. (2003). Coronary Artery Imaging with Multidetector CT: Visualization Issues. RadioGraphics 23: e16-e16 [Abstract] [Full Text]  
• Fayad, Z. A., Fuster, V., Nikolaou, K., Becker, C. (2002). Computed Tomography and Magnetic Resonance Imaging for Noninvasive Coronary Angiography and Plaque Imaging: Current and Potential Future Concepts. Circulation 106: 2026-2034 [Full Text]  
• Gerber, T. C., Kuzo, R. S., Karstaedt, N., Lane, G. E., Morin, R. L., Sheedy, P. F II, Safford, R. E., Blackshear, J. L., Pietan, J. H. (2002). Current Results and New Developments of Coronary Angiography With Use of Contrast-Enhanced Computed Tomography of the Heart. Mayo Clin Proc. 77: 55-71 [Abstract]