CARDIOVASCULAR MEDICINE

Clinical use of multislice spiral computed tomography in 210 highly preselected patients: experience with 4 and 16 slice technology

T Beck^1,*, C Burgstahler^1,*, A Kuettner², A F Kopp², M Heuschmid², C D Claussen², S Schroeder¹

¹ Department of Internal Medicine, Division of Cardiology, Eberhard-Karls University, Tuebingen, Germany
² Department of Radiology, Division of Diagnostic Radiology, Eberhard-Karls University, Tuebingen, Germany

Correspondence to:
Dr Priv-Doz Stephen Schroeder
Department of Internal Medicine, Division of Cardiology, Otfried-Mueller-Strasse 10, 72076 Tuebingen, Germany; stephen.schroeder{at}med.uni-tuebingen.de

Objective: To report an initial experience with multislice spiral computed tomography (MSCT) coronary imaging, as well as differences in diagnostic accuracy between 4 slice and 16 slice MSCT technology.

Methods and results: 210 patients underwent MSCT coronary angiography (4 slices, n = 120; 16 slices, n = 90; suspicion of coronary artery disease, n = 158; suspicion of restenosis, n = 52). Recommendations for further diagnostic tests were based on the MSCT results. Patients were interviewed by telephone after a mean (SD) of 449 (169) days to evaluate their further clinical course. MSCT detected significant lesions in 90 of 210 (43%) patients and invasive coronary angiography (ICA) was recommended. MSCT excluded significant lesions in 120 of 210 (57%) patients. ICA was actually performed in 44 of 210 (21%) patients (corresponding results, 27 of 44 (61%); false positive, 11 of 44 (25%); false negative, 6 of 44 (14%)). No significant differences were found between 4 and 16 slice imaging. No major cardiac event occurred during follow up.

Conclusions: MSCT was found to be useful to evaluate the need for invasive diagnostic procedures. However, the false negative results underline that further improvements of image quality are required before MSCT can replace ICA in carefully selected patients.

Abbreviations: CABG, coronary artery bypass graft; CAD, coronary artery disease; ICA, invasive coronary angiography; IQS, image quality score; MSCT, multislice spiral computed tomography; PTCA, percutaneous transluminal coronary angioplasty

Keywords: coronary artery disease; imaging techniques; multislice spiral computed tomography; invasive coronary angiography; atherosclerosis

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