Gang S, Min L, Li L, Guo-Ying L, Lin X, Qun J, Hua Z. Evaluation of CT coronary artery angiography with 320-row detector CT in a high-risk population.
Br J Radiol 2011;
85:562-70. [PMID:
21304010 DOI:
10.1259/bjr/90347290]
[Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES
The aim of this article was to prospectively evaluate the accuracy and radiation dose of 320-detector row dynamic volume CT (DVCT) for the detection of coronary artery disease (CAD) in a high-risk population.
METHODS
60 patients with a high risk of CAD underwent DVCT without preceding heart rate control and also underwent invasive coronary angiography (ICA), which served as the standard reference.
RESULTS
On a per segment analysis, overall sensitivity was 95.3%, specificity was 97.6%, positive predictive value was 90.6%, negative predictive value was 98.8% and Youden index was 0.93. In both heart rate subgroups, diagnostic accuracy for the assessment of coronary artery stenosis was similar. The accuracy of the subgroup with an Agatston score ≥100 was lower than that for patients with an Agatston score <100. However, the difference between DVCT and ICA results was not significant (p=0.08). The mean estimated effective dose of CT was 12.5 ± 9.4 mSv. In those patients with heart rates less than 70 beats per minute (bpm), the mean radiation exposure of DVCT was 5.2 ± 0.9 mSv. The effective radiation dose was significantly lower than that of ICA (14.1 ± 5.9 mSv) (p<0.001). When the heart rate was >70 bpm, a significantly higher dose was delivered to patients with DVCT (22.6 ± 5.2 mSv, p<0.001) than with ICA (15.0 ± 5.3 mSv, p<0.001).
CONCLUSION
DVCT reliably provides high diagnostic accuracy without heart rate/rhythm control. However, from a dosimetric point of view, it is recommended that heart rate should be controlled to <70 bpm to decrease radiation dose.
Collapse