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ECG-Gated 16-MDCT of the Coronary Arteries: Assessment of Image Quality and Accuracy in Detecting Stenoses

Martin Heuschmid1, Axel Kuettner1, Stephen Schroeder2, Tobias Trabold1, Anja Feyer1, Marcus D. Seemann1, Ronald Kuzo3, Claus D. Claussen1 and Andreas F. Kopp1

1 Department of Diagnostic Radiology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Strasse 3, Tuebingen 72076, Germany.
2 Department of Cardiology, University Hospital, Tuebingen, Germany.
3 Department of Radiology, Mayo Clinic, Jacksonville, FL.



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  		Fig. 1A. —46-year-old man with coronary artery disease (body mass index, 33.6). Heart rate was 60 beats per minute, and Agatston score equivalent was 255.1 (calcium mass, 43.4 mg of calcium hydroxyapatite). Maximum-intensity-projection image of MDCT reconstruction displays complete occlusion of left circumflex artery (arrow, A) and 30% stenosis (arrow, B) of proximal left anterior descending coronary artery.

 


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  		Fig. 1B. —46-year-old man with coronary artery disease (body mass index, 33.6). Heart rate was 60 beats per minute, and Agatston score equivalent was 255.1 (calcium mass, 43.4 mg of calcium hydroxyapatite). Maximum-intensity-projection image of MDCT reconstruction displays complete occlusion of left circumflex artery (arrow, A) and 30% stenosis (arrow, B) of proximal left anterior descending coronary artery.

 


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  		Fig. 1C. —46-year-old man with coronary artery disease (body mass index, 33.6). Heart rate was 60 beats per minute, and Agatston score equivalent was 255.1 (calcium mass, 43.4 mg of calcium hydroxyapatite). Invasive coronary angiogram confirms occlusion of left circumflex artery (arrows), as shown on MDCT.

 


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  		Fig. 2A. —62-year-old man with single-vessel coronary artery disease. Calcified plaque of proximal left anterior descending coronary artery (Agatston score equivalent, 160.7; calcium mass, 39.2 mg of calcium hydroxyapatite). Maximum-intensity-projection images of MDCT angiography reconstruction show occlusion of left anterior descending coronary artery after small first diagonal branch (arrows).

 


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  		Fig. 2B. —62-year-old man with single-vessel coronary artery disease. Calcified plaque of proximal left anterior descending coronary artery (Agatston score equivalent, 160.7; calcium mass, 39.2 mg of calcium hydroxyapatite). Maximum-intensity-projection images of MDCT angiography reconstruction show occlusion of left anterior descending coronary artery after small first diagonal branch (arrows).

 


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  		Fig. 2C. —62-year-old man with single-vessel coronary artery disease. Calcified plaque of proximal left anterior descending coronary artery (Agatston score equivalent, 160.7; calcium mass, 39.2 mg of calcium hydroxyapatite). Vascular stenosis of end branches of right coronary artery can be excluded on the basis of this volume-rendered display.

 


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  		Fig. 2D. —62-year-old man with single-vessel coronary artery disease. Calcified plaque of proximal left anterior descending coronary artery (Agatston score equivalent, 160.7; calcium mass, 39.2 mg of calcium hydroxyapatite). Conventional angiogram confirms occlusion of left anterior descending coronary artery (arrow).

 

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