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Accuracy of 64-MDCT in the Diagnosis of Ischemic Heart Disease

Konstantin Nikolaou1, Andreas Knez2, Carsten Rist1, Bernd J. Wintersperger1, Alexander Leber2, Thorsten Johnson1, Maximilian F. Reiser1 and Christoph R. Becker1

1 Department of Clinical Radiology, University Hospitals, Ludwig-Maximilians University, Klinikum Grosshadern, Marchioninistr. 15, 81377 Munich, Germany.
2 Department of Cardiology, University Hospitals, Grosshadern Ludwig-Maximilians University, Munich, Germany.


Figure 1
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  		Fig. 1 —MDCT image quality: assessability per segment (Seg) (American Heart Association 15-segment coronary artery model).

 

Figure 2
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  		Fig. 2A —Patient-based diagnostic accuracy: detection of significant coronary artery disease (CAD) (i.e., one or more significant stenoses > 50%). PPV = positive predictive value, NPV = negative predictive value. Values are given separately for observer 1 (A), observer 2 (B), and the consensus interpretation (C).

 

Figure 3
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  		Fig. 2B —Patient-based diagnostic accuracy: detection of significant coronary artery disease (CAD) (i.e., one or more significant stenoses > 50%). PPV = positive predictive value, NPV = negative predictive value. Values are given separately for observer 1 (A), observer 2 (B), and the consensus interpretation (C).

 

Figure 4
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  		Fig. 2C —Patient-based diagnostic accuracy: detection of significant coronary artery disease (CAD) (i.e., one or more significant stenoses > 50%). PPV = positive predictive value, NPV = negative predictive value. Values are given separately for observer 1 (A), observer 2 (B), and the consensus interpretation (C).

 

Figure 5
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  		Fig. 3A —65-year-old man. Conventional X-ray angiography shows high-grade stenosis in left circumflex coronary artery (LCX) (arrow).

 

Figure 6
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  		Fig. 3B —65-year-old man. In MDCT images, volume rendering technique (B) and multiplanar reformation (C) images show mixed plaque causing stenosis (arrows). LA = left atrium, Ao = aorta.

 

Figure 7
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  		Fig. 3C —65-year-old man. In MDCT images, volume rendering technique (B) and multiplanar reformation (C) images show mixed plaque causing stenosis (arrows). LA = left atrium, Ao = aorta.

 

Figure 8
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  		Fig. 3D —65-year-old man. Cross-sectional view of vessel clearly delineates different plaque components containing calcified and noncalcified tissue. Remaining contrast-enhanced lumen is depicted as thin rim su A0 = aorta, LA = left atrium.

 

Figure 9
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  		Fig. 4A —58-year-old man. Conventional X-ray angiography shows high-grade stenosis in left circumflex (LCX) coronary artery (arrow).

 

Figure 10
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  		Fig. 4B —58-year-old man. Volume rendering technique (B) and multiplanar reformation (C and D) images of 64-MDCT data set clearly show stenosis (arrows). Additionally, an anomalous origin of right coronary artery (RCA) arising from left coronary sinus and intraarterial course of RCA is depicted (arrowheads, B and D). Ao = aorta, LV = left ventricle, LA = left atrium, RVOT = right ventricular outflow tract.

 

Figure 11
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  		Fig. 4C —58-year-old man. Volume rendering technique (B) and multiplanar reformation (C and D) images of 64-MDCT data set clearly show stenosis (arrows). Additionally, an anomalous origin of right coronary artery (RCA) arising from left coronary sinus and intraarterial course of RCA is depicted (arrowheads, B and D). Ao = aorta, LV = left ventricle, LA = left atrium, RVOT = right ventricular outflow tract.

 

Figure 12
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  		Fig. 4D —58-year-old man. Volume rendering technique (B) and multiplanar reformation (C and D) images of 64-MDCT data set clearly show stenosis (arrows). Additionally, an anomalous origin of right coronary artery (RCA) arising from left coronary sinus and intraarterial course of RCA is depicted (arrowheads, B and D). Ao = aorta, LV = left ventricle, LA = left atrium, RVOT = right ventricular outflow tract.

 

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