Multidetector-row computed tomography vs. angiography and intravascular ultrasound for the evaluation of the diameter of proximal coronary arteries.

BACKGROUND

Multidetector-row computed tomography has evolved as a promising method for noninvasive visualization of coronary arteries and detection of coronary artery calcification. We determined the accuracy of computed tomography for measurement of coronary artery lumen diameters in comparison to quantitative coronary angiography and intravascular ultrasound (IVUS).

METHODS

Eighteen patients (4 female, age 62+/-8 years) with known or suspected coronary artery disease were investigated by computer tomography (4x1 mm collimation, rotation time: 500 ms, table feed: 1.5 mm/rotation). Coronary angiography and IVUS were performed in the left anterior descending, left circumflex and right coronary artery according to common standards. Lumen diameters were measured at the origin of the coronary artery and 10, 30 and 50 mm distally. Results of all three techniques were compared.

RESULTS

Only measuring points evaluated by all measuring techniques were included. Thus, 50 diameters could be analyzed. The correlation R between computed tomography and angiography measures was 0.909 (p<0.05) at the origin of the artery, 0.907 (p<0.05) at 10, 0.841 (p<0.05) at 30 and 0.780 (p<0.05) at 50 mm distally. The correlation R between computed tomography and IVUS was 0.934 at the origin (p<0.05), 0.867 at 10 (p<0.05), 0.880 at 30 (p<0.05) and 0.727 at 50 mm (p<0.05).

CONCLUSIONS

Multidetector-row computed tomography is a promising tool to measure the proximal coronary artery diameters with a good correlation to angiographic and IVUS measurements. Multidetector-row computed tomography might become more feasible with improvement of technology, e.g. with 16 row scanners.