Noninvasive Assessment of Coronary Artery Disease with Multidetector-Row Computed Tomography: Current Status and Future Perspective
Department of Clinical Radiology, Graduate School of Medicine, Nippon Medical School
Department of Radiology, Nippon Medical School
The fast volume coverage of electrocardiogram-gated multidetector-row helical computed tomography (MDCT) allows the entire heart volume to be acquired with nearly isotropic spatial resolution (0.5×0.5×0.6 mm) within a single breath-hold. The submillimeter spatial resolution enables depiction of the major and also of peripheral coronary artery segments with lumen diameter as small as 1.5 mm. The sensitivity and specificity for the detection of coronary arterial stenosis of at least 50% using a 64-detector-row CT scanner has been reported 0.93% and 0.96%, respectively. These results were significantly improved in comparison with that of a 4-detector-row CT scanner. In addition, several reports indicate that MDCT angiography might allow detection and evaluation of atherosclerotic plaques in different stages. The differentiation among lipid-rich, fibrous, or calcified plaques by means of coronary CT angiography correlates well with the results of intracoronary ultrasound based on measurement of the mean HU-value in the lesion. Noninvasive follow-up after percutaneus coronary intervention or coronary artery bypass surgery with electrocardiogram-gated coronary CT angiography can be an important tool for postinterventional patency confirmation or for early detection of restenosis. The development of MDCT creates exciting opportunities for noninvasive diagnostic imaging. In the future, MDCT might play more important roles in the assessment of cardiovascular disease.
日医大医会誌 2008; 4(1), 19-24
coronary computed tomography, cardiac computed tomography, multidetector-row computed tomography, multislice computed tomography, computed tomography angiography
Hiromitsu Hayashi, Department of Radiology, Nippon Medical School, 1-1-5 Sendagi Bunkyo-Ku, Tokyo 113-8603, Japan