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Imaging of Calcified Coronary Arteries with Multislice Computed Tomography

Department of Thoracic and Cardiovascular Surgery, University Hospital, Frankfurt/Main, Germany
¹ Department of Heart Surgery, University Hospital, Marburg, Germany

For reprint information contact: Thomas Wittlinger, MD Tel: 49 69 630 183 315 Fax: 49 67 326 5370 Email: thomaswittlinger{at}t-online.de, Department of Thoracic and Cardiovascular Surgery, University Hospital, Theodor-Stern Kai 7, 60590 Frankfurt/Main, Germany.

Reliable noninvasive detection of coronary artery disease is a prime goal in clinical cardiology. The aim of this study was to investigate the accuracy of multislice computed tomography in detecting coronary artery disease in correlation to the calcium score. Fifty patients with 61 stenoses > 50% and 41 occlusions underwent multislice computed tomography and conventional coronary angiography. Calcium scoring was calculated for the total coronary artery territory and patients were divided into 3 groups based on this score. Multislice computed tomography visualized 89% (365/500) of all coronary segments. The sensitivity and specificity for detection of stenoses > 50% or occlusion was 47%–92%, and 97%–100% for the calcium score. Forty of 500 segments were underestimated by multislice computed tomography, of which 39 were in the group with a calcium score > 400. Multislice computed tomography allows noninvasive angiographic evaluation of coronary artery disease with high diagnostic accuracy. However, the method strongly depends on the degree of vascular calcification and underestimates the degree of stenosis according to the calcium score. This new technology holds promise for noninvasive risk assessment in patients with known or suspected coronary artery disease.