Sixteen-Channel Multidetector Row Computed Tomography versus Coronary Angiography in a Surgical View


  • André Plass
  • Bernhard Baumert
  • Achim Häussler
  • Jürg Grünenfelder
  • Simon Wildermuth
  • Franz R. Eberli
  • Gregor Zund
  • Michele Genoni



Background. Invasive coronary angiography (ICA) is the gold standard for the diagnosis of coronary artery disease and also for imaging procedures for preoperative planning of coronary artery bypass grafting (CABG). Sixteen-multidetector row computed tomography (MDCT) represents an alternative depiction of coronary vessels.

Methods. Preoperative exams included ICA and MDCT in 50 patients. Two blinded surgical readers independently investigated both diagnostic modalities regarding location, severity, and morphology of the stenoses. The right coronary artery, left anterior descending branch, and circumflex branch--each divided in 3 sections--and the left main artery with a diameter ³ 1.5 mm were rated in both procedures, and the percentage of complete evaluations by MDCT was assessed.

Results. Heart rate was 72 ± 8 bpm. Forty-six percent of patients received a complete MDCT evaluation, and 54% received an incomplete MDCT evaluation. In 62% of these incompletely examined patients, 1 branch was not completely analyzable, in 31% 2 branches; and in 7% all 3 branches. In total, 9% of all segments were incompletely assessed. Investigators detected coronary stenoses in complete evaluations with a sensitivity of 94% and a specificity of 95%. Positive predictive value was 87% and negative predictive value was 98%. Plaque classification in soft and hard plaques was possible.

Conclusion. Sixteen-MDCT is not a viable alternative diagnostic tool at present. However, although the percentage of incomplete evaluated patients is more then 50%, only 9% of all segments were incompletely assessable. If this technology can be further improved, especially its software, it will become a valid diagnostic tool for coronary artery disease.


Adams DF, Fraser DB, Abrams HL. 1973. The complications of coronary angiography. Circulation 48:609-18.nBecker CR, Kleffel T, Crispin A. 2001. Coronary artery calcium measurement: agreement of multirow detector and electron beam CT. AJR Am J Roentgenol 176:1295-8.nBecker CR, Knez A, Ohnesorge B, et al. 2000. Imaging of noncalcified coronary plaques using helical CT with retrospective ECG gating. AJR Am J Roentgenol 175:423-4.nAchenbach S, Giesler T, Ropers D, et al. 2001. Detection of coronary artery stenoses by contrast-enhanced, retrospectively electrocardiographically-gated, multislice spiral computed tomography. Circulation 103:2535-8.nAchenbach S, Ropers D, Hoffmann U, et al. 2004. Assessment of coro nary remodeling in stenotic and nonstenotic coronary atherosclerotic lesions by multidetector spiral computed tomography. J Am Coll Cardiol 43:842-7.nKnez A, Becker CR, Leber A, et al. 2001. Usefulness of multislice spiral computed tomography angiography for determination of coronary artery stenoses. Am J Cardiol 88:1191-4.nKuettner A, Kopp AF, Schroeder S, et al. 2004. Diagnostic accuracy of multidetector computed tomography coronary angiography in patients with angiographically proven coronary artery disease. J Am Coll Cardiol 43:831-9.nLeber A, Knez A, White CW, et al. 2001. Composition of coronary atherosclerotic plaques in patients with acute myocardial infarction and stable angina pectoris determined by contrast-enhanced mulitslice computed tomography. Am J Cardiol 37:1430-5.nRopers D, Baum U, Pohle K, et al. 2003. Detection of coronary artery stenoses with thin-slice multi-detector row spiral computed tomography and multiplanar reconstruction. Circulation 107:664-6.nSchroeder S, Kopp AF, Baumbach A, et al. 2001. Noninvasive detection and evaluation of atherosclerotic coronary plaques with multislice computed tomography. J Am Coll Cardiol 37:1430-5.nLevin DC. 1982. Invasive evaluation (coronary angiography) of the coronary artery disease patient: clinical , economic and social issues. Circulation 66(Suppl III):71-9.nNieman K, Cademartiri F, Lemos PA, et al. 2002. Reliable noninavsive coronary angiography with fast submilimeter multislice spiral computed tomography. Circulation 106:2051-4.nOhnesorge B, Flohr T, Becker C, et al. 2001. Technical aspects and applications of fast multislice cardiac CT. In: Reiser MF, Takahashi M, Modic M, Bruening R, eds. Medical Radiology-Diagnostic Imaging and Radiation Oncology . Berlin, Germany: Springer; 2001:121-30.nFlohr T, Bruder H, Stierstorfer K, Simon J, Schaller S, Ohnesorge B. 2002. New technical developments in multislice CT, part 2: sub-millimeter 16-slice scanning and increased gantry rotation speed for cardiac imaging. Rofo 174:1022-7.nLandis JR, Koch GG. 1977. The measurement of observer agreement for categorical data. Biometrics 33:159-74.nLeber AW, Knez A, Becker C, et al. 2003. Non-invasive intravenous coronary angiography using beam tomography and multislice computed tomography. Heart 89:633-9.nNieman K, Oudkerk M, Rensing BJ, et al. 2001. Coronary angiography with multi-slice computed tomography. Lancet 357:599-603.nCohen J. 1960. A coefficient of agreement for nominal scales. Educ Psychol Meas 20:37-46.n



How to Cite

Plass, A., Baumert, B., Häussler, A., Grünenfelder, J., Wildermuth, S., Eberli, F. R., Zund, G., & Genoni, M. (2006). Sixteen-Channel Multidetector Row Computed Tomography versus Coronary Angiography in a Surgical View. The Heart Surgery Forum, 9(2), E572-E578.




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