Quantification of Coronary Artery Stenosis with 16-Slice MSCT in Patients before CABG Surgery: Comparison to Standard Invasive Coronary Angiography


  • C. Probst
  • A. Kovacs
  • C. Schmitz
  • W. Schiller
  • H. Schild
  • A. Welz




Objective: Invasive, selective coronary angiography is the gold standard for evaluation of coronary artery disease (CAD) and degree of stenosis. The purpose of this study was to compare 3-dimensional (3D) reconstructed 16-slice multislice computed tomographic (MSCT) angiography and selective coronary angiography in patients before elective coronary artery bypass graft (CABG) procedure.

Methods: Sixteen-slice MSCT scans (Philips Mx8000 IDT) were performed in 50 patients (42 male/8 female; mean age, 64.44 ± 8.66 years) scheduled for elective CABG procedure. Scans were retrospectively electrocardiogram-gated 3D reconstructed. The images of the coronary arteries were evaluated for stenosis by 2 independent radiologists. The results were compared with the coronary angiography findings using the American Heart Association segmental classification for coronary arteries.

Results: Four patients (8%) were excluded for technical reasons. Thirty-eight patients (82.6%) had 3-vessel disease, 4 (8.7 %) had 2-vessel disease, and 4 (8.7%) had an isolated left anterior descending artery stenosis. In the proximal segments all stenoses >50% (56/56) were detected by MSCT; medial segment sensitivity was 97% (73/75), specificity 90.3%; distal segment sensitivity was 90.7% (59/65), specificity 77%.

Conclusion: Accurate quantification of coronary stenosis greater than 50% in the proximal and medial segments is possible with high sensitivity and specificity using the new generation of 16-slice MSCTs. There is still a tendency to overestimate stenosis in the distal segments. MSCT seems to be an excellent diagnostic tool for screening patients with possible CAD.


Windecker S, Maier-Rudolph W, Bonzel , et al. 1999. Interventional cardiology in Europe 1995. Eur Heart J 20:484-95.nFlohr T, Küttner A, Bruder H, et al. 2003. Performance evaluation of a multi-slice CT-system with 16-slice detector and increased gantry rotation speed for isotropic submillimeter imaging of the heart. Herz 28:7-19.nHeuschmid M, Kuttner A, Flohr T, et al. 2002. Darstellung der Herzkranzgefäße mittels eines neuen 16-Zeilen Computertomographen mit verbesserter Rotationsgescgwindigkeit: Erste klinische Erfahrungen. RöFo Fortschr Geb Röntgenstr Neuen Bildgeb Verfahr 174:721-4.nHill MN. 1998. New targeted AHA program: cardiovascular care and outcomes. Circulation 97:1221-2.nKopp A, Georg C, Schröder S, Küttner A, Claussen C, Ohnesorge B. 2000. Optimization of image reconstruction time point in the Rr-interval for visualization of the coronary arteries with multi-slice CT. Abstract book of the 86th scientific assembly and annual meeting of the RSNA. 217:234.nKopp A, Schröder S, Küttner A, et al. 2001. Coronary arteries: retrospectively ECG-gated multi-detector row CT angiography with selective optimization of the image reconstruction window. Radiology 221:683-8.nNieman K, Cademartiri F, Lemos PA, et al. 2002. Reliable noninvasive coronary angiography with fast submillimeter multislice spiral CT. Circulation 106:2051-4.nPfeiler M. 2000. Development and current status of invasive coronary angiography. Z Kardiol 89:3-10.nSones FM, Shirey EK, Proudfit WL, Westcott RN. 1959. Cine coronary arteriography. Circulation 20:773-5.nAchenbach S, Ulzheimer S, Baum U, et al. 2000. Noninvasive coronary angiography by retrospectively ECG-gated multi-slice spiral CT. Circulation 102:2823-8.nBashore TM, Bates ER, Berger PB, et al. 2001. American College of Cardiology/Society for Cardiac Angiography and Interventions Clinical Expert Consensus Document on cardiac catheterization laboratory standards. A report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents. J Am Coll Cardiol 37:2170-214.nBecker C, Knez A, Ohnesorge B, Schöpf U, Reiser M. 2000. Imaging of non-calcified coronary plaques using helical CT with retrospective ECG gating. AJR Am J Roentgenol 175:423-4.nDetre KM, Wright E, Murphy Ml, Takaro T. 1975. Observer agreement in evaluating coronary angiograms. Circulation 52:979-86.n



How to Cite

Probst, C., Kovacs, A., Schmitz, C., Schiller, W., Schild, H., & Welz, A. (2005). Quantification of Coronary Artery Stenosis with 16-Slice MSCT in Patients before CABG Surgery: Comparison to Standard Invasive Coronary Angiography. The Heart Surgery Forum, 8(1), E42-E46. https://doi.org/10.1532/HSF98.20041144