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MASSIMO MIDIRI

Approccio diagnostico non invasivo con tomografia computerizzata multidetettore a 40 strati per lo studio della malattia aterosclerotica coronarica

  • Authors: Runza, G.; Rizzo, M.; Evola, S.; Alaimo, V.; Novo, G.; Corrado, E.; Evola, G.; Palazzolo, G.; Triolo, O.; Gennaro, F.; Hoffmann, E.; Midiri, M.; Novo, S.
  • Publication year: 2007
  • Type: Articolo in rivista (Articolo in rivista)
  • OA Link: http://hdl.handle.net/10447/2519

Abstract

Background. Multidetector computed tomography coronary angiography (MDCT-CA) is a non-invasive technique that clearly shows coronary anatomy and correctly identifies plaque location and morphology. In this study we assessed diagnostic accuracy of MDCT-CA in detectiong significant stenosis in patients with clinically relevant coronary tree disease. Methods. Fifty patients (38 males, 12 females, mean age 60.9 ± 9.2 years) with atypical chest pain, stable or unstable angina pectoris, or non-ST-elevation myocardial infarction underwent MDCT-CA (Brilliance 40, Philips Medical Systems, Cleveland, OH, USA) within 3 days before diagnostic conventional coronary angiography. Inclusion criteria were sinus rhythm, heart rate <70 b/min, and ability to hold breath for more than 12 s. Exclusion criteria were known intolerance to contrast medium, serum creatinine >2 mg/dl, pregnancy, respiratory insufficiency, unstable clinical conditions, and severe heart failure. Beta-blockers were administered if heart rate was >70 b/min. To synchronize arrival of the contrast bolus (Iomeron 400, Bracco, Milan) in the coronary arteries with the start of the scan the bolus-tracking technique was used. Diagnostic accuracy was evaluated per segment, per vessel, and per patient. Results. Mean heart rate during examination was 61.9 ± 6.2 b/min; 618 segments were evaluated. The assessment was impaired by respiratory artifacts only in 1 patient (2%). MDCT-CA showed good sensitivity, specificity, and positive and negative predictive values in detecting significant coronary artery stenosis (94, 94, 91, and 96% per segment; 91, 97, 95, and 92% per vessel; 100, 100, 100, and 100% per-patient, respectively). Conclusions. Forty-slice MDCT-CA showed a good diagnostic capability in detecting significant coronary artery stenosis in patients referred to our institution for suspected or known significant coronary artery disease.