Curved multiplanar reconstructions for the evaluation of contrast-enhanced electron beam CT of the coronary arteries.

Abstract

We investigated the applicability of curved multiplanar reconstructions for the evaluation of contrast-enhanced electron beam CT scans of the coronary arteries. Thirty-two patients (43-72 years old; mean age, 58 years old) underwent electron beam CT. After injection of i.v. contrast medium, 40 axial cross sections of the heart were acquired, triggered to the ECG during breath-hold (3-mm slice thickness, 1-mm overlap). Curved multiplanar reconstructions were obtained separately for each coronary artery. The reconstructions were independently evaluated by two investigators for the presence of high-grade stenoses and occlusions. The results were then compared with coronary angiography results, of which the two investigators had been unaware. Because of degraded image quality, 15 (12%) of the 128 vessels (left main, left anterior descending, left circumflex, and right coronary arteries in 32 patients) were excluded from evaluation. In the remaining 113 vessels, 16 (89%) of 18 high-grade stenoses and occlusions were correctly detected (89% sensitivity). Absence of significant stenosis was correctly detected in 87 (92%) of 95 vessels (92% specificity). The negative and positive predictive values were 98% and 67%, respectively. Curved multiplanar reconstructions are useful in the evaluation of contrast-enhanced electron beam CT scans of coronary arteries.