Noninvasive detection of coronary lesions using 16-detector multislice spiral computed tomography technology: initial clinical results

J Am Coll Cardiol. 2004 Sep 15;44(6):1230-7. doi: 10.1016/j.jacc.2004.05.079.


Objectives: The aim of our study was to evaluate the feasibility of detecting coronary artery lesions using a new computed tomography (CT) scanner with 16 detectors and faster gantry rotation.

Background: Computed tomography angiography of the coronaries permits assessment of the coronaries; however, image quality is still impaired by motion artifacts and calcifications.

Methods: Sixty patients scheduled for conventional coronary angiography (CCA) were additionally studied by multislice spiral computed tomography (MSCT). Calcium scores and a contrast-enhanced visualization of the coronaries were performed and analyzed regarding evaluability, presence of coronary artery lesions, and correct clinical diagnosis.

Results: Calcium scoring was successful in all patients; 58 of 60 patients had a diagnostic contrast-enhanced scan. Mean calcium score was 506 +/- 743 Agatston score equivalent (ASE); 13 of 58 (22%) patients had an ASE >or=1,000, 46 of 58 (78%) patients <1,000. In 763 coronary segments, CCA detected a total of 75 lesions >or=50%. The MSCT correctly assessed 54 of these. Twenty-one lesions were missed or incorrectly underestimated. Sensitivity was 72%, specificity 97%. When restricting analysis to patients with an ASE <1,000, 40 significant lesions >or=50% were seen on CCA, and MSCT correctly detected 39 lesions (sensitivity 98%, specificity 98%). Regardless of any threshold, the correct clinical diagnosis could be obtained in 58 of 60 (97%) of all patients.

Conclusions: In individuals with low-to-moderate amounts of coronary artery calcium, 16-detector CT coronary angiography has high sensitivity and specificity for the diagnosis of significant coronary artery stenosis.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Calcinosis / diagnostic imaging
  • Contrast Media
  • Coronary Angiography
  • Coronary Artery Disease / diagnostic imaging*
  • Female
  • Germany
  • Humans
  • Image Processing, Computer-Assisted
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Radiographic Image Interpretation, Computer-Assisted
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Tomography, Spiral Computed*


  • Contrast Media