Abstract
The prospective study included 54 asymptomatic high-risk patients who underwent coronary CT angiography (CTA) and regadenoson-induced stress CT perfusion (rsCTP). Diagnostic accuracy of significant stenosis (≥50%) determination was evaluated for CTA alone and CTA + rsCTP in 27 patients referred to ICA due to the positive rsCTP findings. Combined evaluation of CTA + rsCTP had higher diagnostic accuracy over CTA alone (per-segment: specificity 96 versus 68%, p = 0.002; per-vessel: specificity 95 versus 75%, p = 0.012) and high overruling rate of rsCTP was proved in intermediate stenosis (40–70%). Results demonstrate a significant additional value of rsCTP in the assessment of intermediate coronary artery stenosis found with CTA.
Highlights
Computed tomography is routinely used for the detection of coronary heart disease (CHD) with an excellent prognostic value [1]
Diagnostic accuracy of significant stenosis (≥50%) determination was evaluated for CT angiography (CTA) alone and CTA + regadenoson-induced stress CT perfusion (rsCTP) in 27 patients referred to invasive coronary angiography (ICA) due to the positive rsCTP findings
Combined evaluation of CTA + rsCTP had higher diagnostic accuracy over CTA alone and high overruling rate of rsCTP was proved in intermediate stenosis (40–70%)
Summary
Computed tomography is routinely used for the detection of coronary heart disease (CHD) with an excellent prognostic value [1]. CT angiography (CTA) of the coronary arteries achieves high quality in the detection of significant stenosis in comparison with invasive coronary angiography (ICA) as the reference method [2]. In several multicentric studies a high prognostic value was demonstrated in patients with suspected or known CHD [3, 4]. Because of the small diameter of the coronary arteries, the precise quantification of stenosis is still very difficult, if the quality of the examination is not optimal or the level of noise is higher. The evaluation in coronary artery diameters is operator dependent and related to the experience. The quality of imaging is still increasing, the assessment of stenosis caused by heavily calcified plaques is always really challenging
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