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Preliminary Reports on the Accuracy of Coronary CT-Angiography Using 64-slice Multi-slice Spiral CT (MSCT) in Iran

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Abstract:

Introduction & Background: Coronary artery disease (CAD) is the leading cause of death in many western countries. Its prevalence and incidence among Irani-ans particularly in the urban areas are increasing. Ac-cording to the newest Tehran annual mortality re-port, the most common cause of death in Tehran is cardiovascular disease. Diagnostic gold standard in CAD is fluoroscopic coronary angiography (FCA) us-ing catheterization. Nevertheless, it is an invasive method and in recent years, some non-invasive or less-invasive imaging modalities such as MRI and CT scans have been used to investigate CAD. One of the most attractive new methods in this regard is Coro-nary CT-Angiography (CCTA), which has gained considerable attention. Multi-slice spiral CT (MSCT) scanners with simultaneous acquisition of multiple (up to 64) slices in less than half a second of gantry rotation time (in our study, 0.33 second), have be-come available, resulting in minimally-invasive coro-nary artery imaging. The purpose of this study is to determine the diagnostic accuracy of a new 64-slice MSCT scanner in the diagnosis of coronary artery and/or bypass grafts occlusion or hemodynamically significant stenosis. Parients & Methods: This investigation is underway in patients undergoing elective FCA. A 64-channel per rotation MSCT scanner (Somatom Sensation 64, Siemens Medical Systems, Forchheim, Germany), with 0.6 mm collimation, 0.33 second gantry rotation time and 120 KVp was used to perform CCTA. Ap-proximately 70-90 mL of a nonionic contrast medium was injected intravenously. All coronary artery seg-ments, according to American Heart Association (AHA) classification & nomenclature system were analyzed. Patients who had undergone previous coronary artery bypass grafts (CABGs), or used coro-nary stents were enrolled in the study, as well. MSCT scans were carried out within 10 days of catheteriza-tion, and the most dramatically stenotic lesions were analyzed in CCTA by a semi-quantitative scale (0= no lesion, I= non-significant lesions with less than 50% diameter reduction stenosis, II= significant lesions with more than 50% diameter reduction stenosis, and N/A= non-assessable lesions). Results: The results of CCTA are being compared with quantitative FCA findings of native coronary arteries as well as bypass grafts (arterial and/or ve-nous) or stents. Here the preliminary results of this comparison, as well as the CCTA accuracy as com-pared with FCA are demonstrated. Conclusion: We are hoping that this modality of di-agnosis would find its way in the field of coronary artery diseas

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