VOLUMETRIC DYNAMIC 640-SLICE CT OF CORONARY ARTERIES

Purpose. Evaluation of diagnostic efficiency and safety of volumetric dynamic 640-slice CT in the detection of stenotic lesions of the coronary arteries.

Materials and methods. In University clinic N1 in 2016–2017 years we investigated 86 patients with ischemic heart disease or valvular heart disease. All patients were fulfilled volumetric dynamic 640-slice CT-coronarography with retrospective ECG-synchronization and subsequent multiparametric reconstruction and evaluation of the coronary vessels. We determinate the degree of stenosis of the coronary arteries. The results are compared with data of the standard coronarography. 22 patients previously had stenting coronary arteries. In 12 cases, patients have atrial fibrillation. The selection criterion for the study was the absence of progression of the disease for at least 6 weeks and a minimum period of 3 months of optimal medical therapy. The study did not include patients with acute coronary syndrome and patients with aortic-coronary bypass surgery in history. All patients were performed CT-angiography on 640-slice CT Aquilion One (Toshiba, Japan). Contrast agent (Ultravist-370) of room temperature was injected into the cubital vein via catheter 18G at a speed of 4.5 ml/s.

Results. Statistical criteria in the detection of coronary artery stenosis at MSCT-coronarography were as follows: sensitivity – 94.3%, specificity – 93.5%, accuracy – 92.8%, positive prognostic value – 96.4%, negative prognostic value – 87.3%. Spearman rank correlation coefficient in the evaluation of coronary artery lesions according to these methods was 0.68.

Conclusion. Volumetric dynamic 640-slice CT-angiography is a highly sensitive safe non-invasive method of examination of patients with different cardiovascular diseases, which is characterized by low radiation dose and high security.

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