Abstract
Background:
Cardiac multislice spiral computed tomography (MSCT) scanners permit visualization of the coronary arteries with an overall good sensitivity (sens) and specificity (spec). However, in obese patients (pts), who are at higher risk to develop coronary artery disease (CAD), image quality of MSCT is supposed to be limited. At present, there are no data whether the accuracy of MSCT depends on the body mass index (BMI). Thus, we compared the catheter-controlled MSCT results from normal weight and obese pts in a cohort of 117 pts with regard to sens, spec, positive predictive value (PPV), negative predictive value (NPV) and image quality.
Methods and material:
In all, 21 normal weight pts (group I: BMI<25, 64.6±11.1 years, number of risk factors 2.1±1.1), 60 pts with mild overweight (group II: BMI 25–30, 64.6±8.9 years, number of risk factors 3.4±1.0) and 36 obese pts (group III: BMI >30, 63.0±8.5 years, number of risk factors 3.4±0.9) were examined by MSCT (Sensation 16 Speed 4 D®, Siemens, Germany, gantry rotation time 375 ms) and invasive coronary angiography. MSCT results were compared blinded to the results of the coronary angiography with regard to the presence or absence of a significant stenosis (>50%) in a modified AHA 13 segment (sgt) model. Image quality was assessed on a qualitative scale between 1 (very good) and 5 (insufficient image quality) for each sgt.
Results:
Sens, spec, PPV and NPV were statistically not different in all three groups (I: 0.88/0.97/0.91/0.96, II: 0.83/0.97/0.88/0.95, III: 0.87/0.99/0.96/0.96). 3 pts (group I 1, group II 2) had to be excluded from analysis due to technical problems. Group I had significantly less risk factors (P<0.001) and image quality was significantly better than in group II and III (P<0.05). Group II and III did not differ with regard to risk factors or image quality.
Conclusions:
Overweight and obesity have an impact on MSCT image quality but did not hamper the diagnostic accuracy. Thus, MSCT is a noninvasive method to detect or rule out CAD also in pts with higher BMI. These retrospective data have to be confirmed in larger prospective trials.
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References
Smith Jr SC, Jackson R, Pearson TA, Fuster V, Yusuf S, Faergeman O et al. Principles for national and regional guidelines on cardiovascular disease prevention: a scientific statement from the World Heart and Stroke Forum. Circulation 2004; 109: 3112–3121.
Sundell J . Obesity and diabetes as risk factors for coronary artery disease: from the epidemiological aspect to the initial vascular mechanisms. Diabetes Obes Metab 2005; 7: 9–20.
Ropers D, Baum U, Pohle K, Anders K, Ulzheimer S, Ohnesorge B et al. Detection of coronary artery stenoses with thin-slice multi-detector row spiral computed tomography and multiplanar reconstruction. Circulation 2003; 107: 664–666.
Schroeder S, Kopp AF, Baumbach A, Kuettner A, Georg C, Ohnesorge B et al. Non-invasive characterisation of coronary lesion morphology by multi-slice computed tomography: a promising new technology for risk stratification of patients with coronary artery disease. Heart 2001; 85: 576–578.
Kopp AF, Ohnesorge B, Flohr T, Georg C, Schroder S, Kuttner A et al. Cardiac multidetector-row CT: first clinical results of retrospectively ECG-gated spiral with optimized temporal and spatial resolution. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 2000; 172: 429–435.
Kuettner A, Trabold T, Schroeder S, Feyer A, Beck T, Brueckner A et al. Noninvasive detection of coronary lesions using 16-detector multislice spiral computed tomography technology: initial clinical results. J Am Coll Cardiol 2004; 44: 1230–1237.
Kuettner A, Beck T, Drosch T, Kettering K, Heuschmid M, Burgstahler C et al. Diagnostic accuracy of noninvasive coronary imaging using 16-detector slice spiral computed tomography with 188 ms temporal resolution. J Am Coll Cardiol 2005; 45: 123–127.
Schroeder S, Kopp AF, Kuettner A, Burgstahler C, Herdeg C, Heuschmid M et al. Influence of heart rate on vessel visibility in noninvasive coronary angiography using new multislice computed tomography: experience in 94 patients. Clin Imag 2002; 26: 106–111.
Giesler T, Baum U, Ropers D, Ulzheimer S, Wenkel E, Mennicke M et al. Noninvasive visualization of coronary arteries using contrast-enhanced multidetector CT: influence of heart rate on image quality and stenosis detection. AJR Am J Roentgenol 2002; 179: 911–916.
Kuettner A, Kopp AF, Schroeder S, Rieger T, Brunn J, Meisner C et al. Diagnostic accuracy of multidetector computed tomography coronary angiography in patients with angiographically proven coronary artery disease. J Am Coll Cardiol 2004; 43: 831–839.
Nieman K, Cademartiri F, Lemos PA, Raaijmakers R, Pattynama PM, De Feyter PJ . Reliable noninvasive coronary angiography with fast submillimeter multislice spiral computed tomography. Circulation 2002; 106: 2051–2054.
Leschka S, Alkadhi H, Plass A, Desbiolles L, Grunenfelder J, Marincek B et al. Accuracy of MSCT coronary angiography with 64-slice technology: first experience. Eur Heart J 2005; 26: 1482–1487.
Raff GL, Gallagher MJ, O'Neill WW, Goldstein JA . Diagnostic accuracy of noninvasive coronary angiography using 64-slice spiral computed tomography. J Am Coll Cardiol 2005; 46: 552–557.
Leber AW, Knez A, von Ziegler F, Becker A, Nikolaou K, Paul S et al. Quantification of obstructive and nonobstructive coronary lesions by 64-slice computed tomography: a comparative study with quantitative coronary angiography and intravascular ultrasound. J Am Coll Cardiol 2005; 46: 147–154.
Achenbach S, Giesler T, Ropers D, Ulzheimer S, Derlien H, Schulte C et al. Detection of coronary artery stenoses by contrast-enhanced, retrospectively electrocardiographically-gated, multislice spiral computed tomography. Circulation 2001; 103: 2535–2538.
Achenbach S . Detection of coronary stenoses by multidetector computed tomography: it's all about resolution. J Am Coll Cardiol 2004; 43: 840–841.
Burgstahler C, Kuettner A, Kopp AF, Herdeg C, Martensen J, Claussen CD et al. Non-invasive evaluation of coronary artery bypass grafts using multi-slice computed tomography: initial clinical experience. Int J Cardiol 2003; 90: 275–280.
Martuscelli E, Romagnoli A, D'Eliseo A, Tomassini M, Razzini C, Sperandio M et al. Evaluation of venous and arterial conduit patency by 16-slice spiral computed tomography. Circulation 2004; 110: 3234–3238.
Nieman K, Pattynama PM, Rensing BJ, Van Geuns RJ, De Feyter PJ . Evaluation of patients after coronary artery bypass surgery: CT angiographic assessment of grafts and coronary arteries. Radiology 2003; 229: 749–756.
Trabold T, Buchgeister M, Kuttner A, Heuschmid M, Kopp AF, Schroder S et al. Estimation of radiation exposure in 16-detector row computed tomography of the heart with retrospective ECG-gating. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 2003; 175: 1051–1055.
Gerber TC, Stratmann BP, Kuzo RS, Kantor B, Morin RL . Effect of acquisition technique on radiation dose and image quality in multidetector row computed tomography coronary angiography with submillimeter collimation. Invest Radiol 2005; 40: 556–563.
Beck T, Burgstahler C, Kuettner A, Kopp AF, Heuschmid M, Claussen CD et al. Clinical use of multislice spiral computed tomography in 210 highly preselected patients: experience with 4- and 16 slice technology. Heart 2005. Mar 10; [Epub ahead of print].
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Burgstahler, C., Beck, T., Kuettner, A. et al. Image quality and diagnostic accuracy of 16-slice multidetector computed tomography for the detection of coronary artery disease in obese patients. Int J Obes 30, 569–573 (2006). https://doi.org/10.1038/sj.ijo.0803157
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DOI: https://doi.org/10.1038/sj.ijo.0803157
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