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2013, Number 1

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Rev Cubana Cardiol Cir Cardiovasc 2013; 19 (1)

Integral diagnosis of coronary atherosclerosis by coronary multidetector computed tomographyand by invasive coronary angiography

Llerena-Rojas LR, Llerena-Rojas LD, Mendoza-Rodríguez V, Olivares-Aquiles EW, Marcos-Gutierrez Y, Bencomo-Rodriguez L, Rodríguez-Nande LM

Language: Spanish
References: 25
Page: 25-32
PDF size: 340.56 Kb.


ABSTRACT

Introduction Coronary angiography by multidetector computed tomography (CMDCT) visualizes the wall and lumen of coronary arteries. Invasivecoronary angiography (INVCA) only visualizes the arterial lumen but with better resolution.
Objective To assess the contribution of CMDCT and INVCA to the integral diagnosis of coronary atherosclerosis.
Method Eighty five patients suspicious of coronary atherosclerosis were consecutively studied in our centre between 2006 and 2011 by CMDCT and INVCA. Two groups of patients were formed accordingly with INVCA: Group I with stenotic plaques 50% or greater (S≥50%) including stenosis below 50% (S<50%) and Group II only with S<50%. Variables analyzed: age, sex and accordingly with CMDCT, total number of plaques, localization and classification in calcified, soft and mixed plaques.
Result In Group I were observed 48 patients with 512 plaques, 63 of them with S≥50%, only 5% calcified and 37 patients in Group II with 217 plaques. The 77% of all plaques with S< 50% in both groups were calcified. Only two of 35 patients with S≥50% in the left main coronary artery were detected by INVCA. In 6 patients the diagnosis was erroneous or doubtful by CMDCT on account of artifacts and INVCA was necessary to assure it.
Conclusions CMDCT and INVCA contribute to the integral diagnosis of coronary atherosclerosis. CMDCT allows earlier diagnosis of coronary plaques and assess its composition. INVCA with better resolution visualizes very thin vessels and contribute to the assessment of not well defined images by CMDCT.


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