Rule out presence of hemodynamically relevant coronary artery stenosis
Author: Stephan Achenbach, MD, Department of Cardiology, University of Erlangen, Germany
A 62-year-old patient with atypical chest pain was examined with DSCT coronary angiography to rule out the presence of hemodynamically relevant coronary artery stenosis. No pre-medication with beta blockers was given. The heart rate during data acquisition varied between 61 b/min and 70 b/min. 70/min.
Review of the transaxial slices revealed pronounced calcification of the left coronary system (fig. 1) and mild calcification of the right coronary system. However, in spite of the severe calcifications, there were no motion artifacts and the image quality was not impaired at all. In multi-planar reconstructions (fig. 2), it was possible to identify the patient’s lumen without significant stenosis in all segments of the coronary artery system (see also 3D reconstruction, fig. 3).
In summary, the lack of motion artifacts in a coronary CTA data set with severe calcifications provided for unimpaired diagnostic image quality. Coronary artery stenosis could be reliably ruled out and the patient was treated conservatively. Initial experience with DSCT suggests that overall improvements in image quality as compared to previous scanner generations may substantially improve evaluation and diagnostic accuracy in severely calcified coronary arteries.