Multislice Spiral CT in Diagnostics of Coronary Artery Disease

The aim of this study is to review the contribution of multislice computed tomography (MSCT) as a screening tool for coronary artery disease by measuring quantity of coronary calcium. During the period of one year, 59 patients with clinical symptoms of cardiac disease were examined in our Institute of Radiology. The average age of the examined patients was 62 years. The youngest patient was 18 and the oldest 82 years old. 41 patients (69.5%) were male with average age of 62.7 years and 18 patients (30.5%) female with average age of 63 years. The CT examinations were performed with ECG gating MSCT “Somatom Volume Zoom” Siemens native and with intravenous contrast medium administration (140 ml Omnipaque with 50 ml physiological solution) and with 3 mm slice thickness. Special attention was paid to the coronary vessel calcification according to Agatston’s total calcium score(TCS) for account coronary calcification. Calcifications of coronary arteries were found in 52 patients and TCS was made according to Agatston’s method. Among these patients werel2 (20,3%) with mild coronary arthrosclerosis (total calcium scor -TCS 10-100), 11 (18,6%) with moderate coronary atherosclerosis (TCS 100-400), and 29 (49,1%) with severe coronary atherosclerosis (TCS > 400). 42 (71,2%) of these patients were smokers, 22 (37,3%) had hypertension, 9 (15,2%) diabetes, 6 (10,2%) hypercholesterolemia and 5 (6.8%) triglyceridemia, everybody with coronary calcifications. Only 24(40,7%) of these patients had symptoms of angina pectoris. Infarctus myocardii was found in 7 (11.9%) patients, among them 6(85,7%) with severe coronary atherosclerosis (TCS > 400). Calcifications of the coronary arteries are always connected with arthrosclerosis. For this reason, an early detection and quantification of coronary calcifications play an important role in the diagnosis and prognosis in patients with coronary artery disease. MSCT has shown to be the most sensitive modality for this purpose and enables, safe and non-invasive screening investigation of coronary arteries.