Abstract
Recently, technical advances in multi-slice CT (MSCT) have enabled us to visualize the coronary arteries to an extent comparable to that possible with invasive coronary angiography (CAG).
To assess the accuracy of MSCT for the detection of coronary artery stenosis in diabetic patients, we performed MSCT and CAG in 20 type 2 diabetic subjects (mean age, 69.6, mean HbA1c, 8.8%) with clinically suspected coronary artery disease.
The coronary arteries were divided into ten segments (LMT plus RCA, LAD and Circumflex divided into three parts for each) and the imaging interpretations were conducted independently by cardiologists. Out of the total of 200 coronary artery segments, 181 could be analyzed by MSCT. Based on the results of CAG, 29 stenotic lesions were detected and the sensitivity and specificity of MSCT for the detection of significant stenosis were 79.3 and 96.1%, respectively, when greater than 50% stenosis was considered as significant. These results suggest the promise of MSCT as a useful tool to diagnose coronary artery disease in high-risk diabetic subjects. However, the difficulty in diagnosis in calcified vessels, which are characteristic of diabetes, remains a problem that must be resolved in the establishment of MSCT as a screening tool in patients with diabetes.
