Coronary artery stenoses: three-dimensional imaging with electrocardiographically triggered, contrast agent-enhanced, electron-beam CT.

PURPOSE: To compare electron-beam computed tomography (CT) and coronary angiography for depiction of coronary artery stenoses.

MATERIALS AND METHODS: In 27 patients (age range, 50-70 years), electrocardiographically triggered axial electron-beam CT scans of the heart were obtained during breath hold and intravenous administration of contrast agent. Coronary arteries were reconstructed three-dimensionally. Electron-beam CT and angiographic results were compared.

RESULTS: Significant enhancement within the vessel lumen (P < .001) permitted selective reconstruction of the inner coronary artery lumen. Nine of 11 high-grade stenoses and all five occlusions in the proximal left anterior descending artery and three of five high-grade right coronary artery stenoses were clearly identified. Recognition of stenosis of the left circumflex artery was not reliable. Success after percutaneous transfemoral coronary angioplasty was documented in five of five patients by visualizing the increase in vessel diameter at repeat investigation.

CONCLUSION: Contrast-enhanced electron-beam CT yields promising results concerning the visualization of coronary artery stenoses.