Turkish study shows electron beam CT better than angiography at
detecting heart defect
25 October 2005
St. Louis, USA. A study of Turkish cardiology patients conducted by Saint
Louis University School of Medicine has shown that electron-beam computed
tomography (EBCT) is more accurate than conventional catheter angiography
for detecting a dangerous congenital heart abnormality that could cause
Esat Memisoglu, M.D., Assistant Professor of Radiology at Saint Louis
University School of Medicine, and his team studied 28 adults at a heart
hospital and imaging centre in Istanbul, Turkey, who had undergone
conventional X-ray angiography for chest pain or shortness of breath and
then later underwent an EBCT.
In half of the patients, angiography showed a congenital abnormality —
for example, a left coronary artery originating from the right side of the
aorta, or vice versa. EBCT also detected the abnormalities, but in more than
a third of the cases, it was able to provide information the angiography
could not. Specifically, it could confidently determine whether the artery
travelled perilously between the aorta and pulmonary artery, putting that
patient at risk for a heart attack or sudden death, Memisoglu says.
“The most crucial clinical question is whether the artery is coursing
between the aorta and pulmonary artery. Angiography did not always give us
the correct answer, but it was very easy to tell using EBCT,” said
Traditional catheter angiography, an invasive two-dimensional
projectional X-ray technique that involves passing a catheter through a
patient’s groin artery to the heart vessels, is commonly used when physical
examinations and other non-invasive tests are found to be negative in
younger patients who experience chest pain or fainting during strenuous
physical activity. However, catheter angiography “can lead to ambiguities
because of its in defining complex vascular anatomy,” Dr. Memisoglu says.
In contrast, EBCT, which uses a specialized stationary X-ray tube and a
high-resolution detector system, enables doctors to capture “practically
blur-free” cross-sectional images of the beating heart, says Memisoglu.
Because of its speed in capturing images — the study is completed in fewer
than 30 seconds — patients don’t need medication to slow their heart rate.
The study was published in the September issue of Catheterization and
Cardiovascular Interventions: Journal of the Society for Cardiovascular
Angiography and Interventions.