Reprinted with permission from the MUSC Catalyst newspaper, Charleston, SC, December 9, 2005 edition. The use of a non-invasive CT scan for the diagnosis of significant narrowing or blockage of the heart blood vessels was proven to be reliable by MUSC investigators in one of the first studies reported worldwide. The results were announced last week at the Radiological Society of North America meeting in Chicago and two weeks earlier at American Heart Association's Annual Scientific Sessions in Dallas.
The collaborative team, composed of researchers from MUSC’s Department of Radiology and Division of Cardiology, investigated the accuracy of the most cutting-edge generation of computed tomographic (CT) scanners—the 64-slice scanner—to diagnose narrowing and blockages of the heart blood vessels. Such narrowing and blockages are responsible for chest pain and heart attacks, the number one killer in the United States.
MUSC investigators studied 80 consecutive patients who underwent both an invasive heart catheterization and the non-invasive 64-slice CT scan. The research team found that not a single patient with significant narrowing or blockage of the heart blood vessels was missed by the non-invasive CT scan, when compared to the traditional heart catheterization.
The traditional heart catheterization requires the insertion of a tube directly into the heart blood vessels through an incision in the groin. The CT scan only requires injection of a small amount of dye in an arm vein, while images of the heart are taken. The scan takes only 10 seconds to complete.
“There were some minor inaccuracies of the CT scan for pinpointing the exact location of narrowing in the heart blood vessels in some cases,” said Joseph Schoepf, M.D., one of the study’s principal investigators. “And in three patients, we overcalled the narrowing, which turned out to be less severe than we thought based on the CT scan. However, we’d rather err on the side of caution by overcalling areas of narrowing than missing significant disease in our patients.”
“But the good news,” added cardiologist Peter Zwerner, M.D., the other principal investigator, “is that we did not miss a single patient with significant narrowing or blockage of the heart blood vessels that would have required treatment. This means that based on a normal, non-invasive CT scan, we can safely rule out significant narrowing and blockages of the heart vessels in a patient with suspected coronary heart disease, so that the patient does not require a heart catheterization.”
The investigators plan to focus future research on further improvement of the accuracy of CT scanning of the heart, the use of CT scans for rapid diagnosis of acute chest pain in the emergency department, and the evaluation of heart function.
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