所属 医学部 医学科（東京女子医科大学病院） 職種 教授
|表題||Evaluation of cardiac allograft vasculopathy by multidetector computed tomography and whole-heart magnetic resonance coronary angiography.|
|掲載誌名||正式名：Circulation journal : official journal of the Japanese Circulation Society|
略 称：Circ J
|出版社||The Japanese Circulation Society|
|著者・共著者||NUNODA Shinichi†*, MACHIDA Haruhiko, SEKIKAWA Akihiko, SHITAKURA Kazunobu, OKAJIMA Kiyotaka, KUBO Yutaka, UENO Eiko, OTSUKA Kuniaki|
Cardiac allograft vasculopathy (CAV) is a major complication that limits the long-term survival of recipients of heart transplants. In the present study the feasibility of 2 noninvasive approaches for detecting CAV (multidetector computed tomography (MDCT) and whole-heart magnetic resonance coronary angiography (MRCA)) was compared with conventional coronary angiography (CCAG).
METHODS AND RESULTS:
Of 22 heart transplant recipients who underwent CCAG screening, 13 had only MDCT, 16 had only MRCA, and 7 had both noninvasive modalities. The coronary arterial tree was divided into 9 segments. Detection of vasculopathy by coronary segments was compared between 16-/64-detector computed tomography (CT) or MRCA and CCAG. The sensitivity of both 16- and 64-detector CT for diagnosing CAV was 69.6%, and specificity was 96.8%. The sensitivity and specificity by 64-detector CT alone were 90.0% and 97.5%, respectively; its positive and negative predictive values were 81.8% and 98.7% respectively. For MRCA, sensitivity was 60%, specificity, 100%, positive predictive value, 100% and negative predictive value, 92.2%. MRCA showed no false positives.
MDCT, especially 64-detector CT, is feasible for detecting CAV, whereas MRCA currently shows limited sensitivity.