ヌノダ シンイチ   SHINICHI NUNODA
  布田 伸一
   所属   医学部 医学科(東京女子医科大学病院)
   職種   教授
論文種別 原著
言語種別 英語
査読の有無 査読あり
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
ISSNコード:13469843/13474820
掲載区分国内
出版社 The Japanese Circulation Society
巻・号・頁 74(5),946-953頁
著者・共著者 NUNODA Shinichi†*, MACHIDA Haruhiko, SEKIKAWA Akihiko, SHITAKURA Kazunobu, OKAJIMA Kiyotaka, KUBO Yutaka, UENO Eiko, OTSUKA Kuniaki
発行年月 2010/05
概要 BACKGROUND:
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.

CONCLUSIONS:
MDCT, especially 64-detector CT, is feasible for detecting CAV, whereas MRCA currently shows limited sensitivity.
DOI 10.1253/circj.cj-09-0800
PMID 20215697