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Is there a gender difference in noninvasive coronary imaging? Multislice computed tomography for noninvasive detection of coronary stenoses.

Dewey M, Rutsch W, Hamm B - BMC Cardiovasc Disord (2008)

Bottom Line: Also sensitivity (70% vs. 95%), positive predictive value (64% vs. 93%), and the rate of nondiagnostic examinations (14% vs. 4%, all: p < 0.05) were significantly worse for women.The effective radiation dose of MSCT coronary angiography was significantly higher in the examination of women (13.7 +/- 1.2 mSv) than of men (11.7 +/- 0.9 mSv, p < 0.001), mainly as a result of the fact that the radiosensitive female breast (contributing 24.5% of the dose in women) is in the x-ray path.Also, women are exposed to a significantly higher effective radiation dose than men.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Radiology, Charité, Medical School, Humboldt-Universität zu Berlin, Germany. marc.dewey@charite.de

ABSTRACT

Background: Multislice computed tomography (MSCT) coronary angiography is the foremost alternative to invasive coronary angiography.

Methods: We sought to compare the diagnostic accuracy of MSCT in female and male patients with suspected coronary disease. Altogether 50 women and 95 men underwent MSCT with 0.5 mm detector collimation. Coronary artery stenoses of at least 50% on conventional coronary angiography were considered significant.

Results: The coronary vessel diameters of all four main coronary artery branches were significantly larger in men than in women. The diagnostic accuracy of MSCT in identifying patients with coronary artery disease was significantly lower for women (72%) compared with men (89%, p < 0.05). Also sensitivity (70% vs. 95%), positive predictive value (64% vs. 93%), and the rate of nondiagnostic examinations (14% vs. 4%, all: p < 0.05) were significantly worse for women. The effective radiation dose of MSCT coronary angiography was significantly higher in the examination of women (13.7 +/- 1.2 mSv) than of men (11.7 +/- 0.9 mSv, p < 0.001), mainly as a result of the fact that the radiosensitive female breast (contributing 24.5% of the dose in women) is in the x-ray path.

Conclusion: Noninvasive coronary angiography with MSCT might be less accurate and sensitive for women than men. Also, women are exposed to a significantly higher effective radiation dose than men.

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Related in: MedlinePlus

Comparison of the entire coronary vessel lengths in women and men. The LAD (asterisk) was significantly (p < 0.01) shorter in women compared with men on MSCT. LMA indicates left main coronary artery, LAD indicates left anterior descending coronary artery, LCX indicates left circumflex coronary artery, RCA indicates right coronary artery.
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Figure 2: Comparison of the entire coronary vessel lengths in women and men. The LAD (asterisk) was significantly (p < 0.01) shorter in women compared with men on MSCT. LMA indicates left main coronary artery, LAD indicates left anterior descending coronary artery, LCX indicates left circumflex coronary artery, RCA indicates right coronary artery.

Mentions: All four coronary vessels were shorter in women than men, with significance for the LAD (118.2 ± 35.4 mm vs. 136.1 ± 26.5 mm, p < 0.01, Fig. 2). Also, the vessel length free of motion artifacts tended to be shorter in women than men: LMA (10.4 ± 4.3 mm vs. 11.4 ± 5.6 mm, p = 0.269), LAD (114.2 ± 36.2 mm vs. 129.6 ± 33.1 mm, p = 0.01), LCX (85.9 ± 30.3 mm vs. 90.0 ± 38.1 mm, p = 0.511), and RCA (120.7 ± 52.2 mm vs. 124.7 ± 60.2 mm, p = 0.698). Image noise did not show a significant difference between women (18.6 ± 2.8) and men (17.8 ± 4.7, p = 0.523). Similarly, the contrast-to-noise ratios were not significantly different between women and men with the following values for the four coronary arteries for women and men: LMA (19.3 ± 4.2 vs. 19.3 ± 5.8), LAD (19.5 ± 5.5 vs. 19.1 ± 5.7), LCX (17.5 ± 3.5 vs. 17.6 ± 5.6), and RCA (18.3 ± 3.2 vs. 18.1 ± 5.8).


Is there a gender difference in noninvasive coronary imaging? Multislice computed tomography for noninvasive detection of coronary stenoses.

Dewey M, Rutsch W, Hamm B - BMC Cardiovasc Disord (2008)

Comparison of the entire coronary vessel lengths in women and men. The LAD (asterisk) was significantly (p < 0.01) shorter in women compared with men on MSCT. LMA indicates left main coronary artery, LAD indicates left anterior descending coronary artery, LCX indicates left circumflex coronary artery, RCA indicates right coronary artery.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2268658&req=5

Figure 2: Comparison of the entire coronary vessel lengths in women and men. The LAD (asterisk) was significantly (p < 0.01) shorter in women compared with men on MSCT. LMA indicates left main coronary artery, LAD indicates left anterior descending coronary artery, LCX indicates left circumflex coronary artery, RCA indicates right coronary artery.
Mentions: All four coronary vessels were shorter in women than men, with significance for the LAD (118.2 ± 35.4 mm vs. 136.1 ± 26.5 mm, p < 0.01, Fig. 2). Also, the vessel length free of motion artifacts tended to be shorter in women than men: LMA (10.4 ± 4.3 mm vs. 11.4 ± 5.6 mm, p = 0.269), LAD (114.2 ± 36.2 mm vs. 129.6 ± 33.1 mm, p = 0.01), LCX (85.9 ± 30.3 mm vs. 90.0 ± 38.1 mm, p = 0.511), and RCA (120.7 ± 52.2 mm vs. 124.7 ± 60.2 mm, p = 0.698). Image noise did not show a significant difference between women (18.6 ± 2.8) and men (17.8 ± 4.7, p = 0.523). Similarly, the contrast-to-noise ratios were not significantly different between women and men with the following values for the four coronary arteries for women and men: LMA (19.3 ± 4.2 vs. 19.3 ± 5.8), LAD (19.5 ± 5.5 vs. 19.1 ± 5.7), LCX (17.5 ± 3.5 vs. 17.6 ± 5.6), and RCA (18.3 ± 3.2 vs. 18.1 ± 5.8).

Bottom Line: Also sensitivity (70% vs. 95%), positive predictive value (64% vs. 93%), and the rate of nondiagnostic examinations (14% vs. 4%, all: p < 0.05) were significantly worse for women.The effective radiation dose of MSCT coronary angiography was significantly higher in the examination of women (13.7 +/- 1.2 mSv) than of men (11.7 +/- 0.9 mSv, p < 0.001), mainly as a result of the fact that the radiosensitive female breast (contributing 24.5% of the dose in women) is in the x-ray path.Also, women are exposed to a significantly higher effective radiation dose than men.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Radiology, Charité, Medical School, Humboldt-Universität zu Berlin, Germany. marc.dewey@charite.de

ABSTRACT

Background: Multislice computed tomography (MSCT) coronary angiography is the foremost alternative to invasive coronary angiography.

Methods: We sought to compare the diagnostic accuracy of MSCT in female and male patients with suspected coronary disease. Altogether 50 women and 95 men underwent MSCT with 0.5 mm detector collimation. Coronary artery stenoses of at least 50% on conventional coronary angiography were considered significant.

Results: The coronary vessel diameters of all four main coronary artery branches were significantly larger in men than in women. The diagnostic accuracy of MSCT in identifying patients with coronary artery disease was significantly lower for women (72%) compared with men (89%, p < 0.05). Also sensitivity (70% vs. 95%), positive predictive value (64% vs. 93%), and the rate of nondiagnostic examinations (14% vs. 4%, all: p < 0.05) were significantly worse for women. The effective radiation dose of MSCT coronary angiography was significantly higher in the examination of women (13.7 +/- 1.2 mSv) than of men (11.7 +/- 0.9 mSv, p < 0.001), mainly as a result of the fact that the radiosensitive female breast (contributing 24.5% of the dose in women) is in the x-ray path.

Conclusion: Noninvasive coronary angiography with MSCT might be less accurate and sensitive for women than men. Also, women are exposed to a significantly higher effective radiation dose than men.

Show MeSH
Related in: MedlinePlus