Accuracy of thin-slice computed tomography in the detection of coronary stenoses

• Published in: European heart journal 2004-06, Vol.25 (12), p.1043-1048
• Main Authors: Martuscelli, Eugenio, Romagnoli, Andrea, D'Eliseo, Alessia, Razzini, Cinzia, Tomassini, Marco, Sperandio, Massimiliano, Simonetti, Giovanni, Romeo, Francesco
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Cardiology. Vascular system; Conventional coronary angiography; Coronary artery disease; Coronary heart disease; Coronary Stenosis - diagnostic imaging; Female; Heart; Humans; Male; Medical sciences; Middle Aged; Multislice spiral computed tomography; Observer Variation; Sensitivity and Specificity; Tomography, X-Ray Computed - standards
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1016/j.ehj.2004.03.024

Aim Our aim was to investigate the accuracy of multislice spiral computed tomography (MSCT) in the detection of significant (\batchmode \documentclass[fleqn,10pt,legalpaper]{article} \usepackage{amssymb} \usepackage{amsfonts} \usepackage{amsmath} \pagestyle{empty} \begin{document} \(>\) \end{document}50%) coronary stenosis using a scanner equipped for 16×0.625 mm collimation. Methods In 64 patients (59 male, mean age 58±5 years) with suspected coronary artery disease, MSCT (GE Light Speed-16, collimation: 16×0.625 mm) was performed 20±5 days before coronary angiography (CAG). Only angiographic segments \batchmode \documentclass[fleqn,10pt,legalpaper]{article} \usepackage{amssymb} \usepackage{amsfonts} \usepackage{amsmath} \pagestyle{empty} \begin{document} \(>\) \end{document}1.5 mm were considered for analysis. Results In all patients, MSCT was carried out without complications. Three patients were excluded from the analysis. Of 729 angiographic segments, 613 (84%) were judged evaluable by MSCT. Considering only the segments judged evaluable, the sensitivity was 89%, specificity 98%, positive predictive value 90%, and negative predictive value 98%. Including all segments in the analysis (evaluable and nonevaluable), sensitivity was 78%. Conclusions Using a scanner with a collimation of 16×0.625 mm, our study confirms the potential role of MSCT in the detection of significant coronary stenosis with a sensitivity of 89% and a very high specificity (98%). Exclusion criteria and less than full evaluability of the coronary arteries must still be considered limitations of the method.