Diagnostic performance of 64-slice computed tomography coronary angiography to detect significant coronary artery stenosis

• Published in: Acta Cardiologica 2008-02, Vol.63 (1), p.11-17
• Main Authors: Bayrak, Fatih, Guneysu, Tahsin, Gemici, Gokmen, Sevinc, Deniz, Mutlu, Bulent, Aytaclar, Semih, Degertekin, Muzaffer
• Format: Article
• Language: English
• Subjects: Adult; Aged; coronary angiography; Coronary Angiography - methods; Coronary Stenosis - diagnostic imaging; diagnostic performance; Female; Humans; Male; Middle Aged; multi-slice computed tomography; Sensitivity and Specificity; Tomography, X-Ray Computed - methods
• ISSN: 0001-5385; 0373-7934; 0001-5385
• DOI: 10.2143/AC.63.1.2025326

Objective - We aimed to determine the diagnostic accuracy of 64-slice multi-slice computed tomography (MSCT) to detect significant coronary artery stenosis with comparison to conventional coronary angiography (CCA). Methods - In 100 patients (70 men, average age 58 ± 10 years and age range 31-75 years) scheduled to have conventional coronary angiography, MSCT was performed before catheterization (within 2 months).All patients were in sinus rhythm, able to hold breath for 15 seconds, and had serum creatinine levels < 1.5 mg/dl. MSCT scans were analysed by a radiologist and a cardiologist. Sensitivity, specificity, positive and negative predictive values for the detection of significant stenoses by MSCT in comparison with CCA were calculated on patient, vessel, and segmental bases. Results - 64-slice computed tomography is able to detect significant coronary artery stenosis on a segmental basis with a sensitivity of 88% and specificity of 99% when compared with CCA. All patients with significantly stenotic coronary artery disease are correctly diagnosed.The presence of significant stenosis was correctly diagnosed by MSCT in 126 of 144 segments.Twelve non-significant lesions on CCA were overestimated by MSCT. On vessel-based analysis, the sensitivity and specificity of MSCT for detecting significant stenosis were 91% and 97%, respectively. Conclusion - Our results indicate that 64-slice computed coronary angiography is a reliable diagnostic modality for the detection of significant coronary artery stenosis in patients with sinus rhythm and scheduled to have CCA, but still has limitations of diagnostic performance on a per-segment and per-vessel basis.