Diagnostic accuracy of 64-slice multidetector CT coronary angiography for the evaluation of coronary artery disease.
- Author:
June NAMGUNG
1
;
Hyunmin CHOE
;
Sung Uk KWON
;
Joon Hyung DOH
;
Sung Yun LEE
;
Gham HUR
;
Won Ro LEE
Author Information
1. Department of Internal Medicine, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea. jnamgung@paik.ac.kr
- Publication Type:Original Article
- Keywords:
Spiral volumetric computed tomography;
Coronary angiography;
Coronary artery disease
- MeSH:
Constriction, Pathologic;
Coronary Angiography;
Coronary Artery Disease;
Coronary Stenosis;
Coronary Vessels;
Humans;
Male;
Sensitivity and Specificity
- From:Korean Journal of Medicine
2008;75(1):42-53
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Invasive coronary angiography remains the gold standard in the diagnosis of coronary artery disease. However, multidetector CT (MDCT) coronary angiography is an emerging technique that is available for the non-invasive detection of coronary artery stenoses. While the diagnostic accuracy of first generation MDCT is limited, recently released 64-slice MDCT has yielded promising results due to increased temporal and spatial resolution. The objective of this study was to investigate the diagnostic accuracy of non-invasive 64-slice MDCT for coronary artery disease. METHODS: One hundred one patients (63 males and 38 females; mean age, 63.7+/-10.5 years) undergoing conventional coronary angiography were included in this study. All coronary arteries, including the distal segments and side branches, were analyzed for the presence of significant stenosis (> or =50% diameter stenosis) and compared with of the quantitative coronary angiographic findings. RESULTS: Of the 1,440 coronary artery segments studied, 1,348 segments were assessed quantitatively by both MDCT and conventional coronary angiography (94%). Two hundred nine significant stenoses were detected by conventional coronary angiography. On a segment-based analysis, the senisitivity, specificity, and positive and negative predictive values of 64-slice MDCT were 96, 97, 85, and 99%, respectively. On a vessel-based analysis, the sensitivity, specificity, and positive and negative predictive values of 64-slice MDCT were 96, 97, 85, and 99%, respectively. The corresponding values obtained on a patient-based analysis were 100, 94, 97, and 100%, respectively. Coronary calcification was the major cause of false-positive findings. CONCLUSIONS: This study demonstrated that 64-slice MDCT coronary angiography is of similar accuracy as conventional coronary angiography for the detection of coronary artery disease. In selected groups of patients, 64-slice MDCT may replace the more invasive coronary angiography.
