title: Non-invasive coronary artery evaluation with multidetector computed tomography.
abstract: OBJECTIVE
  To evaluate the diagnostic accuracy of 16-slice multidetector spiral computed tomography in the non-invasive detection of coronary artery disease compared to invasive coronary angiography.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  We studied 35 patients, 21 men and 14 women, mean age 63.6+/-13.8 years, who underwent elective invasive coronary angiography one week prior to undergoing 16-slice multidetector computed tomography.
  
  
  METHODS
  We used a Toshiba Aquilion 16-slice system. Helical acquisition was performed with breath holding after injection of 140 ml of a contrast agent into a peripheral vein. Cross-sectional images were reconstructed with a slice thickness of 0.5 mm or 1 mm. We set 15 anatomical segments for the coronary tree and the evaluation was performed independently for both techniques. Coronary artery lesions with over 50% reduction in diameter were considered significant. Findings from both techniques were evaluated using ROC curve analysis.
  
  
  RESULTS
  It was possible to evaluate 87.7% of the coronary tree segments; heavy calcification, enability to perform breath holding, motion artefacts and stents made evaluation of the other segments impossible. Overall sensitivity and specificity were 85.9% and 98.2% respectively with a 95 % confidence interval; positive predictive value was 87% and negative predictive value 97% For the different anatomical segments, sensitivity and specificity were: proximal 88.9% and 97.8%; medial 90.9% and 95.8%; distal 86.7% and 99.1% respectively.
  
  
  CONCLUSIONS
  Multidetector computed tomography is a promising non-invasive technique for detecting or ruling out significant coronary lesions.
authors.affiliation: Serviço de Cardiologia, Hospital Pulido Valente, Lisboa, Portugal. miguelcarmo@netc.pt
authors.forename: Miguel Mota
authors.initials: MM
authors.lastname: Carmo
authors.forename: Teresa
authors.initials: T
authors.lastname: Ferreira
authors.forename: Jorge
authors.initials: J
authors.lastname: Quininha
authors.forename: José
authors.initials: J
authors.lastname: Ferreira
mesh_terms: D017023:Coronary Angiography / Q000379:methods*; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed