title: Initial experience with 64-slice cardiac CT: non-invasive visualization of coronary artery bypass grafts.
abstract: OBJECTIVE
  The aim of this study was to evaluate the diagnostic accuracy in the assessment of coronary artery bypass grafts using 64-slice computed tomography (CT) technology.
  
  
  RESULTS
  CT coronary angiography was performed for 96 bypasses in 31 patients with suspected coronary artery disease using a Siemens Sensation 64-slice CT-scanner and compared with invasive coronary angiography (ICA). Patients with an irregular or fast heart rate despite beta-blocker administration were not excluded from the study. All bypass grafts and 94% of the distal bypass anastomoses could be visualized by CT, non-evaluable distal arterial anastomoses were either due to clip material or calcification artefacts. Forty-two bypass graft occlusions and three significant stenoses were detected by CT and confirmed by ICA. Two venous grafts were missed and one arterial graft was not evaluable with ICA, but both were clearly depicted by multi-slice CT. One false negative and two false positive CT-findings resulted in a sensitivity of 97.8%, a specificity of 89.3%, a positive predictive value of 90%, and a negative predictive value of 97.7%.
  
  
  CONCLUSIONS
  State-of-the-art 64-slice CT coronary angiography demonstrates high diagnostic accuracy in the assessment of arterial and venous bypass graft stenoses.
authors.affiliation: Department of Diagnostic Radiology, University Hospital Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany. pache@mrs1.ukl.uni-freiburg.de
authors.forename: Gregor
authors.initials: G
authors.lastname: Pache
authors.forename: Ulrich
authors.initials: U
authors.lastname: Saueressig
authors.forename: Alex
authors.initials: A
authors.lastname: Frydrychowicz
authors.forename: Daniela
authors.initials: D
authors.lastname: Foell
authors.forename: Nadir
authors.initials: N
authors.lastname: Ghanem
authors.forename: Elmar
authors.initials: E
authors.lastname: Kotter
authors.forename: Annette
authors.initials: A
authors.lastname: Geibel-Zehender
authors.forename: Christoph
authors.initials: C
authors.lastname: Bode
authors.forename: Mathias
authors.initials: M
authors.lastname: Langer
authors.forename: Thorsten
authors.initials: T
authors.lastname: Bley
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000379:methods / Q000592:standards; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000592:standards*