Initial experience with 64-slice cardiac CT: non-invasive visualization of coronary artery bypass grafts.
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.
Pache
Gregor
G
Department of Diagnostic Radiology, University Hospital Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany. pache@mrs1.ukl.uni-freiburg.de
Saueressig
Ulrich
U
Frydrychowicz
Alex
A
Foell
Daniela
D
Ghanem
Nadir
N
Kotter
Elmar
E
Geibel-Zehender
Annette
A
Bode
Christoph
C
Langer
Mathias
M
Bley
Thorsten
T
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*