title: Diagnostic accuracy of 64-slice computed tomography for detecting angiographically significant coronary artery stenosis in an unselected consecutive patient population: comparison with conventional invasive angiography.
abstract: BACKGROUND
  Multislice computed tomography (MSCT) is a promising noninvasive method of detecting coronary artery disease (CAD). However, most data have been obtained in selected series of patients. The purpose of the present study was to investigate the accuracy of 64-slice MSCT (64 MSCT) in daily practice, without any patient selection.
  
  
  RESULTS
  Using 64-slice MSCT coronary angiography (CTA), 69 consecutive patients, 39 (57%) of whom had previously undergone stent implantation, were evaluated. The mean heart rate during scan was 72 beats/min, scan time 13.6 s and the amount of contrast media 72 mL. The mean time span between invasive coronary angiography (ICAG) and CTA was 6 days. Significant stenosis was defined as a diameter reduction of > 50%. Of 966 segments, 884 (92%) were assessable. Compared with ICAG, the sensitivity of CTA to diagnose significant stenosis was 90%, specificity 94%, positive predictive value (PPV) 89% and negative predictive value (NPV) 95%. With regard to 58 stented lesions, the sensitivity, specificity, PPV and NPV were 93%, 96%, 87% and 98%, respectively. On the patient-based analysis, the sensitivity, specificity, PPV and NPV of CTA to detect CAD were 98%, 86%, 98% and 86%, respectively. Eighty-two (8%) segments were not assessable because of irregular rhythm, calcification or tachycardia.
  
  
  CONCLUSIONS
  Sixty-four-MSCT has a high accuracy for the detection of significant CAD in an unselected patient population and therefore can be considered as a valuable noninvasive technique.
authors.affiliation: Department of Cardiology, Toyohashi Heart Center, Toyohashi, Japan. momomar@muc.biglobe.ne.jp
authors.forename: Mariko
authors.initials: M
authors.lastname: Ehara
authors.forename: Jean-Francois
authors.initials: JF
authors.lastname: Surmely
authors.forename: Masato
authors.initials: M
authors.lastname: Kawai
authors.forename: Osamu
authors.initials: O
authors.lastname: Katoh
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Matsubara
authors.forename: Mitsuyasu
authors.initials: M
authors.lastname: Terashima
authors.forename: Etsuo
authors.initials: E
authors.lastname: Tsuchikane
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Kinoshita
authors.forename: Tomomichi
authors.initials: T
authors.lastname: Suzuki
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ito
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Takeda
authors.forename: Kenya
authors.initials: K
authors.lastname: Nasu
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Tanaka
authors.forename: Akira
authors.initials: A
authors.lastname: Murata
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Koyo
authors.initials: K
authors.lastname: Sato
authors.forename: Takahiko
authors.initials: T
authors.lastname: Suzuki
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000592:standards*; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015607:Stents; D014057:Tomography, X-Ray Computed / Q000592:standards*