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.
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.
Ehara
Mariko
M
Department of Cardiology, Toyohashi Heart Center, Toyohashi, Japan. momomar@muc.biglobe.ne.jp
Surmely
Jean-Francois
JF
Kawai
Masato
M
Katoh
Osamu
O
Matsubara
Tetsuo
T
Terashima
Mitsuyasu
M
Tsuchikane
Etsuo
E
Kinoshita
Yoshihisa
Y
Suzuki
Tomomichi
T
Ito
Tatsuya
T
Takeda
Yoshihiro
Y
Nasu
Kenya
K
Tanaka
Nobuyoshi
N
Murata
Akira
A
Suzuki
Yasuyuki
Y
Sato
Koyo
K
Suzuki
Takahiko
T
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*