title: Accuracy of 64-row multidetector computed tomography in detecting coronary artery disease in 134 symptomatic patients: influence of calcification.
abstract: BACKGROUND
  The new 64-row multidetector computed tomography (CT)-assisted angiography can now detect coronary artery disease with shorter breath-hold time and at faster heart rates for symptomatic patients. We aim to determine if the 64-row scanner can also overcome limitations due to mild to moderate calcification.
  
  
  METHODS
  Scheduled for conventional coronary angiography, 134 symptomatic patients underwent multidetector CT-assisted angiography within 3 months. Patients were divided into those with low or high calcium score (median score 142) by modified Agatston formula: group A calcium score <142 Agatston score (68 patients, mean age 53 years, heart rate 62 beat/min) and group B calcium score > or = 142 Agatston score (66 patients, mean age 57 years, heart rate 62 beat/min). Eleven major coronary segments were evaluated.
  
  
  RESULTS
  In group A, 93.6% of segments were evaluable with 97.3% correlation. Segment-by-segment analyses for sensitivity, specificity, and positive and negative predictive values were 85.4%, 98.1%, 76.7%, and 99.2%, respectively. For group B, 86.9% of segments were evaluable with 90.5% correlation. Sensitivity, specificity, and positive and negative predictive values were 79.9%, 92.8%, 78.8%, and 93.5%, respectively.
  
  
  CONCLUSIONS
  The 64-slice multidetector CT coronary angiography can reliably detect the presence of significant coronary stenosis in symptomatic patients with mild calcification, but remains limited by moderate to heavy calcification.
authors.affiliation: Department of Cardiology, Sarawak General Hospital, Kuching, Sarawak, Malaysia.
authors.forename: Tiong Kiam
authors.initials: TK
authors.lastname: Ong
authors.forename: Sze Piaw
authors.initials: SP
authors.lastname: Chin
authors.forename: Chee Khoon
authors.initials: CK
authors.lastname: Liew
authors.forename: Wei Ling
authors.initials: WL
authors.lastname: Chan
authors.forename: M Tobias
authors.initials: MT
authors.lastname: Seyfarth
authors.forename: Houng Bang
authors.initials: HB
authors.lastname: Liew
authors.forename: Annuar
authors.initials: A
authors.lastname: Rapaee
authors.forename: Yean Yip Alan
authors.initials: YY
authors.lastname: Fong
authors.forename: Choon Kiat
authors.initials: CK
authors.lastname: Ang
authors.forename: Kui Hian
authors.initials: KH
authors.lastname: Sim
mesh_terms: D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging*; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003327:Coronary Disease / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods