Detection and characterization of coronary bifurcation lesions with 64-slice computed tomography coronary angiography.
OBJECTIVE
To compare the performance of 64-slice computed tomography coronary angiography (CTCA) and invasive coronary angiography (ICA) in the detection and classification (according to the Medina system) of bifurcation lesions (BLs).


RESULTS
We studied 323 consecutive patients undergoing 64-slice CTCA prior to ICA. All coronary segments >or=2 mm in diameter were evaluated for the presence of a significant (>or=50% diameter reduction on quantitative coronary angiography) BL. Evaluation of BL by CTCA included the assessment of significant lumen obstruction in both main and side branch vessels. Forty-one out of 43 patients (46/48 lesions) with significant BL were identified by CTCA. Excluding coronary segments with non-diagnostic image quality (5%), the sensitivity, specificity, and positive and negative predictive values of CTCA for detecting significant BL were 96, 99, and 85 and 99%, respectively. In 39 of these 41 patients, CTCA assessment was concordant with the Medina lesion classification on ICA.


CONCLUSIONS
Sixty-four-slice CTCA allows accurate assessment of complex BL.
Van Mieghem
Carlos A G
CA
Department of Cardiology, Thoraxcenter, Erasmus MC, Ba 589, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
Thury
Attila
A
Meijboom
Willem B
WB
Cademartiri
Filippo
F
Mollet
Nico R
NR
Weustink
Annick C
AC
Sianos
Georgios
G
de Jaegere
Peter P T
PP
Serruys
Patrick W
PW
de Feyter
Pim
P
D002114:Calcinosis / Q000000981:diagnostic imaging; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000145:classification / Q000000981:diagnostic imaging* / Q000473:pathology; D054059:Coronary Occlusion / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*