title: Evaluation of coronary artery bypass grafts and native coronary arteries using 64-slice multidetector computed tomography.
abstract: BACKGROUND
  The conventional use of 16-slice multidetector computed tomography (MDCT) remains somewhat limited for evaluating stenoses in vein graft distal anastomotic sites and in coronary arteries. We investigated the diagnostic accuracy of 64-slice MDCT for assessment of both grafts and coronary arteries in patients with coronary artery bypass grafts.
  
  
  METHODS
  The study group included 54 consecutive patients. One patient had to be excluded from the study because of arrhythmia. The remaining 53 patients with coronary artery bypass grafts underwent both 64-slice MDCT angiography and invasive coronary angiography. The MDCTs were analyzed for presence of significant stenosis (>50%) or occlusion in grafts and coronary arteries. The results were compared with those of invasive coronary angiography.
  
  
  RESULTS
  Overall, 138 of 146 (94.5%) grafts including distal anastomoses were evaluable with MDCT. Evaluability of arterial grafts, venous grafts, distal runoff arteries, and nongrafted arteries was 90.3%, 98.6%, 84.0%, and 97.3%, respectively. After censoring nonevaluable grafts or arteries and considering them to be positive, the sensitivity to detect significant stenosis or occlusion in arterial grafts was 100% and specificity was 91.4%. In venous graft, sensitivity was 100% and specificity was 98.1%. In distal runoff arteries, sensitivity to detect significant stenoses was 83.3% and specificity was 80.2%. In nongrafted arteries, sensitivity was 100% and specificity was 87.5%.
  
  
  CONCLUSIONS
  Sixty-four-slice MDCT showed improved ability to assess bypass grafts and coronary arteries. However, there were still difficulties in assessment of distal runoff arteries in which relatively low diagnostic accuracy was observed that might limit clinical implementation of MDCT.
authors: Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan.
authors: Yoshinobu
authors: Y
authors: Onuma
authors: Kengo
authors: K
authors: Tanabe
authors: Ruri
authors: R
authors: Chihara
authors: Hirosada
authors: H
authors: Yamamoto
authors: Yujiro
authors: Y
authors: Miura
authors: Ikutaro
authors: I
authors: Kigawa
authors: Sachito
authors: S
authors: Fukuda
authors: Takeshi
authors: T
authors: Miyairi
authors: Hiroyoshi
authors: H
authors: Nakajima
authors: Kazuhiro
authors: K
authors: Hara
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods