Diagnostic value of 64-slice CT angiography in coronary artery disease: a systematic review.
OBJECTIVE
To perform a systematic review of the diagnostic value of 64-multislice CT (MSCT) angiography in the detection of coronary artery disease (CAD) when compared to conventional coronary angiography.


METHODS
A search of PUBMED and MEDLINE databases for English literature was performed. Only studies with at least 10 patients comparing 64-slice MSCT angiography with conventional coronary angiography in the detection of CAD were included. Diagnostic value of MSCT angiography compared to coronary angiography was compared and analysed at segment-, vessel- and patient-based assessment.


RESULTS
Fifteen studies met selection criteria and were included for analysis. Pooled sensitivity, specificity, positive predictive value and negative predictive value as well as 95% confidence interval (CI) were 97% (94 and 99%), 88% (79 and 97%), 94% (91 and 97%), and 95% (90 and 99%) for patient-based assessment; 92% (85 and 99%), 92% (85 and 99%), 78% (66 and 91%) and 98% (96 and 99%) for vessel-based assessment; 90% (85 and 94%), 96% (95 and 97%), 75%(68 and 82%) and 98% (98 and 99%) for segment-based assessment, respectively. No significant difference was found in the diagnostic accuracy of 64-slice CT in the detection of CAD when comparison was performed either among four main coronary arteries, or between proximal and middle or distal segments (p>0.05).


CONCLUSIONS
Our results showed that 64-slice CT angiography has a high-diagnostic value in the detection of CAD. Severe coronary artery calcification seems to be the major factor affecting the visualisation and assessment.
Sun
Zhonghua
Z
Department of Imaging and Applied Physics, Curtin University of Technology, Perth, Western Australia, Australia. z.sun@curtin.edu.au
Lin
Chenghsun
C
Davidson
Robert
R
Dong
Chiauhuei
C
Liao
Yunchan
Y
D017023:Coronary Angiography / Q000706:statistics & numerical data*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D006801:Humans; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*