Diagnostic accuracy of 64-slice computed tomography coronary angiography in patients with low-to-intermediate risk.
OBJECTIVE
Our aim was to evaluate the diagnostic accuracy of 64-slice computed tomography coronary angiography (MSCT-CA) for detecting significant stenosis (>or=50% lumen reduction) in a population of patients at low to intermediate risk.


METHODS
We studied 72 patients (38 men, 34 women, mean age 53.9+/-8.0 years) with atypical or typical chest pain and stratified in the low-to intermediate risk category. MSCT-CA (Sensation 64 Cardiac, Siemens, Germany) was performed after IV administration of 100 ml of iodinated contrast material (Iomeprol 400 mgI/ml, Bracco, Italy). Two observers, blinded to the results of conventional coronary angiography (CAG), assessed the MSCT-CA scans in consensus. Diagnostic accuracy for detecting significant stenosis was calculated.


RESULTS
CAG demonstrated the absence of significant disease in 70.1% of patients (51/72). No patient was excluded from MSCT-CA. There were 37 significant lesions on 1,098 available coronary segments. Sensitivity, specificity and positive and negative predictive value of MSCT-CA for detecting significant coronary artery on a per-segment basis were 100%, 98.6%, 71.2% and 100%, respectively. All patients with at least one significant lesion were correctly identified by MSCT-CA. MSCT-CA scored 15 false positives on a per-segment base, which affected only marginally the per-patient performance (only one false positive).


CONCLUSIONS
We concluded that 64-slice CT-CA is a diagnostic modality with high sensitivity and negative predictive value in patients at low to intermediate risk.
Cademartiri
F
F
Dipartimento di Radiologia e Cardiologia, Erasmus Medical Center, Rotterdam, Holland. filippocademartiri@hotmail.com
Maffei
E
E
Palumbo
A
A
Malagò
R
R
Alberghina
F
F
Aldrovandi
A
A
Brambilla
V
V
Runza
G
G
La Grutta
L
L
Menozzi
A
A
Vignali
L
L
Casolo
G
G
Midiri
M
M
Mollet
N R
NR
D000465:Algorithms; D002637:Chest Pain; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods*; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging; D003627:Data Interpretation, Statistical; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007479:Iopamidol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed / Q000379:methods*; D016277:Ventricular Function, Left
D003287:Contrast Media; C057937:iomeprol; D007479:Iopamidol