title: Diagnostic accuracy of 64-slice computed tomography coronary angiography in patients with low-to-intermediate risk.
abstract: 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.
authors.affiliation: Dipartimento di Radiologia e Cardiologia, Erasmus Medical Center, Rotterdam, Holland. filippocademartiri@hotmail.com
authors.forename: F
authors.initials: F
authors.lastname: Cademartiri
authors.forename: E
authors.initials: E
authors.lastname: Maffei
authors.forename: A
authors.initials: A
authors.lastname: Palumbo
authors.forename: R
authors.initials: R
authors.lastname: Malagò
authors.forename: F
authors.initials: F
authors.lastname: Alberghina
authors.forename: A
authors.initials: A
authors.lastname: Aldrovandi
authors.forename: V
authors.initials: V
authors.lastname: Brambilla
authors.forename: G
authors.initials: G
authors.lastname: Runza
authors.forename: L
authors.initials: L
authors.lastname: La Grutta
authors.forename: A
authors.initials: A
authors.lastname: Menozzi
authors.forename: L
authors.initials: L
authors.lastname: Vignali
authors.forename: G
authors.initials: G
authors.lastname: Casolo
authors.forename: M
authors.initials: M
authors.lastname: Midiri
authors.forename: N R
authors.initials: NR
authors.lastname: Mollet
mesh_terms: 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
chemical_list: D003287:Contrast Media; C057937:iomeprol; D007479:Iopamidol