title: Meta-analysis of 40- and 64-MDCT angiography for assessing coronary artery stenosis.
abstract: OBJECTIVE
  The purpose of our study was to assess the diagnostic performance of thin-slice (< or = 0.625 mm) MDCT coronary angiography compared with invasive coronary angiography for the detection of significant (> or = 50%) stenosis.
  
  
  METHODS
  Twenty-two articles on 40- and 64-MDCT coronary angiography were included. Sensitivity and specificity were calculated on a per-patient and per-segment basis; in addition, proximal versus distal segments were evaluated. The effect of nonevaluable patients, nonevaluable segments, and disease prevalence on diagnostic performance was assessed.
  
  
  RESULTS
  Pooled sensitivity on a patient level was 97.7% ([95% CI] 96.2-98.7%) and specificity 91.0% (88.5-93.1%). Pooled sensitivity on a segmental level was 90.8% (89.0-92.4%) and specificity 95.7% (95.2-96.1%); for proximal segments, respectively, 94.2% (92.3-95.7%) and 94.1% (93.4-94.8%), and for distal segments 84.8% (81.1-88.0%) and 96.9% (96.4-97.4%). If nonevaluable MDCT investigations were included, the per-patient specificity was reduced from 91.0% to 89.1% (p > 0.05) when allocating excluded patients as having significant coronary artery stenosis, and the sensitivity was reduced from 97.7% to 96.2% (p > 0.05) when allocating excluded patients as not having significant stenosis. The per-patient prevalence of coronary artery stenosis had no significant influence on the sensitivity for detecting significant stenosis.
  
  
  CONCLUSIONS
  Forty- and 64-MDCT provide good-to-excellent performance in detecting or ruling out significant coronary artery stenosis, with better results for proximal than for distal coronary artery segments.
authors.affiliation: Department of Radiology, C2-S, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
authors.forename: Alex B
authors.initials: AB
authors.lastname: Meijer
authors.forename: Ying L
authors.initials: YL
authors.lastname: O
authors.forename: Jacob
authors.initials: J
authors.lastname: Geleijns
authors.forename: Lucia J M
authors.initials: LJ
authors.lastname: Kroft
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*