Diagnostic accuracy of 320-row multidetector computed tomography coronary angiography in the non-invasive evaluation of significant coronary artery disease.
OBJECTIVE
Multidetector computed tomography coronary angiography (CTA) has emerged as a feasible imaging modality for non-invasive assessment of coronary artery disease (CAD). Recently, 320-row CTA systems were introduced, with 16 cm anatomical coverage, allowing image acquisition of the entire heart within a single heart beat. The aim of the present study was to assess the diagnostic accuracy of 320-row CTA in patients with known or suspected CAD.


RESULTS
A total of 64 patients (34 male, mean age 61 +/- 16 years) underwent CTA and invasive coronary angiography. All CTA scans were evaluated for the presence of obstructive coronary stenosis by a blinded expert, and results were compared with quantitative coronary angiography. Four patients were excluded from initial analysis due to non-diagnostic image quality. Sensitivity, specificity, and positive and negative predictive values to detect > or =50% luminal narrowing on a patient basis were 100, 88, 92, and 100%, respectively. Moreover, sensitivity, specificity, and positive and negative predictive values to detect > or =70% luminal narrowing on a patient basis were 94, 95, 88, and 98%, respectively. With inclusion of non-diagnostic imaging studies, sensitivity, specificity, and positive and negative predictive values to detect > or =50% luminal narrowing on a patient basis were 100, 81, 88, and 100%, respectively.


CONCLUSIONS
The current study shows that 320-row CTA allows accurate non-invasive assessment of significant CAD.
de Graaf
Fleur R
FR
Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
Schuijf
Joanne D
JD
van Velzen
Joëlla E
JE
Kroft
Lucia J
LJ
de Roos
Albert
A
Reiber
Johannes H C
JH
Boersma
Eric
E
Schalij
Martin J
MJ
Spanó
Fabrizio
F
Jukema
J Wouter
JW
van der Wall
Ernst E
EE
Bax
Jeroen J
JJ
D000368:Aged; D017023:Coronary Angiography / Q000379:methods / Q000592:standards*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000592:standards*