title: Diagnostic accuracy of 64-slice computed tomography in patients with suspected or proven coronary artery disease.
abstract: OBJECTIVE
  Multislice computed tomography (MSCT) is a promising noninvasive method of detecting coronary artery disease. However, most data have been obtained in selected series of patients. The purpose of this study was to investigate the accuracy of 64-slice CT in consecutive patients with suspected or proven coronary artery disease.
  
  
  METHODS
  Seventy-three consecutive patients (57 males, 16 females; mean age 59+/-9 years; range 33 to 83 years) were examined by 64-slice CT before coronary angiography (CA). Eight patients had a history of percutaneous coronary intervention and stenting and five patients had a history of coronary artery bypass grafting. Sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values of MSCT for the detection of significant stenosis were calculated on a segmental, vessel, and patient basis.
  
  
  RESULTS
  Sixty-one patients were diagnosed as having at least one significant stenosis with CA. Of these, MSCT identified 58 patients correctly. Two patients were incorrectly diagnosed as having one-vessel disease by MSCT. Patient-based sensitivity, specificity, NPV, and PPV of MSCT were 95.1%, 83.3%, 76.9%, and 96.7%, respectively. Of 1065 segments evaluated, CA detected 141 significant stenoses. On MSCT, significant stenoses were correctly diagnosed in 116 segments. Twenty-four nonsignificant lesions were overestimated by MSCT. In segment-based analysis, the overall sensitivity was 82.3%, specificity was 97.4%, NPV was 97.3%, and PPV was 82.9%. The accuracy of MSCT was in full agreement with CA in the evaluation of stent and graft patency.
  
  
  CONCLUSIONS
  Our findings show that 64-slice CT is highly accurate for the detection of significant coronary artery disease in an unselected patient population and can be used as a noninvasive technique.
authors.affiliation: Department of Cardiology, Medicine Faculty of Fatih University, Ankara, Turkey. yussel1971@hotmail.com
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Selçoki
authors.forename: Omer Cağlar
authors.initials: OC
authors.lastname: Yilmaz
authors.forename: Makbule Nur
authors.initials: MN
authors.lastname: Kankiliç
authors.forename: Kayihan
authors.initials: K
authors.lastname: Akin
authors.forename: Beyhan
authors.initials: B
authors.lastname: Eryonucu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*