title: Noninvasive evaluation of coronary artery bypass grafts with 16-slice multidetector computed tomography.
abstract: BACKGROUND
  The aim of this study was to investigate the diagnostic accuracy of 16-slice multislice, multidetector computed tomography (MDCT) angiography for the evaluation of grafts in patients with coronary artery bypass grafting (CABG).
  
  
  METHODS
  Fifty-eight consecutive patients with CABG who underwent both MDCT and conventional invasive coronary angiography were included. The median time interval between the 2 procedures was 10 days (range, 1-32 days). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MDCT for the detection of occluded grafts were calculated. The accuracy of MDCT angiography for detecting significant stenoses in patent grafts and the evaluability of proximal and distal anastomoses were also investigated.
  
  
  RESULTS
  Optimal diagnostic images could not be obtained for only 3 (2%) of 153 grafts. Evaluation of the remaining 150 grafts revealed values for sensitivity, specificity, PPV, NPV, and diagnostic accuracy of the MDCT angiography procedure for the diagnosis of occluded grafts of 87%, 97%, 94%, 93%, and 92%, respectively. All of the proximal anastomoses were optimally visualized. In 4 (8%) of 50 patent arterial grafts, however, the distal anastomotic region could not be evaluated because of motion and surgical-clip artifacts. The accuracy of MDCT angiography for the detection of significant stenotic lesions was relatively low (the sensitivity, specificity, PPV, and NPV were 67%, 98%, 50%, and 99%, respectively). The number of significant lesions was insufficient to reach a reliable conclusion, however.
  
  
  CONCLUSIONS
  Our study showed that MDCT angiography with 16-slice systems has acceptable diagnostic performance for the evaluation of coronary artery bypass graft patency.
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey. levent.sahiner@hacettepe.edu.tr
authors.forename: Levent
authors.initials: L
authors.lastname: Sahiner
authors.forename: Ali
authors.initials: A
authors.lastname: Oto
authors.forename: Kudret
authors.initials: K
authors.lastname: Aytemir
authors.forename: Tuncay
authors.initials: T
authors.lastname: Hazirolan
authors.forename: Musturay
authors.initials: M
authors.lastname: Karcaaltincaba
authors.forename: Deniz
authors.initials: D
authors.lastname: Akata
mesh_terms: D017023:Coronary Angiography / Q000295:instrumentation* / Q000379:methods; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012501:Saphenous Vein; D012680:Sensitivity and Specificity; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000295:instrumentation* / Q000379:methods; D014421:Turkey