Diagnostic accuracy of dual-source 64-slice multidetector computed tomography in evaluation of coronary artery bypass grafts.
BACKGROUND
The aim of this study was to compare the diagnostic accuracy of 64-slice multidetector computed tomography (MDCT) with conventional coronary angiography to detect graft patency and stenosis.


METHODS
In this retrospective analysis, we included a total of 284 subjects (210 men, 73.9%; mean ± SD age, 62.6 ± 9.9) and evaluated 684 bypass grafts using a dual-source 64-slice MDCT scanner The mean ± SD time interval between coronary artery bypass grafting operation and MDCT was 30.8 ± 6.2 months. The mean ± SD interval between MDCT angiography and conventional coronary angiography was 14.2 ± 3.6 days. Significant stenosis was defined as lesions causing 50% or greater luminal narrowing. All atherosclerotic lesion components were assessed on per-segment basis.


RESULTS
All of the 684 grafts (420 venous and 264 arterial grafts) were evaluable and included in the analysis. For the detection of 50% or greater graft stenosis, the sensitivity, specificity, positive predictive value and negative predictive value of MDCT was 98.3%, 99.3%, 98.3%, and 99.3% for venous grafts and 100%, 99.5%, 98.0%, and 100% for arterial grafts. In detection of graft patency, the sensitivity, specificity, positive predictive value, and negative predictive value of MDCT was 99.6%, 97.2%, 99.0%, and 99.0% for venous grafts and 99.5%, 97.5%, 99.5%, and 97.5% for arterial grafts. Diagnostic accuracy for the detection of graft patency was 99% (416/420) and 99.2% (262/264) for venous and arterial grafts, respectively.


CONCLUSIONS
The diagnostic accuracy of dual-source 64-slice MDCT angiography for evaluating coronary artery bypass grafts patency and stenosis was high. Dual-source 64-slice MDCT can be used for the evaluation of patients after coronary artery bypass grafting.
Department of Cardiology, Hacettepe University, Ankara, Turkey.
Levent
L
Sahiner
Uğur
U
Canpolat
Hikmet
H
Yorgun
Tuncay
T
Hazrolan
Muşturay
M
Karçaaltncaba
Hamza
H
Sunman
Ergün Barş
EB
Kaya
Kudret
K
Aytemir
Ali
A
Oto
D000368:Aged; D001026:Coronary Artery Bypass / Q000592:standards*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000601:surgery; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods / Q000592:standards*; D012189:Retrospective Studies