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KMID : 0882420080750010042
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Korean Journal of Medicine
2008 Volume.75 No. 1 p.42 ~ p.53
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Diagnostic accuracy of 64-slice multidetector CT coronary angiography for the evaluation of coronary artery disease
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Namgung June
Choi Hyun-Min
Kwon Sung-Uk
Doh Joon-Hyung
Yi Seong-Yoon
Hur Gham
Lee Won-Ro
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Abstract
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Background/Aims : Invasive coronary angiography remains the gold standard in the diagnosis of coronary artery disease. However, multidetector CT (MDCT) coronary angiography is an emerging technique that is available for the non-invasive detection of coronary artery stenoses. While the diagnostic accuracy of first generation MDCT is limited, recently released 64-slice MDCT has yielded promising results due to increased temporal and spatial resolution. The objective of this study was to investigate the diagnostic accuracy of non-invasive 64-slice MDCT for coronary artery disease.
Methods : One hundred one patients (63 males and 38 females; mean age, 63.7±10.5 years) undergoing conventional coronary angiography were included in this study. All coronary arteries, including the distal segments and side branches, were analyzed for the presence of significant stenosis (≥50% diameter stenosis) and compared with of the quantitative coronary angiographic findings.
Results : Of the 1,440 coronary artery segments studied, 1,348 segments were assessed quantitatively by both MDCT and conventional coronary angiography (94%). Two hundred nine significant stenoses were detected by conventional coronary angiography. On a segment-based analysis, the senisitivity, specificity, and positive and negative predictive values of 64-slice MDCT were 96, 97, 85, and 99%, respectively. On a vessel-based analysis, the sensitivity, specificity, and positive and negative predictive values of 64-slice MDCT were 96, 97, 85, and 99%, respectively. The corresponding values obtained on a patient-based analysis were 100, 94, 97, and 100%, respectively. Coronary calcification was the major cause of false-positive findings.
Conclusions : This study demonstrated that 64-slice MDCT coronary angiography is of similar accuracy as conventional coronary angiography for the detection of coronary artery disease. In selected groups of patients, 64-slice MDCT may replace the more invasive coronary angiography. (Korean J Med 75:42-53, 2008)
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KEYWORD
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Spiral volumetric computed tomography, Coronary angiography, Coronary artery disease
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