64-Slice multidetector computed tomographic angiography and invasive coronary angiography in diagnosis of significant coronary artery stenosis

Abstract

Introduction: Introduction of 64-slice multidetector computed tomography (MDCT) has resulted in a great improvement of the non-invasive coronary artery imaging. The present study aimed to evaluate the diagnostic accuracy of 64-Slice MDCT among patients with coronary artery disease (CAD) candidates for invasive coronary angiography (ICA) study. Methods: During the present retrospective study, from March 2009 to March 2010, the diagnostic accuracy of 64-Slice MDCT were evaluated versus ICA in patients with suspected coronary artery disease. MDCT and ICA findings of each coronary segment were compared to determine the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of MDCT in the detection of significant lesions (?50% stenosis). Results: A total of 125 patients were evaluated with both methods. In per patient assessment, the sensitivity, specificity, PPV and NPV of MDCT were 97.6%, 85.2%, 95.2% and 92%, respectively. These values in per vessel evaluation were 86.3%, 92.2%, 86.8%, and 92.2%, and also corresponding values in per segment evaluation were 69.8%, 94.8%, 69%, and 95%, respectively. Conclusion: The coronary angiography with 64-Slice MDCT has high diagnostic performance for evaluation of significant CAD in patients with suspected CAD, but still cannot replace conventional coronary angiography at present time.