Diagnosis of Dissection of the Coronary Artery Dissection by Multidetector Computed Tomography: A Comparative Study With Coronary Angiology

Objectives This study was to assess the diagnostic performance of multidetector computed tomography (MDCT) angiographic protocol for dissection of the coronary artery (DCA) detection compared with coronary angiology (CAG). Methods Intravascular ultrasound was used as the gold standard for DCA diagnosis. Thirty-six DCA patients and 34 non-DCA (control) participants were retrospectively reviewed. The CAG and MDCT angiography images were separately reviewed by 4 independent observers, and a 5-point grading scale was used for DCA diagnosis. Diagnostic performance was compared using receiver operating characteristic analysis. Sensitivity, specificity, and negative predictive values were calculated. Results The MDCT performed significantly better than that of CAG (A(Z) = 0.9943 +/- 0.0034 vs A(Z) = 0.8411 +/- 0.0274, respectively) for DCA detection. The sensitivity (98.6%), specificity (89.7%), and negative predictive value (98.4%) of MDCT for DCA were higher than those of CAG (77.8%, 79.4%, and 77.1%, respectively). Conclusions Multidetector computed tomography angiography was a more sensitive and specific technique for the diagnosis of DCA compared with CAG.