Diagnostic performance of 64-slice computed tomography coronary angiography to detect significant coronary artery stenosis

Objective - We aimed to determine the diagnostic accuracy of 64-slice multi-slice computed tomography (MSCT) to detect significant coronary artery stenosis with comparison to conventional coronary angiography (CCA). Methods - In 100 patients (70 men, average age 58 10 years and age range 31-75 years) scheduled to have conventional coronary angiography, MSCT was performed before catheterization (within 2 months).All patients were in sinus rhythm, able to hold breath for 15 seconds, and had serum creatinine levels < 1.5 mg/dl. MSCT scans were analysed by a radiologist and a cardiologist. Sensitivity, specificity, positive and negative predictive values for the detection of significant stenoses by MSCT in comparison with CCA were calculated on patient, vessel, and segmental bases. Results - 64-slice computed tomography is able to detect significant coronary artery stenosis on a segmental basis with a sensitivity of 88% and specificity of 99% when compared with CCA. All patients with significantly stenotic coronary artery disease are correctly diagnosed.The presence of significant stenosis was correctly diagnosed by MSCT in 126 of 144 segments.Twelve non-significant lesions on CCA were overestimated by MSCT On vessel-based analysis, the sensitivity and specificity of MSCT for detecting significant stenosis were 91% and 97%, respectively. Conclusion - Our results indicate that 64-slice computed coronary angiography is a reliable diagnostic modality for the detection of significant coronary artery stenosis in patients with sinus rhythm and scheduled to have CCA, but still has limitations of diagnostic performance on a per-segment and per-vessel basis.