Coronary Artery Anomalies: Detection on Coronary Artery Calcium Scoring Scan

OBJECTIVE. The objective of this study was to evaluate the accuracy of coronary artery calcium scanning in identifying coronary anomalies and potentially high-risk interarterial courses. MATERIALS AND METHODS. Ninety-five consecutive patients who were diagnosed with a coronary anomaly on CT coronary angiography were enrolled, and 95 age-and sex-matched individuals in whom any coronary anomalies were excluded on CT coronary angiography were used as control subjects (total, 190 patients; 106 men and 84 women; mean age, 58 +/- 12 years). The coronary artery calcium scan for each patient was retrospectively evaluated by three radiologists for the presence of coronary anomalies and the presence of an interarterial course in cases of suspected anomaly. Interobserver agreement was assessed. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of a coronary artery calcium scan for coronary anomalies and their interarterial courses were calculated, with CT coronary angiography as the reference standard. RESULTS. Almost perfect interobserver agreement was achieved in evaluating coronary anomalies and interarterial courses (kappa = 0.81 and 0.92, respectively). We achieved a high grade of diagnostic performance of coronary artery calcium scanning in detecting coronary anomalies (sensitivity, 79-80%; specificity, 95-98%; PPV, 94-97%; and NPV, 82-83%) and interarterial courses (sensitivity, 88-91%; specificity, 95-97%; PPV, 84-91%; and NPV, 97%). CONCLUSION. Coronary anomalies and interarterial courses were detected with great accuracy on coronary artery calcium scans.