Diagnostic accuracy of 64-slice multi-detector CT coronary angiography in the evaluation of coronary artery disease

Ko, Sung Min

Abstract

Conventional coronary angiography (CCA) has been the gold standard for the detection of significant coronary artery disease (CAD). However, CCA is invasive and 2/3 of all CCA have been performed for the diagnosis of significant stenosis without intervention. Recently, the use of multi-detector CT (MDCT) coronary angiography has been rapidly evolving as a promising non-invasive method for the assessment of patients with CAD. With the advent of 64-slice MDCT scanner, both temporal and spatial resolutions of coronary CT angiography have further improved for the non-invasive detection of coronary stenoses. The diagnostic performance for the assessment of CAD has significantly improved, and the nonassessable proportion of segments significantly decreased with the newer generations of MDCT scanners. Namgung et al. reported that high diagnostic accuracy for 64-slice MDCT in the detection of significant stenosis (> or =50% lumen diameter narrowing) on per segment (96% sensitivity and 97% specificity), per vessel (96% sensitivity and 97% specificity), and per patient analyses (100% sensitivity and 94% specificity). The negative predictive value for classification of segments, vessels, and patients with or without CAD was very high (99-100%). These findings indicate that 64-slice MDCT coronary angiography can be reliable as a gatekeeper of CCA in selected groups of patients.