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J Korean Radiol Soc. 2008 Oct;59(4):225-234. English. Original Article.
Ko SM , Yi JG , Nam CW , Kim DH .
Department of Radiology, Konkuk University Hospital and Konkuk University School of Medicine, Korea.
Department of Internal Medicine, Dongsan Medical Center and Keimyung University School of Medicine, Korea.
Department of Radiology, Soonchunhyang University Hospital, Soonchunhyang University School of Medicine, Korea.

PURPOSE: We evaluated the diagnostic accuracy of a 64-slice multi-detector CT (MDCT) coronary angiography against a conventional coronary angiography (CCA) for the detection of significant stenosis (> or =50% lumen diameter narrowing). MATERIALS AND METHODS: Sixty-four patients underwent a MDCT and a subsequent CCA to evaluate the presence of atypical chest pain or suspected coronary artery disease (CAD). A MDCT angiography was performed using a 64-slice MDCT-scanner (Sensation 64, slice collimation 32x0.6 mm). The coronary artery segments were classified according to a 15-segment model. The sensitivity, specificity, and diagnostic accuracy of the 64-slice MDCT for the detection or exclusion of significant CAD were calculated on a per-segment and per-patient basis. RESULTS: Fifty-nine of the 64 (92%) coronary CT angiograms were of diagnostic image quality with 93.5% (809 of 865) of the coronary segments assessable by CT angiography. One-hundred two (12.6%) segments showed significant stenosis by CCA. Stenosis of 50% or greater was detected by sensitivity, specificity, accuracy, positive predictive valve, and negative predictive value on a per segment basis (89%, 99%, 97%, 90%, and 98%, respectively) and a per-patient basis (96%, 69%, 90%, 92%, and 82%, respectively). CONCLUSION: The 64-slice MDCT coronary angiography demonstrated a high diagnostic accuracy for both the per-segment and per-patient analyses for this symptomatic patient group.

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