ABSTRACT
Objective To investigate the accuracy of 320-slice row CT system for the detection of coronary artery disease(CAD)in high pre-test probability population without heart rate/rhythm control.Methods Thirty patients with a high pre-test probability of CAD underwent 320-slice row CT without preceding heart rate/rhythm control.Invasive coronary angigraphy(ICA)served as the standard reference.Data sets were evaluated by 2 observers in consensus with respect to stenoses≥50% decreased diameter.The sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV)and Youden index were analyzed;the impact of heart rate and calcification on image quality as well as diagnostic accuracy were also analyzed by Chi-square test Results Mean heart rate during scanning was 73.7±15.4 beats per min(bpm),and median(QR)of Agatston score of segment was 45.6(181).On a per-segment analysis,overall sensitivity was 96.1%(74/77,95%CI:89.03%-99.19%),specificity was 98.3% (337/343,95%CI:96.23%-99.36%),PPV was 92.5% (74/80,95%CI:84.39%-97.20%),NPV of 99.1% (337/340,95%CI:97.44%-99.82%)and the Youden index was 0.94.In both heart-rate subgroups(242 in heart rate＜70 bpm group,169 in heart ratet≥70 bpm group),diagnostic accuracy for the assessment of coronary artery stenosis was similar(P＜0.05).The accuracy and the quality score of the subgroup Agatston score≥100 were lower than that of the subgroup Agatston score＜100;however,the difiercnce of results between 320-slice row CT and ICA was not significant(P＜0.05).Conclusion 320-detector row CT can reliably detect coronary artery stenoses in a high pre-test probability population without heart rate/rhythm control.