Non invasive detection of coronary artery stenosis using 64-slice computed tomography

ABSTRACT

Coronary artery disease [CAD] is the leading cause of death and disability in many countries. Conventional coronary angiography [CA] is currently the reference test for coronary artery lumen assessment, and its use has been steadily increasing over the last decade. Recent advances in multislice computed tomography [MSCT] seem to respond adequately to the need for a noninvasive and reliable assessment of the coronary artery lumen. This study was designed to determine the diagnostic accuracy of 64-Slice computed tomography [CT] in the detection of coronary artery stenosis using conventional coronary angiography as the reference standard. The study was done on 50 patients who were referred for MSCT [64 slice] computed tomography coronary angiography evaluation after being well prepared to obtain heart rate of less than 60 bpm, then they underwent invasive coronary angiography. In every patient the coronary artery tree was divided into 15 segments according to the American Heart Association 15 segments model of the coronary arteries and each coronary segment was compared between both examinations. The sensitivity, specificity and accuracy of MSCT to determine coronary stenosis were calculated. The sensitivity, specificity, positive and negative predictive values of 64 slice CT coronary angiography to detect significant coronary stenosis were 87.5%, 99.6%, 98.3% and 96.7% respectively. Regarding stenosis severity, the sensitivity of 64 slice CT coronary angiography to detect>90% stenosis and>60% stenosis were 95%and 56% respectively. MSCT 64 slice coronary angiography is a very valuable test for the diagnosis of coronary artery disease also due to its high negative predictive value it can be used to rule out significant coronary artery disease with very high accuracy