Diagnostic accuracy of 64-detector row CT in coronary artery stenosis caused by calcified coronary artery plaques: A multicenter study / 中国医学影像技术

ABSTRACT

Objective To evaluate the diagnostic accuracy of coronary artery stenosis caused by calcified coronary artery plaques with 64-detector row CT under different conditions. Methods Totally 165 patients with coronary artery calcification accompanied by one or more branches stenosis more than 50% detected with computed tomography coronary angiography (CTCA) were collected. The Agatston calcium score (ACS) and stenosis rate were calculated based on per-patient, per-vessel, per-segment, various stenosis degree and different morphology of calcification as the analysis object, respectively. The measurement results of coronary angiography (CAG) were taken as the gold standard. The diagnostic accuracy was evaluated with receiver operating characteristic (ROC) curves which were created to assess the diagnostic value and to determine the diagnostic cutoff level (threshold). Results When per-patient analyzed, the greatest diagnostic accuracy rate was obtained with ACS threshold of 113.5, and the area under curve (AUC) value of ROC was 0.791. With the analysis object of per-vessel, the greatest diagnostic accuracy rate was found in right coronary artery and its sub-branches, and the AUC value was 0.897. Per-segment analyzed, the highest accuracy rate was obtained in RCA1 segment, and the AUC value was 0.894. When the analysis object was the morphology of calcification, the range of AUC value was merely 0.601-0.667, while the diagnostic value was rather low. The highest accuracy of CTCA was obtained in stenosis less than 50%, and the AUC value was 0.856. Conclusion Coronary artery calcification has different influence on the diagnostic accuracy rate of coronary artery stenosis with CTCA in various situations. Moreover, the morphology of the calcification may not be the main impact factors of the diagnostic accuracy.