Korean J Med > Volume 75(1); 2008 > Article
The Korean Journal of Medicine 2008;75(1):42-53.
Diagnostic accuracy of 64-slice multidetector CT coronary angiography for the evaluation of coronary artery disease
June Namgung, Hyunmin Choe, Sung Uk Kwon, Joon Hyung Doh, Sung Yun Lee, Gham Hur, Won Ro Lee
경희대학교 의과대학 순환기내과학교실
원저 : 64절편 다검출기 CT 관상동맥 조영술을 이용한 관상동맥 질환 진단의 정확도
남궁준.최현민.권성욱.도준형.이성윤.허 감.이원로, Hyunmin Choe, Sung Uk Kwon, Joon Hyung Doh, Sung Yun Lee, Gham Hur, Won Ro Lee
Abstract
Background/Aims
: Invasive coronary angiography remains the gold standard in the diagnosis of coronary artery disease. However, multidetector CT (MDCT) coronary angiography is an emerging technique that is available for the non-invasive detection of coronary artery stenoses. While the diagnostic accuracy of first generation MDCT is limited, recently released 64-slice MDCT has yielded promising results due to increased temporal and spatial resolution. The objective of this study was to investigate the diagnostic accuracy of non-invasive 64-slice MDCT for coronary artery disease.
Methods
: One hundred one patients (63 males and 38 females; mean age, 63.7±10.5 years) undergoing conventional coronary angiography were included in this study. All coronary arteries, including the distal segments and side branches, were analyzed for the presence of significant stenosis (≥50% diameter stenosis) and compared with of the quantitative coronary angiographic findings.
Results
: Of the 1,440 coronary artery segments studied, 1,348 segments were assessed quantitatively by both MDCT and conventional coronary angiography (94%). Two hundred nine significant stenoses were detected by conventional coronary angiography. On a segment-based analysis, the senisitivity, specificity, and positive and negative predictive values of 64-slice MDCT were 96, 97, 85, and 99%, respectively. On a vessel-based analysis, the sensitivity, specificity, and positive and negative predictive values of 64-slice MDCT were 96, 97, 85, and 99%, respectively. The corresponding values obtained on a patient-based analysis were 100, 94, 97, and 100%, respectively. Coronary calcification was the major cause of false-positive findings.
Conclusions
: This study demonstrated that 64-slice MDCT coronary angiography is of similar accuracy as conventional coronary angiography for the detection of coronary artery disease. In selected groups of patients, 64-slice MDCT may replace the more invasive coronary angiography. (Korean J Med 75:42-53, 2008) Key Words : Spiral volumetric computed tomography; Coronary angiography; Coronary artery disease
Key Words: Spiral volumetric computed tomography; Coronary angiography; Coronary artery disease


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