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 |
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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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