Detection of significant coronary artery stenosis with 64-section MDCT angiography

Abstract Purpose To prospectively evaluate the diagnostic performance of 64-section multidetector computed tomography (MDCT) to detect significant coronary artery stenosis using conventional coronary angiography (CCA) as the reference standard. Materials and methods Institutional Review Board approval and informed consent were obtained. In this prospective study, 80 patients (61 male, 19 female, mean age 56) were examined. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) were calculated. McNemar test was used to search for the significant difference between 64-section MDCT angiography and CCA to detect stenosis. Also, kappa index ( κ ) for the agreement between MDCT angiography and CCA was calculated. Results The sensitivity, specificity, positive (PPV) and negative predictive values (NPV) for detecting significant stenosis were 96%, 98%, 91%, 99%, respectively. The sensitivity, specificity, PPV and NPV for classification of patients with or without CAD were 100% for all. McNemar test demostrated no significant difference between 64-section MDCT angiography and CCA. Also, kappa index ( κ ) indicated excellent agreement. Conclusion Sixty-four section MDCT angiography is an effective diagnostic tool for the detection of significant coronary artery stenosis. Especially, the potential to differentiate patients with and without CAD may provide MDCT an important role in the prevention of unnecessary invasive diagnostic procedures.