Impact of calcification on diagnostic accuracy of 64-slice spiral computed tomography for detecting coronary artery disease: a single center experience.
Summary of "Impact of calcification on diagnostic accuracy of 64-slice spiral computed tomography for detecting coronary artery disease: a single center experience."
BACKGROUND:
The main aim of our study was to investigate the influence of calcification on the accuracy of 64-slice computed tomography for identification of significant coronary artery disease.
METHODS:
A contrast-enhanced 64-slice computed tomography was performed prior to invasive coronary angiography in 168 consecutive patients with suspected coronary artery disease. All coronary segments 1.5 mm or larger in diameter were evaluated for the presence or absence of significant coronary artery stenosis, defined as a diameter reduction of >50%. The patients were also ranked by total calcium score which was expressed in Agatston units and the impacts of calcification on diagnostic accuracy of 64-slice computed tomography were assessed. Results were compared with quantitative coronary angiography as the standard of reference.
RESULTS:
The overall sensitivity, specificity, positive predictive value, and negative predictive value of 64-slice computed tomography for detection of significant stenosis were: by segments, 95%, 98%, 91%, and 99%, respectively; by patient, 98%, 97%, 96%, and 99%, respectively; and by artery, 94%, 93%, 91%, and 95%, respectively. In mild and moderate calcium scores (0 - 418 Agatston units), the sensitivity was 100%, specificity was 93%, positive predictive value was 97% and negative predictive value was 100%. Severe calcification (>419 Agatston units) reduced the sensitivity, specificity, positive, and negative predictive values of multi-slice computed tomography to 89%, 60%, 89%, and 60%, respectively.
CONCLUSION:
Our study revealed that the 64-slice computed tomography is a highly accurate diagnostic modality for detecting hemodynamically significant coronary stenosis; however, severe calcification is considered as a shortcoming which limits the routine application of multi-slice computed tomography in daily practice.
Affiliation
Department of Cardiology, Day General Hospital, Tehran, Iran. inazeri@yahoo.com.
Journal Details
This article was published in the following journal.
Name: Archives of Iranian medicine
ISSN: 1029-2977
Pages: 373-83
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20804303
- DOI: http://dx.doi.org/010135/AIM.003
Medical and Biotech [MESH] Definitions
Tomography, Spiral Computed
Computed tomography where there is continuous X-ray exposure to the patient while being transported in a spiral or helical pattern through the beam of irradiation. This provides improved three-dimensional contrast and spatial resolution compared to conventional computed tomography, where data is obtained and computed from individual sequential exposures.
Spiral Cone-beam Computed Tomography
Modality of computed tomography in which the patient is irradiated in a spiral path around the body with a cone or pyramid-shaped beam.
Cone-beam Computed Tomography
Computed tomography modalities which use a cone or pyramid-shaped beam of radiation.
Tomography, X-ray Computed
Tomography using x-ray transmission and a computer algorithm to reconstruct the image.
Tomography, Emission-computed
Tomography using radioactive emissions from injected RADIONUCLIDES and computer ALGORITHMS to reconstruct an image.
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