Diagnostic Accuracy Of 64 Slice Computed Tomography For Detecting Coronary Artery Stenosis Comparis On With Convention Alangiography

Objective: Non-invasive coronary angiography by multislice spiral computed tomography (MSCT) is a promising method for the diagnosis of coronary artery disease (CAD). However, the clinical role of this methodhas not been established for specific patient cohorts. Therefore,the objective of the current study was to evaluate the accuracy and feasibility of 64-slice CT angiography in detecting coronary artery stenoses in patients probability for having CAD when compared with invasive angiography and also evaluate the diagnostic performance of 64 -slice spiral CT to detect in-stent restenosis (ISR) after stenting of the PCI.Methods:Between February 2008 and February 2008, 73patients[45male, 28female; mean age 56～86(73.1±5.3)years] probability for having coronary artery disease(22 patients among the total was after stenting) underwent coronary angiography and 64 slice CT angiography.The meantime span between coronary angiography(CAG)and CTA was 7 days. We excluded patients with the following: previous allergic reaction to contrast, impaired renal function (serum creatinine >1.6 mg/dL), contraindication toβ-blockers (high-degree heart block, poor left ventricular function, asthma, or severe chronic obstructive pulmonary disease. all subjects gave informed consent. The primary end point was defined as the diagnostic accuracy in the detection of significant coronary stenosis ( 50% lumen diameter reduction).Evaluation of right coronary artery(RCA),left main(LM),left anterior descending artery(LAD),diagonal branch1(D1), circurs flex branch(CX),and 1st marginal branch was performed by two. All vessels with a diameter>1.5mm were analysed and a lumenrestriction of>50% was considered a significant stenosis.Invasive Secondary end points comprised per-stent -based analyses as well as the comparison of diagnostic accuracy of 64-slice CT angiography vs coronary angiography,and ISR≥50% was considered a significant value.Coronary angiography was both taken as gold standard for calculations of diagnostic accuracy of 64-sCTA.Result:The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of 64 -slice spiral CT coronary angiography in diagnosing (≥50%) coronary stenosis was 75.8%,88.2%,64.3%,92.7% and 85.5% respectively.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of 64 -slice spiral CT coronary angiography in diagnosing (≥50%) ISR were18.1%,68.7%,20.0%,66.7%和42.6%,respectively.Conclusion:The 64 -slice spiral CT coronary angiography has a high accuracy for the detection of significant coronary rtery stenoses and therefore can be considered as a valuable noninvasive technique.The 64 -slice spiral CT coronary angiography has some diagnostic accuracy for detecting in-stent restenosis,can be as a useful tool for the follow up after coronary stenting.