Efficacy of dual-source CT coronary angiography in evaluating coronary stenosis: initial experience

Chen, Hong-wei; Fang, Xiang-ming; Hu, Xiao-yun; Bao, Jian; Hu, Chun-hong; Chen, Yin; Yang, Zhen-yu; Alexander, Lerner; Wu, Xiao-qing

doi:10.1016/j.clinimag.2009.05.012

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Volume 34, Issue 3 , Pages 165-171, May 2010

Efficacy of dual-source CT coronary angiography in evaluating coronary stenosis: initial experience

Hong-wei Chen
- Imaging Center, Wuxi People's Hospital, Nanjing Medical University, 214023, Wuxi City, Jiangsu Province, People's Republic of China
Xiang-ming Fang
- Imaging Center, Wuxi People's Hospital, Nanjing Medical University, 214023, Wuxi City, Jiangsu Province, People's Republic of China
- Corresponding author. Imaging Center, Wuxi People's Hospital, Nanjing Medical University, 214023, Wuxi City, Jiangsu Province, People's Republic of China. Tel.: +86 510 85350235; fax: +86 510 85350555.
Xiao-yun Hu
- Imaging Center, Wuxi People's Hospital, Nanjing Medical University, 214023, Wuxi City, Jiangsu Province, People's Republic of China
Jian Bao
- Imaging Center, Wuxi People's Hospital, Nanjing Medical University, 214023, Wuxi City, Jiangsu Province, People's Republic of China
Chun-hong Hu
- Imaging Center, The First Affiliated Hospital of Soochow University, 215006, Suzhou City, Jiangsu Province, People's Republic of China
Yin Chen
- Imaging Center, Wuxi People's Hospital, Nanjing Medical University, 214023, Wuxi City, Jiangsu Province, People's Republic of China
Zhen-yu Yang
- Cardiologic Medicine, Wuxi People's Hospital, Nanjing Medical University, 214023, Wuxi City, Jiangsu Province, People's Republic of China
Lerner Alexander
- Department of Radiology, LAC+USC Medical Center, University of Southern California, Los Angeles, CA, USA
Xiao-qing Wu
- Cardiologic Medicine, Wuxi People's Hospital, Nanjing Medical University, 214023, Wuxi City, Jiangsu Province, People's Republic of China

Received 26 March 2009; accepted 5 May 2009. published online 15 January 2010.

Abstract

Objective

To retrospectively assess the diagnostic efficacy of dual-source CT angiography (DSCTA) in detecting and grading coronary stenosis.

Methods

Institutional review board approval and informed consent were obtained. One hundred ten patients were performed with both DSCTA and conventional coronary angiography (CCA) without heart rate or rhythm control in 1 week. Regarding CCA as the gold standard, the assessable rate of coronary arteries and diagnostic value of coronary stenosis using DSCTA were analyzed, respectively. The intermodality agreement between DSCTA and CCA in grading coronary stenosis was assessed using κ test. The value of DSCTA in diagnosing >50% coronary stenoses was also assessed.

Results

The overall assessable rate of DSCTA was 98.6% in detecting coronary arteries; there was no significant difference between assessable rates from different groups of heart rate (χ²=0.45, P > .05). The efficacy of DSCTA was of 97.9% sensitivity, 97.3% specificity, 90.4% positive predictive value, and 99.4% negative predictive value for coronary stenosis; and 94.7% sensitivity, 96.8% specificity, 83.7% positive predictive value, and 99% negative predictive value for >50% stenoses. The intermodality agreement in diagnosing coronary stenosis was satisfactory (k=0.87, u=58.46, P<.01).

Conclusions

As an effective noninvasive diagnostic tool, DSCTA yields a promising accuracy and reliability in assessing coronary stenosis. It may be recommended as a valuable screening tool for coronary artery disease, and a potential challenge to CCA as well.

Keywords: Dual-source computed tomography, Angiography, Coronary artery disease