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Diagnostic Accuracy of 64-slice Multislice Computed Tomography in the Noninvasive Evaluation of Significant Coronary Artery Disease |
한림대학교 강남성심병원 심장내과¹ , 한강성심병원² ,춘천성심병원³ ,강동성심병원⁴ ,한림대성심병원5 |
최성훈¹, 정재헌¹ , 이상학¹ , 이남호¹, 박우정² , 홍경순³ , 오동진⁴, 임종윤5 |
Background: 16-slice multislice computed tomography (MSCT) has been used as a noninvasive method to evaluate coronary anatomy. But, despite of good sensitivity & negative predictive value, poor specificity & positive predictive value limit the clinical efficacy. This study was aimed to determine the diagnostic accuracy of 64-sclice MSCT for the detection of significant coronary artery disease.
Method: In 49 patients scheduled for conventional coronary angiography, 64-slice MSCT was performed and evaluated for the presence of significant (≥50% luminal narrowing) stenosis from March 2006 through July 2006. 3 patients were excluded because of poor quality. In 46 patients ( 31 males, 15 females; 59.5 ± 10.2 years). Of these segments & vessels, 711(96.6%) segments & 180(97.8%) vessels were of sufficient image quality.
Result:
Conventional coronary angiography identified 77 segments, 38 vessels, of which 85 segment, 44 vessels were detected by 64-slice MSCT. The corresponding sensitivity, specificity, positive predictive value, negative predictive value for segment were 95.1%, 98.6%, 90.6%, 99.3% respectively. In vessel analysis, sensitivity, specificity, positive predictive value, negative predictive value were 92.7%, 95.7%, 86.4%, 97.8%. These findings were displayed in Table 1. as below.
Conclusion : The present study confirms that the specificity & positive predictive value of significant stenotic coronary artery of 64-slice MSCT improved in compared with that of the 16-sclice MSCT. 64-sclice MSCT enables the accurate and noninvasive evaluation of significant coronary artery stenosis in clinical fields.
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Variable |
Segmental Analysis
(n=736) |
Vessel Analysis
(n=184) |
Excluded |
25/736,
3.4% |
4/184,
2.2% |
Sensitivity |
77/81,
95.1% |
38/41,
92.7% |
Specificity |
576/584,
98.6% |
133/139,
95.7% |
Positive predictive
value |
77/85,
90.6% |
38/44,
86.4% |
Negative predictive
value |
576/580,
99.3% |
133/136,
97.8% | Table
1. Diagnostic accuracy of 64-sclice MSCT
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