Syed Asif Ali, Tahir Naveed, Muhammad Ayub, Muhammad Azhar.
Diagnostic accuracy of multi detector computed angiography for detection of coronary artery disease.
J Cardiovascular Dis Jan ;11(4):82-7.

AIMS AND OBJECTIVES:To compare the accuracy of Multi Detector Computed Tomographic (MDCT) angiography with conventional coronary angiography in detection of significant coronary artery stenosis. MATERIALS AND METHODS: Study was conducted at the Cardiology Department, Punjab Institute of Cardiology, Lahore from 15th May 2009 till 31st December 2009. Thirty patients having intermediate probability of coronary artery disease (CAD) undergoing MDCT and conventional coronary angiography were studied in this observational analytical study. All patients were scanned on a 64 slice scanner (GE, Lightspeed VCT, WI, USA). Conventional coronary angiography (CCA) was performed with the Judkins trans-femoral technique. MDCT angiography results identified coronary artery Disease (CAD) following the 17-segment modified American Heart Association classification model. Stenosis were evaluated by two independent observers and classified as significant if the mean luminal narrowing was ≥50% . These were compared with CCA on the same 17 segment model. Measures of diagnostic accuracy were calculated as true-positive, true-negative, false positive, and false-negative results. With this sensitivity, specificity, positive and negative predictive values were computed. RESULTS: The mean age of the study population was 46.8±9.3 years. Mean Calcium score was 185.9±250 HU. A total of 483 segments were analyzed. Analysis of these segments revealed that 93(19.3%) segments were true positive, 367(75.98%) were true negative, 11(2.3%) were false positive and 12(2.5%) were false negative. The sensitivity of MDCT in detection of significant coronary artery disease was observed to be 88.5% while the specificity was 97%. It was observed that the negative predictive value of MDCT for detection of coronary artery disease was 96.8 and positive predictive value was 89.4%. CONCLUSION: MDCT (64-slice) coronary angiography provides high specificity and NPV to rule out significant stenosis in patients suspected of having CAD. MDCT angiography can be used as a tool for noninvasive detection of coronary artery disease.

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