Diagnostic Performance Of 128-Slice Multi-Slice Computed Tomography For The Detection Of Significant Coronary Artery Lesions

Multi-Slice Computed Tomography (MSCT) is a recently introduced non-invasive technique used for the diagnosis of coronary artery disease (CAD). Both MSCT and conventional coronary angiography (CAG) may provide direct visualization of the coronary arteries. To determine the diagnostic accuracy of 128-slice MSCT compared with the results of conventional CAG for the diagnosis of significant coronary artery stenosis. Forty-two eligible patients who underwent 128-slice MSCT with the suspicion of CAD and had any coronary lesion within the whole coronary tree were enrolled prospectively. Subsequently, CAG was performed to confirm the severity of coronary lesions. The records acquired by MSCT coronary angiography and conventional CAG were evaluated by 16-segment model of American Heart Association (AHA). Mean age of the patients was 56±12 years, and mean heart rate prior to the examination was 69±4 bpm (min-max: 54-78). Of 672 coronary segments, 669 were interpretable and evaluated in 42 patients. For all the interpretable segments, overall sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and the diagnostic accuracy (DA) of 128-slice MSCT to detect significant stenosis were 91%, 98.5%, 93.8%, 97.8% and 97%, respectively. These values for evaluation of proximal segments were 97.8%, 96.4%, 95.7%, 98.1% and 97.1% and, for distal segments were 87.4%, 98.8%, 92.7%, 97.7% and 97%, respectively. Our results show that, the diagnostic performance of MSCT appear almost equivalent to CAG, current gold standard, with excellent, sensitivity, specificity, positive and negative predictive values. We think that, 128 slice-MSCT will be increasingly utilized in future, decreasing unnecessary coronary angiography procedures.