Abstract
Objective: To investigate the diagnostic accuracy of 64-slice spiral computed tomography (MSCT) to coronary artery lesions, and to analyze the impacts of coronary artery calcium to diagnostic accuracy in detecting coronary artery lesions. Methods: Sixty patients underwent 64-slice spiral CT and conventional coronary angiography(CCA). Calciumscoring was estimated with plain scans, while 2D and 3D reconstruction were done with enhanced scans. The diagnostic accuracy of MSCT to detect significant lesions was evaluated regarding quantitative coronary angiography (QCA) as the standard of reference, and to analyze the impacts of coronary artery calcium on diagnostic accuracy. Results: A total of 797 segments can be diagnosed. The overall sensitivity, specificity, positive predictive value and negative predictive value of 64-slice spiral CT were 96%(174 of 182), 98%(601 of 615), 93%(174 of 188), and 99%(601 of 609) respectively. Within a total of 591 segments with calcium score =0 (Agatston score), the specificity was 100%(498 of 499)and the positive predictive value was 99%(86 of 87). However, 49 segments had a calcium score ≥100, with specificity at 63%(12 of 19)and positive predictive value at 81%(30 of 37). Conclusions: In patients with none or moderate coronary calcification, the 64-slice spiral CT coronary angiography allows for the reliable detection of coronary artery stenoses. Severe coronary artery calcification may still degrade the diagnostic specificity and positive predictive value of 64-slice spiral CT.
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