CT angiography using dual source 64-MSCT versus catheter angiography in assessment of coronary atherosclerotic disease

Abstract

We compare the coronary CTA versus catheter angiography in the assessment of coronary atherosclerosis.The study included 51 patients who were referred for coronary catheter angiography after coronary CTA. The following patients were excluded: patients with irregular heart rates, patients with previous coronary bypass grafts and those with coronary stents. Patients with a resting heart rate above 75bpm and a medical contraindication for beta blockers administration are excluded. History of contrast allergy, renal impairment and severe chest conditions are exclusion criteria. The coronary angiographic CT studies were performed using a Somatom Definition “dual source” 64 CT scanner (Siemens, medical scientific Germany). The catheter coronary angiographic studies were performed via femoral arterial puncture. The standard 15-segment model of the coronary tree was employed. Segments were classified as being normal, atherosclerotic (with no significant stenosis), stenotic (>50% luminal narrowing), occlusive or non evaluable. The results of CT angiography are compared with the gold standard catheter angiography.Results: Overall sensitivity, specificity, PPV and NPV were 93%, 92%, 92% and 93%, respectively with an overall diagnostic accuracy of 93%. The sensitivity is 84% to detect stenoses 60–70% in, 85% sensitivity with 70–80% stenoses, 96% with 80–90% stenoses and 96% with stenoses more than 90%.