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Diagnostic Accuracy of Dual-Source Computerized Tomography Coronary Angiography in Symptomatic Patients Presenting to a Referral Cardiovascular Center During Daily Clinical Practice

View Article: PubMed Central - PubMed

ABSTRACT

Background: There are numerous studies that address the diagnostic value of dual-source computed tomography (DSCT) as an alternative to conventional coronary angiography (CCA). However, the benefit of application of DSCT in a real world clinical setting should be evaluated.

Objectives: To determine the diagnostic accuracy of DSCT technique compared with CCA as the gold standard method in detection of coronary artery stenosis among symptomatic patients who are presented to a referral cardiovascular center during daily clinical practice.

Patients and methods: Evaluating the medical records of a tertiary care referral cardiovascular center, 47 patients who had undergone DSCT and CCA, and also met the inclusion and exclusion criteria of the study were selected. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and likelihood ratios (LRs) of the DSCT imaging technique were calculated.

Results: In total, 97.8% of the segments (628/642) could be visualized with diagnostic image quality via DSCT coronary angiography. The mean heart rate during DSCT was 69.2 ± 12.2 bpm (range: 39 - 83 bpm), and the mean Agatston score was 507.7 ± 590.5 (range: 0 - 2328). Per segment analysis of the findings revealed that the sensitivity, specificity, PPV, NPV, positive LR (PLR) and negative LR (NLR) of DSCT technique for evaluation of patients with coronary artery disease were 93.7%, 96.8%, 92.7%, 97.2%, 29.4, and 0.066, respectively. Also per vessel, analysis of the findings showed a sensitivity of 97.1%, a specificity of 94.0%, PPV of 95.3%, NPV of 96.3%, PLR of 16.1, and NLR of 0.030.

Conclusion: Our results indicate that DSCT coronary angiography provides high diagnostic accuracy for the evaluation of CAD patients during daily routine practice of a referral cardiovascular setting.

No MeSH data available.


Related in: MedlinePlus

Dual-source CT coronary angiography of a 51-year-old woman (mean heart rate during scanning, 81 beats per minute; Agatston score, 94). A thin-slab maximum-intensity projection of left descending artery (LAD) demonstrates two non-significant coronary stenosis in proximal and mid segments. A, The first stenosis has a calcified plaque and the second one has a non-calcified plaque; B, conventional coronary angiography reveals that both of the stenoses were non-significant, hence dual-source CT coronary angiography correctly showed stenoses as non-significant.
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fig32194: Dual-source CT coronary angiography of a 51-year-old woman (mean heart rate during scanning, 81 beats per minute; Agatston score, 94). A thin-slab maximum-intensity projection of left descending artery (LAD) demonstrates two non-significant coronary stenosis in proximal and mid segments. A, The first stenosis has a calcified plaque and the second one has a non-calcified plaque; B, conventional coronary angiography reveals that both of the stenoses were non-significant, hence dual-source CT coronary angiography correctly showed stenoses as non-significant.

Mentions: In total, DSCT coronary angiography produced 14 false positive and 12 false negative results. Due to the presence of multiple coronary ectasia in one patient, normal coronary segments were diagnosed as stenotic lesions, giving rise to three false positive results. Examples of three patients who underwent DSCT coronary angiography for evaluation of CAD are provided in Figures 1 and 2.


Diagnostic Accuracy of Dual-Source Computerized Tomography Coronary Angiography in Symptomatic Patients Presenting to a Referral Cardiovascular Center During Daily Clinical Practice
Dual-source CT coronary angiography of a 51-year-old woman (mean heart rate during scanning, 81 beats per minute; Agatston score, 94). A thin-slab maximum-intensity projection of left descending artery (LAD) demonstrates two non-significant coronary stenosis in proximal and mid segments. A, The first stenosis has a calcified plaque and the second one has a non-calcified plaque; B, conventional coronary angiography reveals that both of the stenoses were non-significant, hence dual-source CT coronary angiography correctly showed stenoses as non-significant.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5035936&req=5

fig32194: Dual-source CT coronary angiography of a 51-year-old woman (mean heart rate during scanning, 81 beats per minute; Agatston score, 94). A thin-slab maximum-intensity projection of left descending artery (LAD) demonstrates two non-significant coronary stenosis in proximal and mid segments. A, The first stenosis has a calcified plaque and the second one has a non-calcified plaque; B, conventional coronary angiography reveals that both of the stenoses were non-significant, hence dual-source CT coronary angiography correctly showed stenoses as non-significant.
Mentions: In total, DSCT coronary angiography produced 14 false positive and 12 false negative results. Due to the presence of multiple coronary ectasia in one patient, normal coronary segments were diagnosed as stenotic lesions, giving rise to three false positive results. Examples of three patients who underwent DSCT coronary angiography for evaluation of CAD are provided in Figures 1 and 2.

View Article: PubMed Central - PubMed

ABSTRACT

Background: There are numerous studies that address the diagnostic value of dual-source computed tomography (DSCT) as an alternative to conventional coronary angiography (CCA). However, the benefit of application of DSCT in a real world clinical setting should be evaluated.

Objectives: To determine the diagnostic accuracy of DSCT technique compared with CCA as the gold standard method in detection of coronary artery stenosis among symptomatic patients who are presented to a referral cardiovascular center during daily clinical practice.

Patients and methods: Evaluating the medical records of a tertiary care referral cardiovascular center, 47 patients who had undergone DSCT and CCA, and also met the inclusion and exclusion criteria of the study were selected. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and likelihood ratios (LRs) of the DSCT imaging technique were calculated.

Results: In total, 97.8% of the segments (628/642) could be visualized with diagnostic image quality via DSCT coronary angiography. The mean heart rate during DSCT was 69.2 ± 12.2 bpm (range: 39 - 83 bpm), and the mean Agatston score was 507.7 ± 590.5 (range: 0 - 2328). Per segment analysis of the findings revealed that the sensitivity, specificity, PPV, NPV, positive LR (PLR) and negative LR (NLR) of DSCT technique for evaluation of patients with coronary artery disease were 93.7%, 96.8%, 92.7%, 97.2%, 29.4, and 0.066, respectively. Also per vessel, analysis of the findings showed a sensitivity of 97.1%, a specificity of 94.0%, PPV of 95.3%, NPV of 96.3%, PLR of 16.1, and NLR of 0.030.

Conclusion: Our results indicate that DSCT coronary angiography provides high diagnostic accuracy for the evaluation of CAD patients during daily routine practice of a referral cardiovascular setting.

No MeSH data available.


Related in: MedlinePlus