reza javadrashid

 Laryngospasm is a life-threatening condition caused due to involuntary contraction in laryngeal muscles. It can last seconds to minutes and may cause hypoxemia, loss of consciousness, and death.

 We report a case of laryngospasm in a patient with Coronavirus-2 infection who was admitted to the emergency department for the first time. Laryngospasm was revealed after treatment.

 The clinician should note that laryngospasm can be triggered by Coronavirus-2 infection.

Pulmonary embolism (PE) is a potentially fatal condition. Knowledge of the prognostic factors for PE may facilitate the management of these patients. Pulmonary computed tomography (CT) angiography (PCTA) can play an effective role in their management.

To evaluate the prognostic value of certain PCTA-derived indicators of right ventricular dysfunction in patients with acute PE.

A total of 61 hemodynamically stable patients with acute PE underwent PCTA and were followed-up for 60 days. The Qanadli index and 60-day mortality represented the PE severity and prognostic endpoints, respectively. The clinical significance of the following variables in predicting PE severity and mortality was examined: An abnormally positioned interventricular septum, right ventricular to left ventricular diameter ratio (RVD/LVD) on the axial plane, contrast medium reflux into the inferior vena cava (IVC), transverse diameter of the pulmonary trunk, and bolus-time curve indicators.

The 60-day mortality was estimated at 14.8% in this study. An abnormal interventricular septum morphology, RVD/LVD ratio, and contrast medium reflux into the IVC were significantly correlated with the Qanadli index. The pulmonary trunk diameter was the only predictor of 60-day mortality (optimal cutoff value, 33.5 mm; sensitivity, 66.7%; and specificity, 65.4%). The bolus-time curve indicators did not have any significant predictive value.

Some PCTA-derived indicators of right ventricular dysfunction may serve as severity/prognostic predictors in hemodynamically stable patients with acute PE.

A 47-year-old female with a history of antiphospholipid syndrome and ischemic stroke was presented to the emergency department due to abdominal pain and bloody vomiting. Ultrasonography showed double inferior vena cava and bilateral mild hydronephrosis. Furthermore, the abdominal computed tomography (CT) scan did not show any evidence of urolithiasis. The ultrasound images of distinctive developmental variations of inferior vena cava and other veins are important to be known. Vascular anomalies, although rare, should be taken into account in the differential diagnosis of focal lesions within the abdominal cavity. Double IVC might have been the cause of hydronephrosis in our patient.

Chest computed tomography (CT) scan has been used widely to diagnose COVID-19 in Iran.

To trace the footsteps of COVID-19 in Iran by exploring the trend in using chest CT scans and its economic impact on radiology departments.

In this cross-sectional study, the number of imaging examinations from 33 tertiary radiology departments in 9 large cities of Iran was collected from September 23, 2019 to March 20, 2020 (Months 1 to 6) and the corresponding months in 2018–2019.

A 50.2% increase was noted in the chest CT scan utilization in 2019–2020 compared to 2018–2019. This increase was +15%, +15%, +27%, +2%, +1% in Months 1–5 of 2019–2020, respectively. In Month 6 of 2019–2020, a 251% increase in the acquisition of chest CT scans was observed compared to the Month 6 of 2018–2019. Following negative balance of revenue from Month 1 to 5 with respect to the inflation rate, the total income in Month 6 was further 1.5% less than the same Month in 2018–19.

The observed peak in chest CT utilization in Month 3 prior to the surge in Month 6 could be explained by the seasonal influenza. However, unawareness about an emerging viral disease, i.e. COVID-19, might have underutilized chest CT in Months 4 and 5 before the official announcement in Month 6. The unbalanced increase in the workload of radiology departments in the shortage of cardiothoracic radiologists with the simultaneous decrease in income initiated a vicious cycle that worsened the economic repercussions of the pandemic.

Ultrasonography (USG) allows to the examination of soft tissue and osseous tissues in the head‑and‑neck region. This study compared the accuracy of USG and computed tomography (CT) scan in the diagnosis of mandibular fractures.

In this prospective observational study, spiral CT scan was prescribed for the lower face and, if necessary, midface and upper face in 42 trauma patients suspected of mandibular fractures, referring to Imam Reza Hospital in Tabriz. Two radiologists evaluated the CT scans. Then, another radiologist examined all the patients with USG with a frequency of 7–12 MHz. Ultrasonographic diagnostic results were recorded and compared with the results of the CT scan examinations. The results were reported using descriptive statistical methods

The specificity and sensitivity of USG were 100% and 91.1%, respectively. The USG sensitivities in the angle, condyle, condylar neck, and symphysis fractures were 100%, 91.6%, 85.7%, and 80%, respectively, and the specificity was 100% in all that anatomical regions. Among the confounding factors, the sensitivity of the USG (84.6%) was the lowest in the presence of hematoma; however, its specificity remained 100%. One case of symphysis fracture was not detected in the absence of any confounding factors in USG examination.

Although the sensitivity, specificity, and diagnostic accuracy of the USG were at high levels, there were some limitations, making it difficult to definitively replace USG with CT scans, especially in the case of condylar fractures and in the presence of confounding factors such as hematoma and swelling.

Cerebral venous thrombosis (CVT) is relatively uncommon but important. Because of non-specific signs and symptoms, non-contrast computed tomography (NCT) is performed for most patients. The first aim of this study was to investigate the sensitivity and specificity of NCT in the diagnosis of CVT. Another aim was to assess the value of sinus venous attenuation measurement on NCT in the diagnosis of CVT.

NCT of 187 patients were reviewed. Sensitivity and specificity of NCT were evaluated in the diagnosis of CVT. Hounsfield unit (HU) of sinus venous with thrombus was compared to normal veins of control group, with and without standardization to the average HU of the internal carotids.

CVT was confirmed in 32 patients by MRV (Magnetic Resonance Venography(. NCT has high sensitivity and specificity in the diagnosis of CVT. A significant difference in average venous sinus attenuation was found between thrombus in patients with CVT (66.12±7.4 HU) and normal veins in the control group (48.59±5.91 HU; p<0.05). A similar difference is identified between standardized HU value in venous sinuses with thrombus (1.59±0.24) and venous sinuses without thrombus (1.06±0.14; p<0.05). A HU of >62 and a standardized HU of >1.4 on NCT are associated with high probability of CVT.

High sensitivity of NCT and using sinus venous attenuation can be helpful for the early diagnosis and treatment of CVT in the emergency settings. Sinus venous attenuation value of >62 and standardized HU of >1.4 on NCT can be used as reliable methods to detect CVT.

In the present report, a 68-year-old man with recurrent hematemesis and melena is described. Upper gastrointestinal (UGI) endoscopy and colonoscopy showed normal findings. Abdominal computed tomography showed an aneurysm of left common iliac artery and duodenum located at the superior part of the aneurysm without contrast extravasation. So the aortoenteric fistula was suspected and surgical management of aortoenteric fistula (AEF) was done and the patient recovered successfully without complications. The diagnostic evaluation and management of AEF are discussed.

In all types of ischemic stroke, especially in the acute phase, excessive oxidative stress causes structural and functional damage to the brain. This may play a major role in the pathophysiology of the brain damage. Higher serum levels of bilirubin have therapeutic effects in oxidative stress-induced stroke. Nevertheless, role of increased serum levels of bilirubin in the acute phase of ischemic stroke is controversial. This study was a cross-sectional prospective descriptive study conducted in the Emergency Department (ED) of Imam Reza hospital, Tabriz University of Medical Sciences, Tabriz, Iran, throughout six months. 275 ischemic stroke patients were evaluated based on their brain CT scan infarct size, NIHSS, MRS, and serum levels of bilirubin. Later, data were analyzed using SPSS software. Total, direct and indirect bilirubin levels were significantly higher in expired patients (p< 0.0001). Total (p< 0.0001), direct (p< 0.0001) and indirect (p< 0.0001) bilirubin levels, NIHSS score (p< 0.0001), and ischemic area (p< 0.0001) significantly predicted the outcome in these patients. Total, direct and indirect bilirubin levels was significantly associated with mortality in the acute phase of ischemic stroke patients.

Pulmonary embolism (PE) is a potentially lethal condition if left untreated. There have been many efforts to find prognostic factors in patients with PE. The descending aorta enhancement (DAE) to main pulmonary artery enhancement (MPAE) ratio is a rather new imaging finding that has been suggested for prognostic purposes in such patients. To examine the prognostic value of DAE/MPAE in massive/submassive PE. Patients and Methods: A total of 47 patients with massive/submassive acute PE and compromised right ventricular function were studied prospectively. The Hounsfield units of DAE and MPAE were obtained on pulmonary computed tomography angiography (PCTA). The DAE/MPAE ratio was compared between two groups of patients with and without in-hospital major adverse event/30-day mortality. Twenty-four patients (51.1%) were hemodynamically unstable at the time of admission. Endotracheal intubation and cardiopulmonary resuscitation were indicated in 27.7% (n = 13) and 10.6% (n = 5) of patients, respectively. The rate of PE-unrelated adverse events or mortality was 10.6%. High correlations were present between observers in terms of reported DAE and MPAE (intraclass correlation coefficient = 0.99 for both). No significant association was found between DAE/MPAE and the occurrence of PE-related or unrelated in-hospital major adverse event or 30-day mortality. A significant reverse correlation was observed between DAE/MPAE and patients’ age (Pearson r = -0.47, P = 0.001). DAE/MPAE measured on PCTA may not predict PE-related or PE-unrelated poor outcome in patients with massive or submassive pulmonary embolism.

Vertebral artery occlusion (VAO) may result from closed head or neck trauma and can be lifethreatening due to brain-stem and cerebellar infarction. CT angiography is recommended as a screening diagnostic tool in selected patients after blunt cervical trauma. A 24-year-old woman was admitted to our emergency department with left hemiplegia two days after motor vehicle collision. Final diagnosis of occlusion of the right vertebral artery was made in CT angiography. She was treated with anticoagulant for 4 days then discharged with 5/5 muscle forces. She was advised to continue warfarin and atorvastatin for her after discharge.

Gastric cancer is one of the relatively common malignancies all over the world, and is one of major problems of health care system. Nowadays, importance of cachexia is demonstrated in prognosis of various malignancies. The aim of the present study was to evaluate frequency of cachexia index and its relationship with resection operability in patients with gastric adenocarcinoma.
In a descriptive-analytical study, 36 patients with gastric adenocarcinoma who referred to Imam Reza and Sina educational medical centers of Tabriz University of Medical Sciences, Tabriz, Iran, for surgery procedures, were included and evaluated in the study. Skeletal muscle index (SMI) was calculated using computed tomography (CT)-scan before performing surgery, patients’ cachexia index was calculated by the following formula: . Cachexia syndrome, patients’ weight loss, resection operability, and cachexia index were evaluated in patients. R
esults: Among 36 patients whom were studied, 25 patients (69.4%) were men, and 11 patients (30.6%) were women. Cachexia was seen in 5 patients (13.9%). In terms of gastrostomy operability, 26 patients (72.2%) were operable, and 10 patients (27.8%) were non-operable. Gastrostomy operability in patients with cachexia were significantly less than patients without cachexia syndrome (P = 0.001). No significant differences were seen in cachexia index of operable and non-operable patients (P = 0.105).
Based on the findings of the present study, gastrostomy operability in patients with cachexia was significantly less than patients without cachexia syndrome; but operable and non-operable patients do not have significant differences in cachexia in comparison to each other.

10 year survival rates for thyroid cancer is about 90%, but papillary thyroid cancer often spread to regional lymph nodes resulting in survival rate falls below 90%. In patients with thyroid cancer, cervical lymph node metastasis risk is about 20 to 50 percent. The aim of this study was to evaluate the association between ultrasound results and the involvement of lymph nodes before thyroidectomy and compare it with the pathologic response after thyroidectomy in patients with non-medullary thyroid cancer.
60 patients with thyroid cancer were randomly selected and entered into the study. Ultrasonographic examination of cervical lymph nodes was performed by two radiologists using an ultrasound machine in all patients diagnosed with thyroid cancer. Patients underwent total thyroidectomy and neck lymph node dissection by surgeon.
In papillary thyroid cancer, there was a significant relationship between ultrasonographic results and pathologic outcomes in determining the presence of cervical lymph node metastasis before thyroidectomy. And also, there was a significant relationship between the results of ultrasonography and pathologic findings in determining the location of affected lymph nodes.
Compared to histological examination, ultrasonography can be a useful tool in determining the location of affected cervical lymph node in thyroid cancers before surgery.

Aim: This study was intended to explore the effect of various drugs used to treat fatty liver on intimal-media thickness in patients with NAFLD.
Nonalcoholic fatty liver disease (NAFLD) is an indicator of a broad spectrum of pathologic disorders, which is characterized with macro vesicular steatosis in the absent of alcohol use. It has a wide range of laboratory, clinical and pathological presentations such as simple steatosis to the diseases like non-alcoholic steatohepatitis, fibrosis, and cirrhosis and hepatocellular cancer.
In this cross - sectional study, as a part of a 10-year cohort study (from 2007-2017) at Tabriz University of Medical Sciences, a group of 100 patients with NAFLD were studied. They were examined by color doppler sonography of the carotid arteries to detect any carotid intima- media thickness, before and one year after treatment with various drugs. The effect of treatment on right and left carotid intima- media thickness (IMT) was examined by using SPSS. V21.
Over all, 36 (36%) patients were male and 64 (64%) were female. The mean age of the patients was a 43.5±10.3 year, ranging from 16 to 64. The decrease in patient's intima- media thickness in both right and left carotids was statistically significant (P Treatment of patients with nonalcoholic fatty liver has a significant role in reduction of their carotid intima -media thickness and consequently in reducing cerebrovascular events such as stroke.

Right ventricle failure and massive pulmonary artery occlusion are the main causes of mortality in patients with acute pulmonary embolism. Although pulmonary CT angiography could be helpful in these patients there are some controversies. In current study we want to investigate correlation between pulmonary artery obstruction score and right ventricular dysfunction with mortality rate in patients with acute pulmonary embolism.

Pulmonary CT angiography of 76 patients with acute pulmonary embolism and no previous comorbidity were reviewed at this prospective study. Maximum short axis dimensions of the right ventricle (RVD) and the left ventricle (LVD) and their ratio were measured. The pulmonary artery obstruction score (PAOS) was determined according to Qanadli. At the end the correlation between these findings and mortality at first 60 days were evaluated.

The 60-days mortality rate was 19.7%. The expired and survived groups were comparable for PAOS, whereas both the median age and RVD/LVD ratio were significantly higher in the first group. In multivariate analysis, however, age was the only significant, independent predictor of 60-day mortality (p=0.02).

Without pre-existing morbidities, neither the RVD/LVD ratio nor PAOS is not an independent predictor of mortality in hemodynamically stable patients with acute PE.

Osteoprotegerin (OPG) could be a marker of vascular calcification extent. The purpose of this study was to evaluate relationships between OPG and coronary artery calcification (CAC) extent in an Iranian population.
A total of 151 patients with chest pain [107 males/44 females, mean age: 57.23 (30-85)] were enrolled, excluding patients with previously established coronary artery diseases. All underwent chest multidetector computed tomography (MDCT) for CAC scoring. Blood samples were collected for measurement of OPG. A potential relationship between CAC, OPG, age and number of involved coronary arteries was investigated, and a receiver-operating characteristic (ROC) curve was designed thereafter to identify a cut-off value of OPG that best predicted the presence of CAC.
A total of 93 patients did not have CAC, who were younger than others. The mean age of patients with a different number of involved arteries was significantly different and is significantly correlated with a number of involved coronary arteries. The mean level of OPG differed by the number of calcified coronary arteries and is significantly correlated with the number of involved coronary arteries. The level of OPG had a weak but positive correlation with Ca score. ROC curve analysis showed that plasma OPG level had a fair prediction of CAC score, with an area under ROC curve of 0.62. The cut-off value best predicting CAC score was 59.1 pg/ml.
This study suggests that a serum level of OPG can fairly predict extent of coronary retry calcification in symptomatic population.

The most common diagnostic modality for pulmonary emboli is CT angiography (CTA). Because of the availability and inexpensiveness, taking an electrocardiogram (ECG) is the first step in patients suspicious to pulmonary emboli. However, ECG does not provide any sensitive or specific manifestations for diagnosis of pulmonary emboli. We aim to evaluate the correlation between severity of pulmonary emboli in CTA and ECG changes. In this study, 102 patients diagnosed with massive or submassive pulmonary emboli due to Qanadli index in CTA studies were evaluated. ECG was taking in all patients. There are 35 previously reported pathologic changes in ECG which were all evaluated in these patients. The correlation between ECG findings and pulmonary emboli severity in CTA was evaluated. Massive emboli were present in 56.9% and submassive emboli in 43.1% of cases. In 76.5% of cases, pathologic changes in ECG considering emboli were present. In cases with massive emboli compared to submassive emboli, ECG changes (86.2% vs. 63.6%) and mean pathologic findings in ECG (5.82±2.95 vs. 4.25±2.84) were significantly higher. Prevalence of S1O3T3, S1&SaVL>1.5 mm, ST depression in V1-V3, ST elevation in V1-V3, Negative T wave in V1-V3, Right axis deviation, RVH criteria, P-pulmonale, QR pattern in V1 were significantly higher in massive emboli group. ECG changes and number of pathologic findings were higher in massive emboli group. Most significant changes were negative T and ST depression or elevation in V1-V3 and right heart involvement findings and could predict severity of pulmonary emboli.

The imaging techniques commonly used for foreign body detection include plain radiography, xeroradiography, computed tomography (CT) scans, magnetic resonance imaging (MRI) and ultrasonography. The aim of the present study was to compare cone-beam computed tomography (CBCT) with conventional CT scan in determination of the exact location of a foreign body in the maxillofacial area in vitro. In this descriptive study, seven different materials were selected as foreign bodies with dimensions of approximately 2 mm, 1 mm, and 0.5 mm. These materials consisted of metal, glass, wood, stone, plastic, graphite and tooth. These foreign bodies were placed in a sheep head between the corpus of the mandible and muscle, in the tongue and in an air space. One conventional CT scan and two CBCT scans were made on the models. Results. Tooth, metal, stone and glass foreign bodies were seen clearly on CT and CBCT scans made by NewTom at the smallest size in air. However, CBCT scan by NewTom was a more effective technique for visualization of foreign bodies in air compared to conventional CT. Foreign bodies measuring 0.5 mm made of metal, stone, glass, graphite and teeth were detected by all devices in muscle tissue and adjacent bone. According to the results, CBCT scans of NewTom and Planmeca are appropriate tools for detecting foreign bodies with relative high density in the maxillofacial area.

Coronary Artery Diseases (CAD) are the major cause of morbidity and mortality in most societies. Despite the invasive nature of angiography, it was used as a diagnostic procedure evaluates coronary artery diseases. This study was aimed at evaluating the Pattern of coronary arteries and anatomic risk factors of significant stenosis by 64-slice multi-detector computed tomography (MDCT). In this prospective-analytic study, CT angiography data of 200 patients with suspected CAD reviewed in order to identify the coronary arteries anatomy and determine the site of stenosis. Also, Length of LM and the first Diagonal from the origin of LAD were measured. There were three types of dominancy of coronary artery: 91% with Right Coronary Artery (RCA), 8% with Left Coronary Artery (LCA), two patients with co-dominant system. Also stenosis was observed in 6 (3%), 5 (2.5%) and 4 (2%) of arteries in LCx, RI and LM, respectively. In 21 (67.7%) of LAD stenosis were near the first diagonal (D1) origin and in RCA were near the SAN origin. There was no significant relationship between the length of LM and the first Diagonal and number of LAD branching and stenosis frequency in LAD.

Massive Pulmonary Embolism (MPE) is a life threating condition. MPE is defined as a 50% or more occlusion of the main pulmonary arteries or obliteration of two or more of lobar arteries. Patients often die at the primary hours as a result of right heart failure, therefore finding the signs of Right Ventricular (RV) dysfunction is helpful in early diagnostic concern of MPE in first studies for example spiral CT scans in patients with respiratory symptoms. The aim of this study was to determine the CT angiographic findings due to RV dysfunction in patients with acute MPE. We conducted analytic study. This study was performed on 80 humans by using of CT angiography for evaluation of findings due to RV dysfunction. They were obtained from CT Angiography Department of Madany Hospital in Tabriz City. The mean of maximum short axis diameter of RV in case group is higher than control group and it is statistically significant (p<0.05). The mean of maximum short axis diameters of right and left ventricular ratio in case group is higher than control group and it is statistically significant too (p<0.05). The mean of superior vena cava and azygus veins diameter in case group is higher than control group and it is statistically significant (p<0.05). Evaluation of RV afterload findings by computed tomography could be effective in prediction of sever MPE, faster therapeutic management and resultant decreased mortality.

This study aimed to evaluate the effect of NAFLD on CIMT as a risk factor for atherosclerosis. The prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing worldwide due to rise of obesity and diabetes mellitus (DM) prevalence. Non-invasive assessment of carotid intima media thickness (CIMT) by high-resolution carotid B-mode ultrasonography is widely used for determining the atherosclerosis. Patients and In this case-control setting, 151 subjects were categorized in three groups: group I including 49 patients with NAFLD and DM; group II including 50 non-diabetic NAFLD patients; and the control including 52 normal subjects as group III. The right and left CIMTs and its maximum reading (CIMTmax) were measured by a skilled sonographist blind to the groups. The sonographic grading of the NAFLD was determined in group I and II. Median CIMTmax was significantly higher in group I comparing with group II and control group (p<0.001). This difference between group I and group II was not significant after adjusting for age and history of hypertension and hyperlipidemia (p=0.089). After controlling the confounders, there was statistical significant between group I and group II with the control group (p<0.05). There was no significant difference in median maximal thickness of intima-media in the carotid of group I compare to group II in patients with and without elevated liver enzymes (in both groups, 0.6 mm, p= 0.402). Based on our findings, there is a significant association between the presence of NAFLD and atherosclerosis. This association was independent to the DM presence. The grade of NAFLD and elevated liver function tests had no effect on severity of atherosclerosis.

Atherosclerotic cardiovascular disease is a dispersed pathology involving the coronary arteries, carotid arteries, aorta and peripheral arteries. It has been previously suggested that coronary and aortic atherosclerosis may be associated. Imaging of the aorta and the aortic wall can be performed by various imaging modalities including state-of-the-art multidetector computer tomography (MDCT). This study aimed to investigate a possible association between the MDCT-measured thickness of the thoracic aorta and the presence of coronary artery disease (CAD) as well as its severity. Three hundred and fifty candidates of coronary computer tomography angiography (CTA) with signs and symptoms suggestive of CAD were recruited in Tabriz Parsian and Iran CTA Centers. Contrast-enhanced MDCT examinations were performed using a 64 detector scanner. Maximum aortic wall thickness in the mid-portion of descending thoracic aorta (region of pulmonary trunk to diaphragm) was measured perpendicular to the center of the vessel. CAD was confirmed in 189 cases (54%) and the remaining 161 cases served as controls. The mean age of the cases, as well as the percentage of male subjects was significantly higher in the CAD group. The mean aortic wall thickness was also significantly higher in the patient group (2.21±0.63 mm vs. 1.88±0.58 mm; P<0.001). In multivariate analysis, however, the two groups turned up comparable as to the aortic wall thickness (P=0.31). The optimal cut-off point of aortic wall thickness was ≥2 mm in discriminating between CAD+ and CAD- groups, with a corresponding sensitivity and specificity of 65% and 57%, respectively. There was no significant association between aortic wall thickness and the severity of CAD (the number of significantly occluded coronary arteries). Aortic wall thickness is apparently neither an independent predictor of CAD nor is it associated with the severity of CAD in candidates of CTA.

Scimitar syndrome or pulmonary venolobar syndrome is a rare, complex, and variable malformation of the right lung characterized by an abnormal right sided pulmonary drainage into the inferior vena cava, malformation of the right lung, abnormal arterial supply, and sometimes cardiac malformation. Despite the varying degrees of pulmonary hypoplasia and pulmonary artery hypertension, about half of the patients with scimitar syndrome are asymptomatic or mildly symptomatic when the diagnosis is made. Neonates have severe symptoms and worse prognosis while older children come to light because of recurrent respiratory infections, heart murmur, or an abnormal chest radiograph.

Introduction of 64-Slice Multidetector Computed Tomography (MDCT (has resulted in a great improvement in the non-invasive coronary artery imaging. In a retrospective cross sectional study we evaluated the diagnostic accuracy of 64-Slice MDCT versus invasive coronary angiography in patients with the suspected coronary artery disease who underwent both MDCT and invasive coronary angiography (ICA). Computed tomography angiography and invasive coronary angiography findings of each coronary segment were compared to determine the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of MDCT in the detection of significant lesions(≥50% diameter decrease stenosis or total occlusion with no luminal flow shown). a total of 125 patients were evaluated with both methods. In per patient assessment, the sensitivity, specificity, PPV and NPV of MDCT were 97.6%, 85.2%, 95.2% and 92% respectively. These values in per vessel evaluation were 86.3%, 92.2%, 86.8%, and 92.2%, and also corresponding values in per segment evaluation were 69.8%, 94.8%, 69%, and 95% respectively. We concluded that coronary angiography with 64-Slice MDCT has high diagnostic performance for evaluation of significant coronary artery disease (CAD) in patients with the suspected coronary artery disease but cannot replace conventional coronary angiography at present time.