Comparision of 64-Slice MDCT and Invasive Angiography in Diagnosis of Significant Coronary Artery Stenosis

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.