OBJECTIVE: The aim of this study was to evaluate the clinical value of MDCT in the diagnosis of coronary artery disease in a population having a low pretest likelihood of significant disease. SUBJECTS AND METHODS: Sixty-four patients with suspected coronary artery disease and a low pretest likelihood of significant disease according to the criteria of the American Heart Association underwent both MDCT of the heart and quantitative conventional coronary angiography (QCA). MDCT examinations were performed on a 16-MDCT scanner. CT data sets were evaluated on a per-patient basis and a per-segment basis and were classified as indicating no disease, nonsignificant disease (stenoses </= 50%), or significant disease (stenoses > 50%). Sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of 16-MDCT in the detection or exclusion of significant and nonsignificant coronary artery disease were evaluated on both per-patient and per-segment bases. RESULTS: Regarding the success rate of 16-MDCT, 94% (60/64) of patients and 92% (388/420) of vessel segments were of sufficient quality for diagnosis. In the remaining 60 patients evaluated, QCA revealed significant coronary artery disease, nonsignificant disease, and no disease in 8.3% (5/60), 75.0% (45/60), and 16.7% (10/60) of cases, respectively, on a per-patient basis, and in 1.3% (5/388), 23.2% (90/388), and 75.5% (293/388) of cases, respectively, on a per-segment basis. The sensitivity, specificity, NPV, and PPV of 16-MDCT for the detection of significant coronary artery disease were 80.0%, 94.5%, 98.1%, and 57.1%, respectively, on a per-patient basis, and 80.0%, 99.2%, 99.7%, and 57.1% on a per-segment basis. CONCLUSION: In a population having a low pretest likelihood of significant coronary artery disease, 16-MDCT shows a moderate to high sensitivity and high NPV for the detection or exclusion of significant disease, but has a somewhat reduced PPV compared with QCA.
OBJECTIVE: The aim of this study was to evaluate the clinical value of MDCT in the diagnosis of coronary artery disease in a population having a low pretest likelihood of significant disease. SUBJECTS AND METHODS: Sixty-four patients with suspected coronary artery disease and a low pretest likelihood of significant disease according to the criteria of the American Heart Association underwent both MDCT of the heart and quantitative conventional coronary angiography (QCA). MDCT examinations were performed on a 16-MDCT scanner. CT data sets were evaluated on a per-patient basis and a per-segment basis and were classified as indicating no disease, nonsignificant disease (stenoses </= 50%), or significant disease (stenoses > 50%). Sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of 16-MDCT in the detection or exclusion of significant and nonsignificant coronary artery disease were evaluated on both per-patient and per-segment bases. RESULTS: Regarding the success rate of 16-MDCT, 94% (60/64) of patients and 92% (388/420) of vessel segments were of sufficient quality for diagnosis. In the remaining 60 patients evaluated, QCA revealed significant coronary artery disease, nonsignificant disease, and no disease in 8.3% (5/60), 75.0% (45/60), and 16.7% (10/60) of cases, respectively, on a per-patient basis, and in 1.3% (5/388), 23.2% (90/388), and 75.5% (293/388) of cases, respectively, on a per-segment basis. The sensitivity, specificity, NPV, and PPV of 16-MDCT for the detection of significant coronary artery disease were 80.0%, 94.5%, 98.1%, and 57.1%, respectively, on a per-patient basis, and 80.0%, 99.2%, 99.7%, and 57.1% on a per-segment basis. CONCLUSION: In a population having a low pretest likelihood of significant coronary artery disease, 16-MDCT shows a moderate to high sensitivity and high NPV for the detection or exclusion of significant disease, but has a somewhat reduced PPV compared with QCA.
Authors: Filippo Cademartiri; Erica Maffei; Anselmo Alessandro Palumbo; Roberto Malagò; Ludovico La Grutta; W Bob Meiijboom; Annachiara Aldrovandi; Michele Fusaro; Luigi Vignali; Alberto Menozzi; Valerio Brambilla; Paolo Coruzzi; Massimo Midiri; Miles A Kirchin; Nico R A Mollet; Gabriel P Krestin Journal: Eur Radiol Date: 2007-10-13 Impact factor: 5.315
Authors: Wen Jie Yang; Ke Min Chen; Bo Liu; Li Fang Pang; Huan Zhang; Zi Lai Pan; Fu Hua Yan Journal: Int J Cardiovasc Imaging Date: 2012-05-23 Impact factor: 2.357
Authors: Stephanie Busch; Thorsten R C Johnson; Konstantin Nikolaou; Franz von Ziegler; Andreas Knez; Maximilian F Reiser; Christoph R Becker Journal: Eur Radiol Date: 2006-12-16 Impact factor: 5.315
Authors: F Cademartiri; E Maffei; F Notarangelo; F Ugo; A Palumbo; D Lina; A Aldrovandi; E Solinas; C Reverberi; A Menozzi; L Vignali; R Malagò; M Midiri; N R Mollet; G Cervellin; D Ardissino Journal: Radiol Med Date: 2008-04-02 Impact factor: 3.469
Authors: F Cademartiri; E Maffei; A Palumbo; R Malagò; F Alberghina; A Aldrovandi; V Brambilla; G Runza; L La Grutta; A Menozzi; L Vignali; G Casolo; M Midiri; N R Mollet Journal: Radiol Med Date: 2007-10-21 Impact factor: 3.469
Authors: Thorsten R C Johnson; K Nikolaou; C Fink; A Becker; A Knez; C Rist; M F Reiser; C R Becker Journal: Radiologe Date: 2007-04 Impact factor: 0.635
Authors: Franz von Ziegler; Alexander W Leber; Alexander Becker; Ingo Kaczmarek; Ulf Schönermarck; Christine Raps; Janine Tittus; Peter Uberfuhr; Christoph R Becker; Maximilian Reiser; Gerhard Steinbeck; Andreas Knez Journal: Int J Cardiovasc Imaging Date: 2008-07-19 Impact factor: 2.357