BACKGROUND: The impact of the coronary calcium score on the diagnostic accuracy of multislice computed tomography (MSCT) to detect obstructive coronary stenoses remains controversial. METHODS AND RESULTS: We examined 41 patients (mean Agatston score, 340 +/- 530 [range, 0-2546]) with coronary artery disease with 16-slice MSCT and 60 patients (mean Agatston score, 446 +/- 877 [range, 0-6264]) with 64-slice MSCT. MSCT scans were analyzed with invasive coronary angiography (CA) as the standard of reference. Lesions with luminal narrowing of 50% or greater were considered obstructive. In total, 9% and 2% of uninterpretable segments were excluded from analysis in patients examined with 16- and 64-slice MSCT, respectively. On a segment basis, the percentage of false-negative segments in the groups with Agatston scores of 0 to 100, 101 to 400, and greater than 400 with 16-slice MSCT were 0%, 5.3%, and 2.9% (P = .0005), respectively; other comparisons of false-positive and false-negative segments were not significant. The sensitivity and specificity on a vessel and patient basis with 16- and 64-slice MSCT were not significantly different in different calcium score groups. CONCLUSIONS: A slight impact of coronary calcium was observed on the diagnostic accuracy of 16-slice MSCT CA on a segment basis, with no significant impact on a vessel and patient basis. No significant impact of coronary calcium was observed on the diagnostic accuracy of 64-slice MSCT CA on a segment, vessel, or patient basis.
BACKGROUND: The impact of the coronary calcium score on the diagnostic accuracy of multislice computed tomography (MSCT) to detect obstructive coronary stenoses remains controversial. METHODS AND RESULTS: We examined 41 patients (mean Agatston score, 340 +/- 530 [range, 0-2546]) with coronary artery disease with 16-slice MSCT and 60 patients (mean Agatston score, 446 +/- 877 [range, 0-6264]) with 64-slice MSCT. MSCT scans were analyzed with invasive coronary angiography (CA) as the standard of reference. Lesions with luminal narrowing of 50% or greater were considered obstructive. In total, 9% and 2% of uninterpretable segments were excluded from analysis in patients examined with 16- and 64-slice MSCT, respectively. On a segment basis, the percentage of false-negative segments in the groups with Agatston scores of 0 to 100, 101 to 400, and greater than 400 with 16-slice MSCT were 0%, 5.3%, and 2.9% (P = .0005), respectively; other comparisons of false-positive and false-negative segments were not significant. The sensitivity and specificity on a vessel and patient basis with 16- and 64-slice MSCT were not significantly different in different calcium score groups. CONCLUSIONS: A slight impact of coronary calcium was observed on the diagnostic accuracy of 16-slice MSCT CA on a segment basis, with no significant impact on a vessel and patient basis. No significant impact of coronary calcium was observed on the diagnostic accuracy of 64-slice MSCT CA on a segment, vessel, or patient basis.
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