• Department of Cardiovascular Surgery, West China Hospital of Sichuan University,Chengdu 610041,P. R. China;
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Abstract: Objective To evaluate the diagnostic accuracy for the the assessment of coronary artery stenoses
using 64-multislice spiral computed tomography (64-MSCT) scanner compared with selective coronary angiography(SCA). Methods 64-MSCT and SCA were both performed in 93 patients with 74 males and 19 females at mean age of (58.2±8.5) years in West China Hospital between April 2004 and December 2010. The cardiacrhythm of all the patients was stably sinus. Patients with initial heart rates≥90 time/min were received treatments of β-blockers. All available coronary segments(internal diameter ≥ 2.0 mm)were included in the evaluation. Lesions with ≥ 50% luminalnarrowing were considered as significant stenosis. According to the image detail of segments and existance of artfacts,the image quality was randed Ⅰ to Ⅳ ,with rank Ⅰ to Ⅲ meeting demands of image evaluation. Evaluations had been done concerning the 64-MSCT scanner for detecting the stenosis of the variant branches or segments of the coronary artery. Results 64-MSCTprovided a full image correspondence(100%,1 238/1 238)of all the segments clearly displayed in the SCA. All of the coronary segments involved (n=1 238) met the quality demands of being evaluated as rankⅠ to Ⅲ. Considering SCA as the golden standard, overall sensitivity for classifying stenosis using 64-MSCT scannerwas 88.8%(427/481), specificity was 91.7%(694/757), positive predictive value was 87.1%(427/490),and negative predictive value was 92.8%( 694/748).While the stenosis diagnostic accuracy of proximal left circumflexbranch and the first obtuse marginal branch of left coronay artery is lower than other branches: the sensitivity of the proximal left circumflex branch was 68.3%(41/60),specificity was 60.6%(20/33),positive predictive value was 75.9%(41/54),negative predictive value was 51.3%(20/39);the sensitivity of the first obtuse marginalbranch was 58.8%(10/17),specificity was 93.5%(58/62),positive predictive value was 71.4%(10/14),negative predictive value was 89.2%(58/65). Arterial wall calcification and false image of cardiac movements were the maininfluence factors for accuracy of the the assessment of coronary artery stenosis with 64-MSCT scanner. Conclusion 64-MSCT scanner provids a high diagnostic accuracy in assessing stenosis of the coronary artery. The anatomical location and luminal area of coronary artery were the main influence factors of diagnostic accuracy. Thus the diagnostic accuracy in proximal left circumflex branch and the first obtuse marginal branch of left coronary artery was lower than other coronary
segments.

Citation: BAI Zhixuan,SHI Jun,PENG Yong,et al .. Accuracy of Detecting Coronary Artery Stenosis Between 64-multislice Spiral CT and Selective Coronary Angiography: A Comparative Study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2012, 19(1): 8-14. doi: Copy