[Detection of stenoses in the coronary arteries using 64-slice computed tomography]

The purpose of the present study was to assess the diagnostic value of 64-slice computed tomography of the coronary arteries (CTCA) with invasive coronary angiography (CA) as reference.

We studied 194 patients (mean age: 62.7 ± 9.5 years, males: 97) with symptoms suggesting angina who had been referred for CA according to usual criteria. We excluded patients with known ischaemic heart disease and patients with an unstable heart rhythm. CTCA was analysed without knowledge of CA and vice versa. Stenoses > 50% were considered significant. The effective radiation (mSv) was measured with both methods.

In 17 patients (8.8%), the CT-angiogram was not assessable. In 177 patients (91.2%) with assessable CT-angiogram, the sensitivity of CTCA was 97%, the specificity 63%, the predictive value of a positive test 58%, and the predictive value of a negative test 97%. In the 174 patients in whom CTCA was performed using retrospective technique, the effective radiation was 14.0 ± 2.3, versus 4.9 ± 2.6 at CA (p < 0.0005). In the 20 patients in whom CTCA was performed using prospective technique, the effective radiation was 5.4 ± 1.2 versus 5.9 ± 3.6 at CA (non-significant)

CTCA with 64-slice scanner has a high sensitivity for demonstration coronary artery stenoses.