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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
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Computed tomography coronary angiography in asymptomatic patients

E Maffei1, A Palumbo, C Martini

  • 1Department of Radiology and Cardiology, c/o Piastra Tecnica, Piano 0, Azienda Ospedaliero-Universitaria, Via Gramsci 14, 43100, Parma, Italy.

La Radiologia Medica
|September 6, 2011
PubMed

Insights

Computed tomography coronary angiography (CT-CA) accurately detects significant coronary artery disease (CAD) in high-risk asymptomatic patients. This noninvasive test is excellent for ruling out CAD when stress tests are inconclusive or not feasible.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Diagnostic Accuracy

Background:

  • Intermediate/high-risk asymptomatic patients often have inconclusive or nonfeasible noninvasive stress tests.
  • Accurate detection of coronary artery disease (CAD) is crucial in these individuals.
  • Noninvasive imaging modalities are sought to improve diagnostic pathways.

Purpose of the Study:

  • To assess the diagnostic accuracy of computed tomography coronary angiography (CT-CA).
  • To evaluate CT-CA's ability to detect significant CAD (≥50% lumen reduction).
  • To determine CT-CA's utility in intermediate/high-risk asymptomatic patients with inconclusive stress tests.

Main Methods:

  • 183 asymptomatic patients with risk factors and nonfeasible/inconclusive stress tests underwent CT-CA.
  • Conventional coronary angiography (CAG) served as the gold standard.
  • CT-CA results were compared with CAG findings for significant CAD detection.

Main Results:

  • The prevalence of obstructive CAD was 19%.
  • CT-CA demonstrated high diagnostic performance: sensitivity 100%, specificity 98%, PPV 97%, NPV 100%.
  • Positive and negative likelihood ratios were 151 and 0, respectively.

Conclusions:

  • CT-CA is a highly accurate noninvasive imaging modality.
  • It effectively excludes significant CAD in intermediate/high-risk asymptomatic patients.
  • CT-CA is valuable when stress testing is inconclusive or not feasible.
Abstract

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