Coronary computed tomography angiography using 128-slice dual-source computed tomography in patients with severe...

Area of Science:

• Cardiovascular Imaging
• Radiology
• Medical Diagnostics

Background:

• Coronary artery calcification (CAC) poses challenges for accurate assessment of luminal stenosis.
• Severe calcification, indicated by a high Agatston score (>400), can limit the diagnostic accuracy of imaging modalities.

Purpose of the Study:

• To compare the luminal graphic definition of calcified segments between coronary computed tomography angiography (CTA) and coronary angiography (CAG).
• To evaluate the efficacy of 128-slice dual-source computed tomography (DSCT) in patients with severe coronary calcification (Agatston score >400).

Main Methods:

• Retrospective analysis of 1148 patients undergoing coronary CTA with 128-slice DSCT.
• Inclusion of 39 patients with Agatston score >400 who also underwent coronary angiography (CAG) within 3 months.
• Visual evaluation of calcification distribution and significant stenosis in calcified and all segments, compared with CAG findings.

Main Results:

• The study cohort had a mean Agatston score of 1771 ± 1724.
• For calcified segments, coronary CTA demonstrated a sensitivity of 93.2%, specificity of 83.9%, PPV of 70.8%, and NPV of 96.7%.
• For all segments, the respective values were sensitivity 92.2%, specificity 87.5%, PPV 69.6%, and NPV 97.3%.

Conclusions:

• 128-slice DSCT shows significant potential for evaluating the lumen of calcified coronary segments.
• The technique is effective even in patients with very high Agatston scores, indicating severe coronary calcification.