The diagnostic evaluation of 640 slice computed tomography angiography in the diagnosis of coronary artery stenosis

Objective: The aim was to evaluate diagnostic accuracy of 640 slice computed tomography angiography (640-CTCA) in diagnosis of coronary artery stenosis. Materials and Methods: Selective coronary angiography (SCA) and 640 slice CTCA were performed in 120 patients with suspected coronary artery disease (CAD) (78 male, 42 female, aged from 36 to 79 years old, with an average of 58.23 years). Various post-processing reconstructions of coronary arteries and branches, such as volumetric imaging, multi-planar reconstruction, curved planar reconstruction, maximum intensity projection were used. The coronary segments, with statistical evaluations combined with its diameter ≥1.5 mm were collected to analyze the diagnosis accuracy of 640-CTCA on coronary artery stenosis, with SCA as the reference standard. Results: About 96.91% (1535/1584) of coronary artery segments were evaluable arteries, and the sensitivity, specificity, positive and negative predictive value of 640-CTCA for detecting coronary artery stenosis were 93.44%, 99.59%, 95.00% and 99.45% respectively. 3.09% (49/1584) of coronary artery segments could not be evaluated due to motion artifact in 21 segments, calcification in 18 segments and poor display of lumen in 10 segments. There were no significant differences in the diagnostic accuracy of coronary artery stenosis between 640-CTCA and SCA. Conclusion: 640-CTCA has a higher accuracy and specificity, which is a reliable tool in the screening of CAD, coronary surgery, preoperative evaluation and the postoperative follow-up.