Meta-Analysis of 40- and 64-MDCT Angiography for Assessing Coronary Artery Stenosis  

Oleh:

Meijer, Alex B. ; Geleijns, Jacob ; Kroft, Lucia J. M.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: American Journal of Roentgenology vol. 191 no. 06 (Dec. 2008), page 1667-1675.
Topik: Cardiac; coronary angiography; CT; diagnostic imaging; stenoses

Ketersediaan

Perpustakaan FK Nomor Panggil: A13.K Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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OBJECTIVE. The purpose of our study was to assess the diagnostic performance of thin-slice (= 0.625 mm) MDCT coronary angiography compared with invasive coronary angiography for the detection of significant (= 50%) stenosis. MATERIALS AND METHODS. Twenty-two articles on 40- and 64-MDCT coronary angiography were included. Sensitivity and specificity were calculated on a per-patient and per-segment basis; in addition, proximal versus distal segments were evaluated. The effect of nonevaluable patients, nonevaluable segments, and disease prevalence on diagnostic performance was assessed. RESULTS. Pooled sensitivity on a patient level was 97.7% ([95% CI] 96.2–98.7%) and specificity 91.0% (88.5–93.1%). Pooled sensitivity on a segmental level was 90.8% (89.0–92.4%) and specificity 95.7% (95.2–96.1%); for proximal segments, respectively, 94.2% (92.3–95.7%) and 94.1% (93.4–94.8%), and for distal segments 84.8% (81.1–88.0%) and 96.9% (96.4–97.4%). If nonevaluable MDCT investigations were included, the per-patient specificity was reduced from 91.0% to 89.1% (p > 0.05) when allocating excluded patients as having significant coronary artery stenosis, and the sensitivity was reduced from 97.7% to 96.2% (p > 0.05) when allocating excluded patients as not having significant stenosis. The per-patient prevalence of coronary artery stenosis had no significant influence on the sensitivity for detecting significant stenosis. CONCLUSION. Forty- and 64-MDCT provide good-to-excellent performance in detecting or ruling out significant coronary artery stenosis, with better results for proximal than for distal coronary artery segments.

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