Comparison of 16-multidetector computed tomography versus conventional coronary angiography in the detection of coronary artery disease : an initial experience from jordan

Abstract EN

Objective: To report our initial experience in evaluating the role of 16-slice multidetector computed tomography (MDCT) in the non-invasive detection of coronary artery disease. Methods: During a period of three months (between 15/12/2004 to 21/3/2005), 50 patients (39 M, 11 F; mean age 54 ±7.2 years) in sinus rhythm with stable angina pectoris scheduled for conventional coronary angiography, were examined with a 16-slice multidetector computed tomography (GE Medical systems, USA) which began working at King Hussein Medical Center at mid 2004.

Multiplanar reconstructions were made for all coronary artery segments with a diameter above 2mm.

A total of 14 coronary vessel segments were assessed in each patient with respect to image quality, presence and degree of coronary artery stenosis and the amount of coronary artery calcification. Results: Six hundred sixty three segments were studied (there were 46 significant lesions).

The images were classified as good, adequate and poor in 584 (88%), 37(5%) and 42(7%) segments respectively.

The sensitivity, specificity, positive and negative predictive value of MDCT for the detection of significant lesions were 82%, 97%, 71% and 98% respectively.

False negative results occurred in 10 segments, 6 of which were in the left circumflex coronary artery branch and mid right coronary artery.

The false positive segments were 19, 74% of these (n=14) were calcified. Conclusion: Multidetector computed tomography is sensitive and highly specific in the detection of coronary artery disease in patients with stable angina.

It is expected that using the new generation of 64-row scanners will get better results.