Comparison of Multi-Detector Computed Tomography Coronary Angiography with Invasive Coronary Angiography in Patients with Coronary Artery Disease

Abstract

Aim: This study aimed to investigate the accuracy of multi-detector computed tomography (MDCT) coronary angiography via comparing with the invasive coronary angiography (ICA).
Material and Method: Sixty-three patients (42 male, 21 female) that presented with chest pain and underwent MDCT, followed by ICA within one month were evaluated. The age of the patients ranged from 35 to 75 years. The coronary arteries were examined over a total of 15 segments according to American Heart Association classification. The detected stenoses of coronary artery were divided into four groups; non-obstructive (1-49%), significant stenosis (50-74%), high-grade stenosis (75-99%), and occlusion (100%). Segment-based and patient-based analyses were performed. The results of MDCT coronary angiography and ICA were compared. The sensitivity, specificity, positive predictive and negative predictive values were calculated by comparing the MDCT coronary angiography and ICA data.
Results: In the segment-based analysis, regardless of the stenosis rate, the sensitivity was 90.8%, specificity was 95%, positive predictive value was 82.7% and negative predictive value was 97.5%. In the segment-based analysis regarding the detection of ≥ 50% stenosis, the sensitivity specificity, positive predictive and negative predictive values were 89.6%, 95.9%, 59.0%, and 99.2%, respectively. In the patient-based analysis regarding the detection of ≥ 50% stenosis, the sensitivity was 96.2%, specificity was 66.6%, positive predictive value was 68.4%, and negative predictive value was 96%.
Conclusion: MDCT coronary angiography is an examination that can be used as a non-invasive method for patients in the low and medium risk group for coronary artery disease.

Keywords

• Multi-detector computed tomography
• invasive coronary angiography
• coronary artery disease

Koroner Arter Hastalığı Olan Hastalarda Çok Dedektörlü Bilgisayarlı Tomografi Koroner Anjiografi ile İnvaziv Koroner Anjiografinin Karşılaştırılması

Öz

Amaç: Bu çalışma, çok dedektörlü bilgisayarlı tomografi (ÇDBT) koroner anjiyografinin doğruluğunu, invazif koroner anjiyografi (İKA) ile karşılaştırarak incelemeyi amaçladı.
Materyal ve Metot: Göğüs ağrısı ile başvurup ÇDBT koroner anjiografi çekilen ve bunu takiben bir ay içerisinde İKA yapılan hastalar çalışmaya alındı. Çalışma grubumuzda yaşları 35-75 arasında değişen 42’si erkek, 21’i kadın toplam 63 hasta vardı. Koroner arterler American Heart Association sınıflamasına göre toplam 15 segment üzerinden incelendi. Tespit edilen koroner arter stenozları 4 gruba ayrıldı; non-obstrüktif (%1–49), anlamlı stenoz (%50–74), yüksek dereceli stenoz (%75–99) ve oklüzyon (%100). ÇDBT sonuçları İKA ile karşılaştırılarak segment bazlı ve hasta bazlı analizler yapıldı. Elde ettiğimiz veriler İKA sonuçları ile kıyaslanarak sensivite, spesifite, pozitif prediktif değer ve negatif prediktif değerleri hesaplandı.
Bulgular: Çalışmamızda segment bazlı analizde stenoz oranlarına bakılmaksızın yapılan değerlendirmede sensitivite %91.5, spesifite %95, pozitif prediktif değer %84.7 ve negatif prediktif değer %97.4, segment bazlı ≥ %50 stenozları saptamada sensitivite %89.6, spesifite %95.9, pozitif prediktif değer %59.0 ve negatif prediktif değer %99.2, hasta bazlı değerlendirmelerimizde ≥ %50 stenoz tespit etmede sensitivite %96.2, spesifite %66.6, pozitif prediktif değer %68.4 ve negatif prediktif değeri %96 bulduk.
Sonuç: ÇDBT koroner anjiografi, koroner arter hastalığı açısından düşük ve orta risk grubunda yer alan hastalarda non-invaziv bir yöntem olarak kullanılabilir bir tetkiktir.

Anahtar Kelimeler

• Multi-dedektör bilgisayarlı tomografi
• invaziv koroner anjiografi
• koroner arter hastalığı

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