Impact of coronary calcium score on diagnostic accuracy of multislice computed tomography coronary angiography for detection of coronary artery disease

✍ Scribed by Gabija Pundziute; Joanne D. Schuijf; J. Wouter Jukema; Hildo J. Lamb; Albert de Roos; Ernst E. van der Wall; Jeroen J. Bax

• Publisher: Springer
• Year: 2007
• Tongue: English
• Weight: 211 KB
• Volume: 14
• Category: Article
• ISSN: 1071-3581
• DOI: 10.1016/j.nuclcard.2006.11.002

✦ Synopsis

Background:

The impact of the coronary calcium score on the diagnostic accuracy of multislice computed tomography (msct) to detect obstructive coronary stenoses remains controversial.

Methods and results:

We examined 41 patients (mean agatston score, 340 +/- 530 [range, 0-2546]) with coronary artery disease with 16-slice msct and 60 patients (mean agatston score, 446 +/- 877 [range, 0-6264]) with 64-slice msct. msct scans were analyzed with invasive coronary angiography (ca) as the standard of reference. lesions with luminal narrowing of 50% or greater were considered obstructive. in total, 9% and 2% of uninterpretable segments were excluded from analysis in patients examined with 16- and 64-slice msct, respectively. on a segment basis, the percentage of false-negative segments in the groups with agatston scores of 0 to 100, 101 to 400, and greater than 400 with 16-slice msct were 0%, 5.3%, and 2.9% (p = .0005), respectively; other comparisons of false-positive and false-negative segments were not significant. the sensitivity and specificity on a vessel and patient basis with 16- and 64-slice msct were not significantly different in different calcium score groups.

Conclusions:

A slight impact of coronary calcium was observed on the diagnostic accuracy of 16-slice msct ca on a segment basis, with no significant impact on a vessel and patient basis. no significant impact of coronary calcium was observed on the diagnostic accuracy of 64-slice msct ca on a segment, vessel, or patient basis.