Myungsoo Lee MD, Presenter: Nothing to Disclose

Byoung Wook Choi MD, Abstract Co-Author: Nothing to Disclose

Na-Young Shin MD, Abstract Co-Author: Nothing to Disclose

Young-Jin Kim, Abstract Co-Author: Nothing to Disclose

Jin Hur, Abstract Co-Author: Nothing to Disclose

Kyu Ok Choe MD, Abstract Co-Author: Nothing to Disclose

Even though coronary CT angiography with 64-slice computed tomography (CT) is very accurate in diagnosing coronary artery occlusive disease, most patients who are diagnosed as having critical coronary artery disease with CT take invasive coronary angiography (CAG), then if indicated, undergo coronary artery bypass graft surgery (CABG). We focused on accuracy of CT for detecting three-vessel disease, which is one of potential candidates for CABG.

We enrolled a total of 90 patients, who were composed of consecutive 30 patients who were diagnosed as having significant stenosis (more than 50% narrowing in diameter) of any one major epicardial coronary artery with 64-slice CT, 30 who having significant stenoses of any two coronary arteries, and 30 who having significant stenoses of three coronary arteries. All patients underwent invasive coronary arteriography (CAG). We calculated accuracy of CT for detection of three-vessel disease considering CAG as standard of reference.

CAG revealed no significant stenosis in 11 patients, 1-vessel disease in 19, 2-vessel disease in 26, and 3-vessel disease in 34. With CAG, three-vessel disease was diagnosed in 1 patient who was diagnosed as 1-vessel disease with CT and in 4 who diagnosed as 2-vessel disease with CT, and in 29 who diagnosed as 3-vessel disease with CT. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of CT for detecting 3-vessel disease were 85.3%, 98.2%, 93.3%, 96.7%, and 91.7%, respectively. In 6-month follow-up, 13 patients with 3-vessel disease underwent CABG.

Coronary CT angiography with 64-slice CT is highly accurate to diagnose three-vessel coronary artery disease. In selected patients with three-vessel disease, CABG could be performed without preoperative invasive coronary arteriography.

Coronary CT Angiography is highly accurate to diagnose three-vessel coronary artery disease, which are potential candidates for coronary artery bypass graft surgery.

Lee, M, Choi, B, Shin, N, Kim, Y, Hur, J, Choe, K, Diagnostic Accuracy of 64-slice Computed Tomography in Detecting Three-Vessel Coronary Artery Disease: Potential Candidates for Coronary Artery Bypass Graft Surgery.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5015486.html