Diagnostic Accuracy of Noninvasive Coronary Angiography Using 64-Slice Spiral Computed Tomography
Gilbert L. Raff, MD, FACC*,
Michael J. Gallagher, MD,
William W. O'Neill, MD, FACC and
James A. Goldstein, MD, FACC
Cardiology Division, William Beaumont Hospital, Royal Oak, Michigan
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Figure 1 Visualization of soft and hard coronary atherosclerotic plaques by 64-slice multislice computed tomography (MSCT). (A, B) Volume rendering technique demonstrates stenosis of right coronary artery below the acute marginal branch (A), as well as nodular coronary calcifications largely extrinsic to the right coronary lumen and (B) normal left coronary artery. (C, D) Maximum-intensity projection of the same arteries demonstrates severe soft plaque stenosis of the right coronary artery and superficial calcific plaque. (E, F) Invasive coronary angiography of the same arteries.
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Figure 2 (A) Correlation between maximum percent diameter stenosis by quantitative analysis of multislice computed tomography (MSCT) compared with quantitative coronary angiography (QCA). The Spearman correlation showed an R value of 0.76, p < 0.0001, n = 130. (B) Bland-Altman analysis of the differences of percent diameter stenosis measured by MSCT and QCA compared to the average percent diameter stenosis by the two methods. The mean difference was 1.3 ± 14.0% (central line). A total of 94% (122 of 130) of the values lie within 1.96 SDs of the mean (outer lines). A total of 90% (119 of 130) of the observations were within one qualitative stenosis score (25%) of the mean difference. There was no significant correlation between stenosis difference and stenosis severity (Spearman correlation coefficient = –0.07, p = 0.59).
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