Key result
64-slice CTCA detects significant coronary bifurcation lesions with ~96% sensitivity compared to invasive angiography.
Why the study?
Does 64-slice CTCA accurately detect and classify coronary bifurcation lesions compared to invasive coronary angiography in patients undergoing both procedures?
Cross-Sectional (n=323)
Does 64-slice CTCA accurately detect and classify coronary bifurcation lesions compared to invasive coronary angiography in patients undergoing both procedures?
64-slice CTCA demonstrates high diagnostic accuracy for the detection and classification of complex coronary bifurcation lesions compared to invasive angiography.
AIMS: To compare the performance of 64-slice computed tomography coronary angiography (CTCA) and invasive coronary angiography (ICA) in the detection and classification (according to the Medina system) of bifurcation lesions (BLs). METHODS AND RESULTS: We studied 323 consecutive patients undergoing 64-slice CTCA prior to ICA. All coronary segments >or=2 mm in diameter were evaluated for the presence of a significant (>or=50% diameter reduction on quantitative coronary angiography) BL. Evaluation of BL by CTCA included the assessment of significant lumen obstruction in both main and side branch vessels. Forty-one out of 43 patients (46/48 lesions) with significant BL were identified by CTCA. Excluding coronary segments with non-diagnostic image quality (5%), the sensitivity, specificity, and positive and negative predictive values of CTCA for detecting significant BL were 96, 99, and 85 and 99%, respectively. In 39 of these 41 patients, CTCA assessment was concordant with the Medina lesion classification on ICA. CONCLUSION: Sixty-four-slice CTCA allows accurate assessment of complex BL.
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Mieghem et al. (2007) conducted a cross-sectional in Coronary bifurcation lesions (n=323). 64-slice computed tomography coronary angiography (CTCA) vs. Invasive coronary angiography (ICA) was evaluated on Detection and classification of significant bifurcation lesions. 64-slice CTCA accurately detected significant coronary bifurcation lesions compared to invasive angiography, demonstrating 96% sensitivity, 99% specificity, 85% PPV, and 99% NPV.
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