Comparison of 128-slice dual source CT coronary angiography with invasive coronary angiography

Abstract

Background: Coronary artery disease (CAD) is one of the leading cause of the morbidity and mortality in India as well as worldwide & last decade has seen a steep rise in incidence of CAD in India. Direct visualization of the coronary arteries by invasive catheterization still represents the cornerstone of the evaluation of coronary artery disease. Cardiac imaging is a challenge of 21st century and is being answered by 128 slice dual source CT as it has good temporal resolution, high scanning speed as well as low radiation dose. Aim: To assess the diagnostic accuracy of 128-slice dual source CT Cardiac Angiography in comparison with Conventional Catheter Cardiac Angiography. Materials and Methods: Forty patients attending the cardiology OPD with complaint of chest pain and suspected of having coronary artery disease (CAD) were evaluated by CT coronary angiography and conventional invasive Catheter coronary angiography and the results were compared. All patients were checked for serum creatinine and ECG before the angiography. Computed Tomography (CT) coronary angiography was done using SIEMENS 128- slice Dual Source Flash Definition CT Scanner under either Retrospective or Prospective mode depending on the heart rate of the patient. Oral/ IV beta-blocker were used whenever required. Results: Coronary arteries were assessed as per 17- segment AHA model. A total of 600/ 609 segments were evaluable in 40 suspected patients on CT coronary angiography, of which 21 were false positives and 8 were false negatives with specificity of 95.12% and sensitivity and positive predictive value of 95.26% & 88.46% respectively. Conclusion: Non-invasive assessment of coronary artery disease is now possible with high accuracy on 128-slice dual source CT scanner.