Prediction of coronary stenosis by computed tomography

To investigate whether coronary stenosis is detectable noninvasively, we correlated coronary calcification findings obtained by computed tomography (CT) with coronary angiographic (CAG) findings in 59 consecutive patients including 35 with angina pectoris or myocardial infarction. Their mean age was 50.4 years and 83 % were men. CT scans without contrast enhancement (3 sec scan time) were obtained at 1 cm thickness from the ascending aorta to cardiac apex to identify calcification in coronary arteries. CAG revealed coronary stenosis in 33 patients, and stenosis was present more often in the calcified vessels as determined by CT. The overall correlative evaluation of CT was as follows. Sensitivity LAD: 74 %, RCA: 78 %, LCX: 33 %. Specificity LAD: 82 %, RCA: 88 %, LCX: 100 %. Predictive value LAD: 82 %, RCA: 78 %, LCX: 100 %. Calcification occurred more often in 2 or 3 vessels of the stenotic cases. However stenotic segments were not always calcified. We conclude that CT is sensitive in detecting stenosis and an important method for the diagnosis of coronary artery diseases. (author)