Clinical experience regarding the diagnostic value of segment-by-segment coronary computed tomography angiography in comparison with that of invasive coronary angiography

节段性冠状动脉计算机断层扫描血管造影术与有创冠状动脉造影术在诊断价值方面的临床经验比较

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Abstract

OBJECTIVE: To compare the degree of coronary stenosis (≥ 50% luminal narrowing) determined by coronary computed tomography angiography (CCTA) with that determined by invasive coronary angiography (ICA), using segment-by-segment analysis. MATERIALS AND METHODS: This was a retrospective study of the records of patients who underwent CCTA and ICA between January 2014 and June 2018 at a general hospital in Brazil. Receiver operating characteristic curve analysis was applied, and the areas under the curve were used in order to assess the overall accuracy of the methods. RESULTS: The degree of coronary stenosis was evaluated in a total of 844 arterial segments. The diagnostic performance of CCTA was good, with a sensitivity of 82.3%, a specificity of 96.4%, and a negative predictive value of 97.7% (95% CI: 96.5-98.5). In the segment-by-segment analysis, CCTA had excellent accuracy for the left main coronary artery and for other segments. CONCLUSION: In clinical practice at general hospitals, CCTA appears to have diagnostic performance comparable to that of ICA.

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