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Diagnostic Accuracy of Dual-Source 64-Slice Multidetector Computed Tomography in Evaluation of Coronary Artery Bypass Grafts
  1. Levent Şahiner, MD*,
  2. Uğur Canpolat, MD*,
  3. Hikmet Yorgun, MD,
  4. Tuncay Hazırolan, MD,
  5. Muşturay Karçaaltıncaba, MD,
  6. Hamza Sunman, MD*,
  7. Ergün Barış Kaya, MD*,
  8. Kudret Aytemir, MD, FESC*,
  9. Ali Oto, MD, FESC, FACC, FHRS*
  1. From the *Department of Cardiology, Hacettepe University, Ankara; †Develi State Hospital, Kayseri; and ‡Department of Radiology, Hacettepe University, Ankara, Turkey.
  1. Received May 6, 2012, and in revised form June 10, 2012.
  2. Accepted for publication July 3, 2012.
  3. Reprints: Uğur Canpolat, MD, Department of Cardiology, Hacettepe University Faculty of Medicine, Altındağ 06100, Ankara, Turkey. E-mail: dru_canpolat{at}yahoo.com.
  4. This study was not supported by any institution or grant.
  5. Authors have no conflict of interest.

Abstract

Background The aim of this study was to compare the diagnostic accuracy of 64-slice multidetector computed tomography (MDCT) with conventional coronary angiography to detect graft patency and stenosis.

Methods In this retrospective analysis, we included a total of 284 subjects (210 men, 73.9%; mean ± SD age, 62.6 ± 9.9) and evaluated 684 bypass grafts using a dual-source 64-slice MDCT scanner The mean ± SD time interval between coronary artery bypass grafting operation and MDCT was 30.8 ± 6.2 months. The mean ± SD interval between MDCT angiography and conventional coronary angiography was 14.2 ± 3.6 days. Significant stenosis was defined as lesions causing 50% or greater luminal narrowing. All atherosclerotic lesion components were assessed on per-segment basis.

Results All of the 684 grafts (420 venous and 264 arterial grafts) were evaluable and included in the analysis. For the detection of 50% or greater graft stenosis, the sensitivity, specificity, positive predictive value and negative predictive value of MDCT was 98.3%, 99.3%, 98.3%, and 99.3% for venous grafts and 100%, 99.5%, 98.0%, and 100% for arterial grafts. In detection of graft patency, the sensitivity, specificity, positive predictive value, and negative predictive value of MDCT was 99.6%, 97.2%, 99.0%, and 99.0% for venous grafts and 99.5%, 97.5%, 99.5%, and 97.5% for arterial grafts. Diagnostic accuracy for the detection of graft patency was 99% (416/420) and 99.2% (262/264) for venous and arterial grafts, respectively.

Conclusion The diagnostic accuracy of dual-source 64-slice MDCT angiography for evaluating coronary artery bypass grafts patency and stenosis was high. Dual-source 64-slice MDCT can be used for the evaluation of patients after coronary artery bypass grafting.

Key Words
  • coronary artery bypass graft
  • multidetector computed tomography

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