Significant Coronary Artery Stenosis: Comparison on Per-Patient and Per-Vessel or Per-Segment Basis at 64-Section CT Angiography

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Abstract
Purpose: To prospectively evaluate the accuracy of 64-section computed tomographic (CT) coronary angiography for assessing significant stenosis on a global and segmental level, by using conventional coronary artery angiography as the reference standard. Materials and Methods: This study was HIPAA compliant and had local institutional review board approval. Patients gave informed consent. Patients suspected of having coronary artery disease (CAD) underwent both conventional coronary catheter angiography and contrast material–enhanced retrospectively electrocardiographically gated 64-section multi–detector row CT of the coronary arteries. Two experienced observers analyzed all CT scans for signs of CAD (stenosis of 0%, ≤49%, 50%–69%, 70%–99%, or 100%). Diagnostic accuracy of CT coronary angiography compared with that of conventional angiography was determined on a per-segment, per-vessel, and per-patient basis. No patients, vessels, or segments were excluded from analysis. Spearman correlation, cross tables...