Diagnosis of Dissection of the Coronary Artery Dissection by Multidetector Computed Tomography: A Comparative Study With Coronary Angiology.

OBJECTIVES: This study was to assess the diagnostic performance of multidetector computed tomography (MDCT) angiographic protocol for dissection of the coronary artery (DCA) detection compared with coronary angiology (CAG).

METHODS: Intravascular ultrasound was used as the gold standard for DCA diagnosis. Thirty-six DCA patients and 34 non-DCA (control) participants were retrospectively reviewed. The CAG and MDCT angiography images were separately reviewed by 4 independent observers, and a 5-point grading scale was used for DCA diagnosis. Diagnostic performance was compared using receiver operating characteristic analysis. Sensitivity, specificity, and negative predictive values were calculated.

RESULTS: The MDCT performed significantly better than that of CAG (AZ = 0.9943 ± 0.0034 vs AZ = 0.8411 ± 0.0274, respectively) for DCA detection. The sensitivity (98.6%), specificity (89.7%), and negative predictive value (98.4%) of MDCT for DCA were higher than those of CAG (77.8%, 79.4%, and 77.1%, respectively).

CONCLUSIONS: Multidetector computed tomography angiography was a more sensitive and specific technique for the diagnosis of DCA compared with CAG.