Dual-source CT coronary angiography without heart rate or rhythm control in comparison with conventional coronary angiography

To explore the value of dual-source CT angiography (DSCTA) in diagnosing coronary artery stenosis (CAS) without heart rate or rhythm control. Eighty-nine patients with different heart rates/rhythms underwent both DSCTA and conventional coronary angiography (CCA) in 1 week. The diagnostic quality of normal coronary arteries and stenosed segments using DSCTA and CCA were analyzed, respectively, with CCA as the gold standard. Kappa test was used to assess the intermodality agreement between DSCTA and CCA in grading CAS. The value of DSCTA in diagnosing CAS (>50% stenoses) were analyzed as well. The total evaluable rate of DSCTA in detecting coronary arteries was 98.8%. No significant difference between evaluable rates from different groups of heart rate (χ2 = 1.745, P > 0.05) was found. Sensitivity, specificity, positive and negative predictive values of DSCTA in detecting CAS and >50% stenoses were 97.9, 96.8, 89.5, 99.4 and 97.2, 95.5, 80.3, 99.4%, respectively; The inter-modality agreement between DSCTA and CCA in grading CAS was found to be excellent (k = 0.856, P < 0.01). DSCTA provides high accuracy and reliability for evaluation of CAS in a high suspected patient group without heart rate/rhythm control. It can be used as a powerful primary tool for the detection of CAS and a potential substitute of CCA.