Follow-up of coronary artery bypass graft patency: diagnostic efficiency of high-pitch dual-source 256-slice MDCT findings

J Comput Assist Tomogr. 2014 Jan-Feb;38(1):61-6. doi: 10.1097/RCT.0b013e3182a58a8c.

Abstract

Objectives: Our aim was to evaluate the diagnostic accuracy of 256-slice, high-pitch mode multidetector computed tomography (MDCT) for coronary artery bypass graft (CABG) patency.

Methods: Eighty-eight patients underwent 256-slice MDCT angiography to evaluate their graft patency after CABG surgery using a prospectively synchronized electrocardiogram in the high-pitch spiral acquisition mode. Effective radiation doses were calculated. We investigated the diagnostic accuracy of high-pitch, low-dose, prospective, electrocardiogram-triggering, dual-source MDCT for CABG patency compared with catheter coronary angiography imaging findings.

Results: A total of 215 grafts and 645 vessel segments were analyzed. All graft segments had diagnostic image quality. The proximal and middle graft segments had significantly (P < 0.05) better mean image quality scores (1.18 ± 0.4) than the distal segments (1.31 ± 0.5). Using catheter coronary angiography as the reference standard, high-pitch MDCT had the following sensitivity, specificity, positive predictive value, and negative predictive value of per-segment analysis for detecting graft patency: 97.1%, 99.6%, 94.4%, and 99.8%, respectively.

Conclusions: In conclusion, MDCT can be used noninvasively with a lower radiation dose for the assessment of restenosis in CABG patients.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cardiac-Gated Imaging Techniques
  • Coronary Angiography
  • Coronary Artery Bypass*
  • Electrocardiography
  • Female
  • Follow-Up Studies
  • Heart Rate / physiology
  • Humans
  • Male
  • Middle Aged
  • Multidetector Computed Tomography / methods*
  • Predictive Value of Tests
  • Radiation Dosage
  • Radiographic Image Interpretation, Computer-Assisted
  • Sensitivity and Specificity
  • Vascular Patency*