HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text All Versions of this Article: 2473071132v1 247/3/679    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Hamon, M. Articles by Hamon, M. PubMed PubMed Citation Articles by Hamon, M. Articles by Hamon, M.

Diagnostic Performance of 16- and 64-Section Spiral CT for Coronary Artery Bypass Graft Assessment: Meta-Analysis¹

¹ From the Departments of Radiology (Michèle Hamon), Thoracic and Cardiovascular Surgery (O.L.), Nuclear Medicine (D.A.), Cardiology (J.W.R., Martial H.) and Statistics (R.M.), University Hospital of Caen, Avenue Côte de Nacre 14033 Caen, Normandy, France; INSERM 744, Institut Pasteur de Lille, Lille, France (Martial H.); and Department of Cardiology, S. Anna Hospital, Ferrara, Italy (P.M.). Received June 28, 2007; revision requested August 30; revision received October 29; accepted January 4, 2008; final version accepted January 16. Address correspondence to Michèle H. (e-mail: hamon-mi{at}chu-caen.fr).

Purpose: To perform a meta-analysis to evaluate the accuracy of 16- and 64-section spiral computed tomography (CT) to help assess coronary artery bypass grafts (CABGs).

Materials and Methods: The MEDLINE, Cochrane library, and BioMed Central databases were searched for relevant original articles published up to May 2007. Major criteria for article inclusion were that it (a) used multisection CT as a diagnostic test for the assessment of significant lesions (occlusion or >50% stenosis) of CABG, (b) used a 16- or 64-section scanner, and (c) used coronary angiography as the reference standard. After data extraction, the analysis was performed according to a random-effects model. Between-study statistical heterogeneity was also assessed by using the Cochran Q ² test.

Results: Of 158 screened articles, 15 fulfilled all inclusion criteria. Graft assessability (including distal anastomosis) ranged from 78%–100% among all included studies (mean, 92.4%; 90% with 16- and 96% with 64-section CT; P < .001). Statistical heterogeneity was observed for specificity and positive likelihood ratio (LR), justifying the use of the random-effects model. The analysis, pooled from 15 studies (723 patients, 2023 CABGs), provided the following results for the assessment of graft obstruction (occlusion and >50% stenosis): sensitivity, 97.6% (95% confidence interval [CI]: 96%, 98.6%); specificity, 96.7% (95% CI: 95.6%, 97.5%); positive predictive value, 92.7% (95% CI: 90.5%, 94.6%); negative predictive value, 98.9% (95% CI: 98.2%, 99.4%); positive LR, 23.42 (95% CI: 13.69, 40.07); negative LR, 0.045 (95% CI: 0.028, 0.071); and diagnostic odds ratio, 780.32 (95% CI: 379.12, 1606.1).

Conclusion: Multisection CT provided high accuracy for the evaluation of CABG obstruction in assessable conduits, and might be used as a noninvasive tool for the evaluation of suspected graft dysfunction in patients who are at high risk for complications from coronary angiography.

© RSNA, 2008