64层螺旋CT诊断冠状动脉不同程度狭窄的临床价值

目的 用传统的冠状动脉造影作对照,评价64层螺旋CT诊断冠状动脉不同程度狭窄的准确性与一致性.方法 78例患者临床怀疑冠心病并同期接受64层螺旋CT冠状动脉成像及常规冠状动脉造影,计算64层螺旋CT检测冠状动脉严重狭窄(管腔狭窄＞75%)、中等度狭窄(管腔狭窄＞50%)和轻度狭窄(管腔狭窄≤50%)的敏感性、特异性、阳性预测值、阴性预测值.按图像质量(4分法)对冠状动脉节段进行分组,探讨图像质量对64层螺旋CT诊断冠状动脉狭窄的影响.定性与定量比较64层螺旋CT与QCA诊断冠状动脉狭窄的一致性.结果 64层螺旋CT检测冠状动脉狭窄总体敏感性、特异性、阳性预测值、阴性预测值分别为:93.4%、97.9%、88.3%、98.9%.诊断严重、中等度及轻度冠状动脉狭窄的敏感性为81%、59%、75%,特异性为98%.64层螺旋CT能够显示的冠状动脉节段有999段,图像质量为4分的有17段.64层螺旋CT与QCA诊断冠状动脉狭窄一致性的Kappa值=0.7856,P<0.01,两者一致性有统计学意义.相关系数r=0.661,P<0.01,具有正相关关系.结论 64层螺旋CT是一种有效的无创性的检测冠状动脉狭窄的工具.其与QCA诊断冠状动脉不同程度狭窄具有正相关关系.     

16层CT显示冠状动脉狭窄与导管法造影的对照研究

目的:评价16层CT在显示冠状动脉狭窄中的价值和限度。方法:55例临床诊断或可疑冠心病的患者做16层CT冠状动脉成像检查(回顾性心电门控、0.5s螺旋扫描、单或双扇区重建算法和静脉注射对比剂),其检查结果与导管法冠状动脉造影对照。结果:在55例患者冠状动脉的568节段(血管直径≥2mm)中,CT图像能够满足管腔评价者为492节段(占86.6%),其中16层CT显示中度或中度以上狭窄(≥50%)的敏感度和特异度分别为87.5%和97.2%,阳性和阴性预测值分别为82.4%和98.1%;16层CT显示高度狭窄(≥75%)的敏感度和特异度分别为91.6%和98.7%,阳性和阴性预测值分别为 84. 6%和 99. 3%。结论:如果冠状动脉 CT 图像能够满足管腔评价, 16 层 CT 显示冠状动脉狭窄(≥50%)的准确性很高。在冠状动脉中、高度狭窄的初步诊断以及介入治疗的筛选方面,16 层 CT可以部分取代传统的导管法冠状动脉造影。     

64层螺旋CT冠状动脉成像与冠状动脉造影的对比研究

目的 评价64层螺旋CT冠状动脉造影对冠状动脉疾病的临床诊断价值.方法 59例临床诊断或可疑冠心病患者行64层螺旋CT冠状动脉成像检查,并以冠状动脉造影结果作为对照,分段评价结果,冠状动脉狭窄≥50%为阳性病变.分析64层螺旋CT冠状动脉血管成像(CTA)诊断冠状动脉狭窄的敏感性、特异性、阳性预测值及阴性预测值.结果 共评价741段冠状动脉,64层螺旋CT冠状动脉血管成像用于诊断冠心病的敏感性、特异性、阳性预测值、阴性预测值分别为58.8%、97.7%、76.9%、94.8%.结论 64层螺旋CT冠状动脉血管成像有较高的诊断准确性,可以作为评价冠状动脉狭窄的一种无创检查方法.     

64层螺旋CT冠状动脉成像诊断冠状动脉狭窄的初步探讨

目的：探讨64层螺旋CT（MSCT）冠状动脉成像对冠状动脉狭窄的诊断价值。方法：53例冠心病患者同期均行64层螺旋CT冠状动脉成像和常规冠状动脉造影（CCA）,以CCA的诊断结果作为金标准,采用美国心脏协会冠状动脉改良分段法,分析745个冠状动脉节段MSCT图像质量及对冠状动脉狭窄的显示情况,得出有意义病变（冠状动脉狭窄率≥500%）MSCT诊断的正确性,并分析钙化对其影响。结果：587个冠状动脉节段图像可以满足诊断要求,158个节段因运动伪影（27个节段）或管壁严重钙化（131个节段）无法进行血管评价。MSCT诊断冠状动脉狭窄的敏感度为93．4％、特异度为97．9％、阳性预测值为93．9％、阴性预测值为97．7％。钙化积分≥1000的患者,MSCT诊断冠状动脉狭窄的特异度、敏感度、阳性预测值、阴性预测值分别为74％、82％、68％、96％。结论：64层螺旋CT冠状动脉成像是一种快速、安全、无创的检查方法,与常规冠状动脉造影检查结果有较好的一致性,可以作为临床怀疑冠心病患者的首选检查方法。     

64层螺旋CT冠状动脉成像诊断冠状动脉疾病的临床应用

目的：探讨64层螺旋CT冠状动脉成像（64SCTCA）诊断冠状动脉中、重度狭窄（管腔直径≥50%）的临床应用价值。方法：收集140例患者64SCTCA的完整资料,依据AHA15段分段法,对有效节段进行评价,并以近期实施的选择性X线冠状动脉造影（CAG）结果为＂金标准＂进行对照分析,了解64SCTCA诊断冠状动脉中、重度狭窄的敏感性、特异性和准确度。结果：所有病例可用于评估的1360节段冠状动脉中,共显示病变284节段,其中272节段得到CAG证实,18节段64SCTCA显示中度狭窄而CAG显示仅为轻度狭窄,6节段64SCTCA显示正常或轻度狭窄而CAG显示中度狭窄,23节段重和中度狭窄的评估两者结果不一致,64SCTCA诊断冠状动脉中、重狭窄的敏感性为95.77%、特异性99.07%、准确度为98.68%。结论：64SCTCA是一种安全可靠且准确有效的冠状动脉检查方法,可作为临床进行CAG检查前的有效筛选手段。     

CT冠状动脉成像在冠心病诊断中的应用

目的:研究CT冠状动脉成像在冠心病早期诊断冠状动脉狭窄定性定量判读的作用。方法:对34例临床未发生急性冠脉综合征的冠心病患者,先后进行冠状动脉造影、128排双源CT冠状动脉成像。以冠状动脉造影为"金标准",计算CT冠状动脉成像敏感性、特异性、阳性预测值、阴性预测值。结果:①与冠状动脉造影相比,CT冠状动脉成像的敏感性为68%,特异性为97%,阳性预测值为89%,阴性预测值为90%。②CT冠状动脉成像有65个血管段图像质量差,约占12%,造成图像质量差的原因主要为钙化,心跳、呼吸伪影,少部分为管腔显示不良。结论:冠心病早期诊断中,CT冠状动脉成像可用作冠状动脉造影前筛选,CT冠状动脉成像阴性的患者不必行冠状动脉造影检查;CT冠状动脉成像阳性的患者,可行冠状动脉造影进一步确认病变。     

新型256层螺旋CT自由心率CCTA评价高心率冠状动脉狭窄患者诊断准确性

【摘要】目的：探讨新型256层螺旋CT自由心率下CCTA对高心率冠心病患者冠状动脉管腔狭窄程度的诊断准确性。方法：回顾性分析40例高心率（≥80bpm）冠心病患者,均采用自适应前瞻性心电门控且自由心率下扫描,均在CCTA检查3周内行冠状动脉造影（CGA）检查,且以CAG为金标准,计算其冠状动脉狭窄程度的敏感度、特异度、阳性预测值、阴性预测值及准确性,用Kappa检验对CCTA及CAG检测冠状动脉狭窄程度进行一致性分析。结果：40例患者共检出467个冠状动脉节段,其CCTA图像质量可诊断率达到98.93%,CAG与CCTA对诊断冠状动脉狭窄的一致性显著,kappa系数均>0.8;CCTA诊断冠状动脉狭窄节段的敏感度、特异度、阳性预测值、阴性预测值及准确度分别为96.80%、92.93%、90.30%、97.71%、94.50%,对中度狭窄、重度狭窄及闭塞的冠状动脉的诊断准确度分别为97.27%、99.03%、98.92%。结论：新型256层螺旋CT自由心率下CCTA对高心率冠心病患者冠状动脉管腔狭窄程度有较好的诊断准确性。     

64层螺旋CT冠状动脉血管成像与冠脉造影结果对照研究

目的:评价多层螺旋CT(MSCT)冠状动脉血管成像方法显示管腔≥50%狭窄的准确性,分析改善成像质量的方法.方法:对72例临床诊断或可疑冠心病的患者在心电门控下采用64层螺旋CT进行冠状动脉血管成像.其中56例在2周内行导管法冠状动脉造影.结果:本组56例与冠状动脉造影结果相对照,冠状动脉血管成像诊断≥50%血管狭窄的敏感性为91.5%,特异性为97.5%,阳性预测值为82.3%,阴性预测值为98.9%.结论:64层螺旋CT冠状动脉血管成像具有较高的敏感性和特异性,同时具有无创和简便的特点,可以作为临床对高危人群筛查的首选方法.     

40层螺旋CT冠状动脉造影诊断冠状动脉狭窄

目的:评价40层螺旋CT冠状动脉造影诊断冠状动脉明显狭窄的准确性和可行性.材料和方法:78例疑似冠心病患者在3周内进行40层CT冠状动脉造影及经皮选择性冠状动脉造影,以冠状动脉造影结果为金标准对照40层CT诊断冠状动脉主干及主要分支狭窄的准确性.结果:40层螺旋CT所显示的786支冠状动脉中狭窄61处,确诊52处、漏诊3处和误诊9处;敏感性94.5%,特异性98.7%;阳性预测值85.2%和阴性预测值99.5%.结论:40层螺旋CT对冠状动脉狭窄诊断有较高的准确性,可作为诊断冠状动脉狭窄的一种筛选手段.     

64层螺旋CT检测不同程度冠状动脉狭窄临床分析

目的：探索64层螺旋CT对冠脉管腔的可评价率和诊断不同程度冠脉狭窄的敏感性、特异性、阳性预测值和阴性预测值并进行比较。方法：将我院2006年1月～2008年7月经选择性冠状动脉造影（selective coronary angiography,SCA）对比的127例64层螺旋CT检测的冠脉狭窄患者的资料进行整理、统计、分析和对比。结果：冠脉管腔可评价率为95.6%。轻、中、重度冠脉狭窄的敏感性为85.9%、90.3%、95.3%（P〈0.05）;特异性为98.3%、99.0%、99.5%（P〈0.05）;阳性预测值为87.8%、91.6%、93.5%（P〉0.05）;阴性预测值为98.0%、99.0%、99.7%（P〈0.001）。结论：64层CT对冠脉管腔的可评价率高,对诊断轻、中、重度冠脉狭窄的敏感性、特异性、阳性预测值、阴性预测值均较高,且各百分率有随冠脉狭窄程度的增加而逐渐增高的趋势,并且发现排除性指标优于诊断性指标。     

64层螺旋CT冠状动脉造影对冠状动脉狭窄的诊断价值

目的：评价64层螺旋CT冠状动脉造影（64-slice CTCA）诊断冠状动脉狭窄的临床应用价值。方法：对120例临床怀疑冠状动脉疾病及支架置入术、冠脉搭桥术后的患者进行64层螺旋CT冠状动脉成像。采用回顾性心电门控扫描,并采用曲面重建、多平面重组,容积再现及最大密度投影技术显示冠状动脉主干及分支,其中30例患者近期行传统冠状动脉造影（CCA）。结果：120例患者可评价冠脉节段1377个,可满足诊断的冠脉节段1341个,占97．39％。30例患者近期行CCA检查,MSCTCA诊断冠脉狭窄节段103个与CCA相符,占88．03％,显示轻、中、重度狭窄及血管闭塞与CCA符合率分别为77．8％、93．3％、91．6％、77．8％,得出64SCTCA诊断冠脉狭窄敏感性97．52％,特异性96．02％,阳性预测值95．16％,阴性预测值96．01％。结论：64层螺旋CT冠状动脉造影在诊断冠状动脉疾病方面有很高的诊断价值,可以成为筛查、排除冠状动脉病变及支架、搭桥术后随访的常规检查方法。     

Diagnostic value of 64-slice CT angiography in coronary artery disease: a systematic review

PURPOSE: To perform a systematic review of the diagnostic value of 64-multislice CT (MSCT) angiography in the detection of coronary artery disease (CAD) when compared to conventional coronary angiography. MATERIALS AND METHODS: A search of PUBMED and MEDLINE databases for English literature was performed. Only studies with at least 10 patients comparing 64-slice MSCT angiography with conventional coronary angiography in the detection of CAD were included. Diagnostic value of MSCT angiography compared to coronary angiography was compared and analysed at segment-, vessel- and patient-based assessment. RESULTS: Fifteen studies met selection criteria and were included for analysis. Pooled sensitivity, specificity, positive predictive value and negative predictive value as well as 95% confidence interval (CI) were 97% (94 and 99%), 88% (79 and 97%), 94% (91 and 97%), and 95% (90 and 99%) for patient-based assessment; 92% (85 and 99%), 92% (85 and 99%), 78% (66 and 91%) and 98% (96 and 99%) for vessel-based assessment; 90% (85 and 94%), 96% (95 and 97%), 75%(68 and 82%) and 98% (98 and 99%) for segment-based assessment, respectively. No significant difference was found in the diagnostic accuracy of 64-slice CT in the detection of CAD when comparison was performed either among four main coronary arteries, or between proximal and middle or distal segments (p>0.05). CONCLUSION: Our results showed that 64-slice CT angiography has a high-diagnostic value in the detection of CAD. Severe coronary artery calcification seems to be the major factor affecting the visualisation and assessment.     

Intraindividual comparison of 3D coronary MR angiography and coronary CT angiography

RATIONALE AND OBJECTIVES: To compare the diagnostic value of magnetic resonance (MR) and computed tomography (CT) for the detection of coronary artery disease (CAD) with special regard to calcifications. MATERIALS AND METHODS: Twenty-seven patients with known CAD were examined with a targeted, navigator-gated, free-breathing, steady-state free precession MR angiography sequence (repetition time = 5.6 milliseconds, echo time = 2.8 milliseconds, flip angle 110 degrees ) and 16-slice coronary CT angiography. Segment-based sensitivity, specificity, and accuracy for the detection of stenoses larger than 50% were determined as defined by the gold standard catheter coronary angiography along with the subjective image quality (Grade 1-4). The degree of calcifications in each segment was quantified using a standard calcium scoring tool. RESULTS: Of 115 possible segments, 7% had to be excluded in MR imaging because of poor image quality. In CT, 3% were nondiagnostic because of image quality and 15% were not evaluable because of calcifications. Values for the detection of relevant coronary artery stenoses in the evaluated segments were: sensitivity: MR imaging 85% versus CT 96%; specificity: 88% versus 96%; accuracy: 87% versus. 96%. Average subjective image quality was 1.8 for MR imaging and 1.6 for CT. Of the 15% of segments that had to be excluded from CT evaluation because of calcifications, MR imaging provided the correct diagnosis segments in 67%. CONCLUSIONS: CT provided a better image quality with superior accuracy for the detection of CAD. Despite its overall inferiority, MR imaging proved to be helpful method in interpreting coronary stenosis in severely calcified segments.     

64排螺旋CT冠脉成像在冠心病诊断中的应用

目的 评价64排螺旋CT冠状动脉(冠脉)成像(CTA)在冠心病诊断中的应用价值.方法 以选择性冠脉造影(SCA)结果为金标准,采用64排螺旋CT对68例疑诊冠心病患者的冠脉主干及主要分支272节段进行重建和分析,评价其诊断冠心病的灵敏度和特异度.结果 CTA能够清晰显示冠脉主干及其分支狭窄、钙化、开口起源异常及桥血管病变,CTA发现钙化病变52节段,SCA仅发现钙化病变35节段.CTA诊断冠脉病变的灵敏度96.33%,特异度98.16%,阳性预测值97.22%,阴性预测值97.56%.其中对左主干、左前降支病变及＞75%的病变灵敏度最高,分别达到100%和94.4%.结论 CTA对冠脉狭窄病变、桥血管、开口畸形、支架管腔均显影良好,对冠心病诊断有较高的准确性,对钙化病变诊断率优于冠脉造影,可以作为冠心病高危人群无创性筛选检查及冠脉支架术后随访手段.     

Non-invasive evaluation of coronary artery stent patency with retrospectively ECG-gated 64-slice CT angiography

The aim of our study has been to evaluate the ability of 64-slice computed tomographic angiography (CTA) to assess coronary artery stent patency, relative to selective coronary angiography (SCA). Fifty-five consecutive patients (age range 45–80 years) with 97 previously implanted coronary artery stents underwent 64-slice CTA. The 55 patients comprised 40 subjects (group A) who were referred for follow-up SCA at a mean interval of 9.6 months after stent positioning, and 15 subjects (group B) in whom SCA was clinically indicated. Stent evaluation was performed independently by two blinded readers in terms of image quality and presence of in-stent restenosis (ISR; lumen obstruction of ≥50%). SCA was performed in 41/55 patients; 14 patients refused to undergo SCA after the 64-slice CTA exam. A total of 88 stents in 74 segments were analyzed. Twenty-one of the 74 stented segments were of poor image quality and were not considered for further analysis. Sixty-four-slice CTA detected 12/16 ISR (sensitivity: 75%) and ruled out ISR in 32/37 cases (specificity: 86%). Sixty-four-slice CTA is a valuable modality for follow-up of coronary artery stent patency only in selected patients. Appropriate candidates for follow-up 64-slice CTA should be established based on stent diameter, stent material and type as well as HR and heart rhythm. However, given the number of non-assessable segments, further work would appear necessary before 64-slice CTA can be considered a suitable procedure for broad clinical application in the evaluation of coronary artery stent patency.     

Diagnostic accuracy of 16-slice multidetector-row CT for detection of in-stent restenosis vs detection of stenosis in nonstented coronary arteries

The purpose of this study was to assess the diagnostic accuracy of 16-slice multidetector-row computed tomography (MDCT) for detecting in-stent restenosis. Fifty patients with 69 previously implanted coronary stents underwent 16-slice MDCT before quantitative coronary angiography (QCA). Diagnostic accuracy of MDCT for detection of in-stent restenosis defined as >50% lumen diameter stenosis (DS) in stented and nonstented coronary segments >1.5-mm diameter was computed using QCA as reference. According to QCA, 18/69 (25%) stented segments had restenosis. In addition, 33/518 (6.4%) nonstented segments had >50% DS. In-stent restenosis was correctly identified on MDCT images in 12/18 stents, and absence of restenosis was correctly identified in 50/51 stents. Stenosis in native coronary arteries was correctly identified in 22/33 segments and correctly excluded in 482/485 segments. Thus, sensitivity (67% vs 67% p=1.0), specificity (98% vs 99%, p=0.96) and overall diagnostic accuracy (90% vs 97%, p=0.68) was similarly high for detecting in-stent restenosis as for detecting stenosis in nonstented coronary segments. MDCT has similarly high diagnostic accuracy for detecting in-stent restenosis as for detecting coronary artery disease in nonstented segments. This suggests that MDCT could be clinically useful for identification of restenosis in patients after coronary stenting. Grant Funding: Dr Gerber was supported by a grant from the Fondation Nationale de la Recherche Scientifique of the Belgian Government (FRSM 3.4557.02).     

Diagnostic value of multislice computed tomography angiography in coronary artery disease: a meta-analysis

PURPOSE: To perform a meta-analysis of the diagnostic value of multislice CT (MSCT) angiography in the detection of coronary artery disease (CAD) when compared to conventional coronary angiography. MATERIALS AND METHODS: A search of PubMed and MEDLINE databases for English literature was performed. Only studies with at least 10 patients comparing MSCT angiography with conventional coronary angiography in the detection of CAD were included. Diagnostic value of MSCT angiography compared to coronary angiography was compared and analyzed at segment-, vessel- and patient-based assessment. RESULTS: 47 studies (67 comparisons) met the criteria and were included in our study. Pooled overall sensitivity, specificity and 95% confidence interval for MSCT angiography in the detection of CAD were 83% (79%, 89%), 93% (91%, 96%) at segment-based analysis; 90% (87%, 94%), 87% (80%, 93%) at vessel-based analysis; and 91% (88%, 95%), 86% (81%, 92%) at patient-based analysis, respectively. Diagnostic accuracy of MSCT angiography in evaluating assessable segments was significantly improved with 64-slice scanners when compared to that with 4- and 16-slice scanners (p<0.05). CONCLUSION: Our meta-analysis showed that MSCT angiography has potential diagnostic accuracy in the detection of CAD. Diagnostic performance of MSCT angiography has been significantly improved with the latest 64-slice CT, with resultant high qualitative and quantitative diagnostic accuracy. 16-slice CT was limited in spatial resolution which makes it difficult to perform quantitative assessment of coronary artery stenoses.     

Diagnostic accuracy of 64 multislice CT angiography in the assessment of coronary in-stent restenosis: A meta-analysis

Purpose

The aim of this study was to perform a meta-analysis of the diagnostic accuracy of 64-slice CT angiography for the detection of coronary in-stent restenosis in patients treated with coronary stents when compared to conventional coronary angiography.

Materials and methods

A search of PUBMED/MEDLINE, ProQuest and Cochrane library databases for English literature was performed. Only studies comparing 64-slice CT angiography with conventional coronary angiography for the detection of coronary in-stent restenosis (more than 50% stenosis) were included for analysis. Sensitivity and specificity estimates pooled across studies were tested using a fixed effects model.

Results

Fourteen studies met selection criteria for inclusion in the analysis. The mean value of assessable stents was 89%. Prevalence of in-stent restenosis following coronary stenting was 20% among these studies. Pooled estimates of the sensitivity and specificity of overall 64-slice CT angiography for the detection of coronary in-stent restenosis was 90% (95% CI: 86%, 94%) and 91% (95% CI: 90%, 93%), respectively, based on the evaluation of assessable stents. Diagnostic value of 64-slice CT angiography was found to decrease significantly when the analysis was performed with inclusion of nonassessable segments in five studies, with pooled sensitivity and specificity being 79% (95% CI: 68%, 88%) and 81% (95% CI: 77%, 84%). Stent diameter is the main factor affecting the diagnostic value of 64-slice CT angiography.

Conclusion

Our results showed that 64-slice CT angiography has high diagnostic value (both sensitivity and specificity) for detection of coronary in-stent restenosis based on assessable segments when compared to conventional coronary angiography.     

Forty-slice spiral computed tomography of the coronary arteries: assessment of image quality and diagnostic accuracy in a non-selected patient population

PURPOSE: To investigate prospectively the image quality and diagnostic accuracy of 40-slice computed tomography (CT) for the detection of hemodynamically significant coronary artery disease (CAD) in a non-selected, consecutive patient cohort. MATERIAL AND METHODS: Forty consecutive patients (28 men, 12 women) underwent both 40-slice CT and conventional invasive coronary angiography (ICA) within 10+/-7 days. The results of both methods were compared on a per-segment and per-patient basis, using ICA as the standard of reference. RESULTS: According to ICA, significant CAD was present in 30/40 patients (75%). Of a total of 545 segments, 43 segments (7.9%) could not be sufficiently evaluated by CT due to motion artifacts in 15 segments (34.9%), small vessel size and suboptimal contrast enhancement in 14 segments (32.6%), severe calcification in 10 segments (23.3%), and opacified adjacent structures such as cardiac veins in four segments (9.3%). Segment-based analysis for detection of significant stenosis >50% yielded an overall sensitivity, specificity, positive predictive value, and negative predictive value of 87%, 99%, 98%, and 95%, respectively. Restricting the assessment to clinically relevant proximal coronary segments led to an increase in sensitivity to 96%, specificity to 99%, and negative predictive value to 99%. Patient-based analysis demonstrated a high negative predictive value (91%) of CT for excluding significant CAD, even when all segments were included in the analysis. CONCLUSION: In a non-selected patient population with a high prevalence of CAD, 40-slice CT demonstrates high diagnostic accuracy in the assessment of significant CAD per patient and per segment.     

Dual source computed tomography coronary angiography in new onset cardiomyopathy

AIM:To evaluate safety and utility of coronary computed tomography angiography(CCTA) compared to invasive coronary angiography(ICA) in new cardiomyopathy.METHODS:Eighteen patients(mean age 56.5 years,10 males) who presented for evaluation of new onset heart failure with evidence of systolic dysfunction(ejection fraction < 40%) on echocardiography and recent ICA were prospectively enrolled.Patients with known coronary artery disease,atrial fibrillation,creatinine > 1.5 g/dL,and contraindication to intravenous contrast administration were excluded.CCTA was performed using a dual source 64-slice scanner.Mean heart rate was 75 beats per minute.Stenosis was graded for each coronary segment as:none,mild(< 50%),moderate(50%-70%),severe(> 70%),or non-evaluable.Ischemic cardiomyopathy(ICM) was diagnosed if severe stenosis was present in the left main,proximal left anterior descending artery,or two or more major arteries.RESULTS:Two patients were diagnosed with ICM by ICA.CCTA correctly identified 2 patients with ICM and 16 patients as non-ICM.CCTA successfully evaluated 240/246 coronary segments with an accuracy of 97.5%,sensitivity 70%,specificity 98.7%,positive predictive value of 70%,and negative predictive value of 98.7% for identifying severe stenosis on a per-segment level.CONCLUSION:Dual source 64-slice multi-detector CCTA is a safe,accurate,and non-invasive technique for diagnosing ICM in patients presenting during the acute phase of newly diagnosed cardiomyopathy.