Comparison of Electron Beam Computed Tomographic Coronary Angiography and Selective Coronary Angiography for Segmental Analysis of Coronary Artery Stenosis

[Objective]By comparing intravenous coronary angiography using electron beam computed tomography (EBCT) and selective coronary angiography, to investigate the segmental differences of EBCT coronary angiography for analysis of significant coronary stenosis. [Methods] Intravenous EBCT and selective coronary angiography were performed during the same period in 38 patients. The value of EBCT angiography for identifying and localizing significant coronary artery stenosis was evaluated on a segmental basis. [Results] Of the 332 segments assessable by selective coronary angiography, 264 (79.5%) were visualized and technically adequate to evaluate by EBCT angiography. Significantly more segments in the left main and left anterior descending coronary arteries were adequately visualized than in the left circumflex and right coronary arteries (P 0.05 or 0.01). Significantly more proximal segments were adequately visualized than distal segments (P 0.05 or 0.01). The sensitivity, specificity, accuracy, positive and negative predictive value of EBCT angiography for segmental coronary stenosis were 81.0%, 95.9%, 93.6%, 79.1% and 96.4%, respectively. [Conclusion] Intravenous electron beam computed tomographic coronary angiography may be used for evaluating segmental coronary stenosis. Its diagnostic accuracy is significantly higher in the left main and left anterior descending coronary artery and the proximal segments, but it is influenced by the coronary artery anatomy and vessel size.