Document Detail


Diagnostic performance of 16- and 64-section spiral CT for coronary artery bypass graft assessment: meta-analysis.
MedLine Citation:
PMID:  18403629     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 chi(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.
Authors:
Michèle Hamon; Olivier Lepage; Patrizia Malagutti; John W Riddell; Rémy Morello; Denis Agostini; Martial Hamon
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Publication Detail:
Type:  Journal Article; Meta-Analysis     Date:  2008-04-10
Journal Detail:
Title:  Radiology     Volume:  247     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-19     Completed Date:  2008-06-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  679-86     Citation Subset:  AIM; IM    
Copyright Information:
(c) RSNA, 2008.
Affiliation:
Departments of Radiology, University Hospital of Caen, Avenue Côte de Nacre 14033 Caen, Normandy, France. hamon-mi@chu-caen.fr
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MeSH Terms
Descriptor/Qualifier:
Chi-Square Distribution
Coronary Angiography
Coronary Artery Bypass*
Coronary Artery Disease / radiography*,  surgery*
Humans
Postoperative Complications / radiography
Predictive Value of Tests
Sensitivity and Specificity
Tomography, Spiral Computed / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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