Diagnostic value of dual-energy CT (DECT) to coronary artery stenosis and ischemic cardiomyopathy

Liu Zheng; Li Hai-jun; WANG Ai-guo; ZHANG Li-jia; ZHANG Lei

doi:10.3969/j.issn.1674-4055.2016.06.21

Abstract：Objective To review the value of dual-energy CT (DECT) to coronary artery stenosis and ischemic cardiomyopathy by using receiver operating characteristic curve (ROC).Methods CHD patients (n=70, male 48, female 22, aged from 51 to 78 and average age=61.8±7.2) were chosen from Jan. 2011 and Oct. 2013. The patients accepted successively DECT and coronary angiography (CAG), and 40 of 70 patients were given SPECT stress-rest myocardial perfusion imaging (MPI) 2 w after DECT. The outcomes of CAG (stenosis≥50% and stenosis≥75%) were taken as gold standard, and sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and correct index of DECT in diagnosis of coronary artery stenosis and ischemic cardiomyopathy were calculated.Results①When the outcome of CAG were stenosis≥50% and stenosis≥75%, the sensitivity of DECT in diagnosis of coronary artery stenosis was, respectively, 74.19% (92/124) and 81.52% (75/92), specificity was 90.26% (139/154) and 93.01%(173/186), PPV was 85.98% (92/107) and 85.22% (75/88), NPV was 81.29% (139/171) and 91.05% (173/190), and correct index was 83.09% (231/278) and 89.21% (248/278). The area under curve (AUC) of ROC was, respectively, 0.82 and 0.87, andZ=13.96 andZ=16.64 (AllP<0.001). ②The comparison in outcomes of DECT and SPECT MPI showed that the sensitivity of DECT in diagnosis of ischemic cardiomyopathy was 90.00%, specificity was 80.00%, PPV was 49.09%, NPV was 97.39%, correct index was 81.76%, AUC=0.823 andZ=18.722 (P<0.001).Conclusion DECT has higher accuracy in diagnosis of coronary artery stenosis and ischemic cardiomyopathy, and can provide effective imaging evidence for clinical treatment.