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Follow-Up of Coronary Artery Bypass Graft Patency: Diagnostic Efficiency of High-Pitch Dual-Source 256-Slice MDCT Findings

Yuceler, Zeyneb MD,; Kantarci, Mecit MD, PhD,; Yuce, Ihsan MD,; Kizrak, Yesim MD,; Bayraktutan, Ummugulsum MD,; Ogul, Hayri MD,; Kiris, Adem MD,*; Celik, Omer §; Pirimoglu, Berhan MD,; Genc, Berhan MD,; Gundogdu, Fuat MD,

Journal of Computer Assisted Tomography: January/February 2014 - Volume 38 - Issue 1 - p 61–66
doi: 10.1097/RCT.0b013e3182a58a8c
Cardiovascular Imaging

Objectives: Our aim was to evaluate the diagnostic accuracy of 256-slice, high-pitch mode multidetector computed tomography (MDCT) for coronary artery bypass graft (CABG) patency.

Methods: Eighty-eight patients underwent 256-slice MDCT angiography to evaluate their graft patency after CABG surgery using a prospectively synchronized electrocardiogram in the high-pitch spiral acquisition mode. Effective radiation doses were calculated. We investigated the diagnostic accuracy of high-pitch, low-dose, prospective, electrocardiogram-triggering, dual-source MDCT for CABG patency compared with catheter coronary angiography imaging findings.

Results: A total of 215 grafts and 645 vessel segments were analyzed. All graft segments had diagnostic image quality. The proximal and middle graft segments had significantly (P < 0.05) better mean image quality scores (1.18 ± 0.4) than the distal segments (1.31 ± 0.5). Using catheter coronary angiography as the reference standard, high-pitch MDCT had the following sensitivity, specificity, positive predictive value, and negative predictive value of per-segment analysis for detecting graft patency: 97.1%, 99.6%, 94.4%, and 99.8%, respectively.

Conclusions: In conclusion, MDCT can be used noninvasively with a lower radiation dose for the assessment of restenosis in CABG patients.

From the *Mehmet Akif Ersoy Training and Research Hospital, Department of Radiology, İstanbul; †Atatürk University, School of Medicine, Department of Radiology; and ‡Regional Training and Research Hospital, Department of Radiology, Erzurum;§Mehmet Akif Ersoy Training and Research Hospital, Department of Cardiology, İstanbul;∥Şifa University, School of Medicine, Department of Radiology, İzmir; and ¶Atatürk University, School of Medicine, Department of Cardiology, Erzurum, Turkey.

Received for publication April 25, 2013; accepted July 16, 2013.

Reprints: Mecit Kantarci, MD, PhD, Atatürk University, School of Medicine, Department of Radiology, 200 Evler Mah. 14. Sok No 5, Dadaskent, Erzurum, Turkey (e-mail: akkanrad@hotmail.com).

The authors declare no conflict of interest.

© 2014 by Lippincott Williams & Wilkins