Introduction The latest technological advances in Computer Tomography technology allow non-invasive coronary angiography imaging (CT-CA) providing a high dia- gnostic accuracy for the detection of coronary artery stenosis (1-17). With 64-slice CT scanners, the higher perfor- mance of x-ray source (tube) and sensitivity of the de- tectors result in an improved temporal resolution of 330ms and an isotropic spatial resolution,respectively, with minimal residual-motion artefacts (1-17). The aim of the study is to assess diagnostic accu- racy of non-invasive coronary angiography with 64- slice CT-CA in the detection of ≥50% stenosis in 44 high risk symptomatic patients. Materials e Methods Patient population Weenrolledinthestudy44patients(30maleand 14 female; mean age 60.2±12.1 yrs) with chest pain Diagnostic accuracy of Computed Tomography Coronary Angiography in a high risk symptomatic population Erica Maffei 1 , Alessandro Palumbo 1 , Chiara Martini 1 , Fabrizio Ugo 1 , Daniela Lina 1 , Annachiara Aldrovandi 1 , Claudio Reverberi 1 , Carlo Manca 1 , Diego Ardissino 1 , Girolamo Crisi 1 , Filippo Cademartiri 1,2 Department of Radiology and Cardiology 1 , University Hospital of Parma,Parma, Italy: Department of Radiology and Cardio- logy 2 , Erasmus Medical Center, Rotterdam,The Netherlands Abstract. Objective: To evaluate the diagnostic accuracy of 64-slice computed tomography (CT) coronary an- giography (CA) for the detection of significant coronary artery stenosis (≥50% lumen reduction) as compared to invasive coronary angiography (ICA) in a population of patients with chest pain and high risk. Materials andmethods: 44patients(30male;meanage60.2±12.1yrs)withchestpainwereprospectivelyenrolled.Inpa- tients with heart rate ≥70 bpm an oral dose of 100 mg of β-blocker was administered.For CT-CA (Sensation 64, Siemens, Germany) an intravenous bolus of 100 ml of iodinated contrast material (Iomeron 400, Bracco, Italy) was injected.The average scan time was 13.3±0.9s.Two observers evaluated CT-CA vs. ICA as a refe- rence standard for the detection of significant (≥50% lumen reduction) coronary artery stenosis. Results: ICA demonstrated the absence of coronary artery disease (CAD) in 13.6% of the patients (6/44), the presence of non significant CAD 4.6% (2/44), single vessel disease in 27.2% (12/44) and multi-vessel disease in 54.6% (24/44) of the patients. None of the patients was excluded from the study population. Ninety-three significant obstructivecoronarylesionswereobserved.Sensitivity,specificity,positiveandnegativepredictivevalueofCT- CAwere98.6%(70/71),92.4%(97/105),89.7%(70/78)and99%(97/98),respectively.Allpatientswithatlea- st one significant coronary lesion were correctly identified by CT-CA. Conclusions: CT-CA is a reliable alter- native to ICA in a selected population of patients with chest pain and high risk. (www.actabiomedica.it) Key words: Multislice ComputedTomography, Invasive Coronary Angiography, Coronary Artery Disease, Diagnostic Accuracy,High Risk O RIGINAL ARTICLE ACTA BIOMED 2010; 81: 47-53 © Mattioli 1885