The effect of calcium score on the diagnostic accuracy of coronary computed tomography angiography

  • Chien-Cheng Chen
  • Chun-Chi Chen
  • I-Chang Hsieh
  • Yuan-Chang Liu
  • Chia-Yi Liu
  • Tiffany Chan
  • Ming-Shien Wen
  • Yung-Liang Wan
Original Paper


The influence of coronary calcification on the diagnostic performance of coronary computed tomography angiography (CTA) remains controversial. This study attempts to assess the effect of coronary calcium score (CS) on the diagnostic accuracy of detecting coronary artery disease (CAD) using 64-row multidetector computed tomography (MDCT). Over a period of 2 years and 9 months, 113 symptomatic patients (37–87 year-old, mean 62.3, 92 males) underwent 64-row MDCT for coronary CS and CTA. All had conventional coronary angiography (CCA) within 90 (mean 9.6) days. Coronary CTA was evaluated with CCA as the gold standard. Of 113 patients, 18 patients had a CS of 0, 18 had scores between 1 and 100, 27 between 101 and 400, and 50 had scores >400. With respect to patient-based analysis, the accuracy of CTA was 90.3%, the sensitivity was 95%, and the specificity was 78.8%. Regarding patients with CS > 400, the accuracy, sensitivity, and specificity were 92, 95.6, and 60%, respectively. On vessel-based analysis, the specificity of CTA in different vessels with CS ≦ 400 and CS > 400 was as follows: right coronary artery 87.1% versus 87.5% (P = 0.924); left main artery 94.8% versus 66.7% (P = 0.173); left anterior descending artery 77.1% versus 27.3% (P = 0.001); and left circumflex artery 83.3% versus 42.8% (P = 0.011). A high CS does not significantly affect the diagnostic accuracy and sensitivity of CTA; however, it significantly decreases the specificity, particularly the left anterior descending and left circumflex arteries.


64-row MDCT Coronary angiography Calcium score CT angiography 



This study was supported by a grant from the National Science Council, No. NSC95-2314-B-182A-131-MY2.

Conflict of interest

All authors assert that there are no conflicts of interest (both personal and institutional) regarding specific financial interests that are relevant to the work conducted or reported in this manuscript.


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Copyright information

© Springer Science+Business Media, B.V. 2011

Authors and Affiliations

  • Chien-Cheng Chen
    • 1
  • Chun-Chi Chen
    • 2
  • I-Chang Hsieh
    • 2
  • Yuan-Chang Liu
    • 1
  • Chia-Yi Liu
    • 3
  • Tiffany Chan
    • 4
  • Ming-Shien Wen
    • 2
  • Yung-Liang Wan
    • 1
  1. 1.Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at LinkouChang Gung UniversityGueishan Township, Taoyuan CountyTaiwan
  2. 2.Department of Internal Medicine, Second Section of Cardiology, Chang Gung Memorial Hospital at LinkouChang Gung UniversityTaoyuanTaiwan
  3. 3.Department of StatisticsTunghai UniversityTaichungTaiwan
  4. 4.Michael G. DeGroote School of MedicineMcMaster UniversityHamiltonCanada

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