Diagnostic accuracy of cardiac computed tomography angiography for myocardial infarction

Table 1 Patient characteristics

Clinical characteristics	Patients (n = 24)
Age (yr)	65 ± 11 (40-86)
Male gender	88%
Body mass index	28.4 ± 5.3 (19.2-40.7)
Hypertension	58%
Hyperlipidemia	75%
Diabetes mellitus	37.5%
Prior tobacco use	29%
Positive family history	62.5%
Prior MI > 5 yr ago	75%
Prior PCI	21%
Prior CABG	21%
Infarct region
Anterior	9
Lateral	4
Inferior	5
Septal	7
Apical	8
Examination characteristics
Beta-blocker administration	2
Nitroglycerin administration	15
Mean heart rate	63 ± 12 bpm
Mean contrast amount	150 mL
DECT dose-length product (mGycm)	808 ± 191
DECT effective dose (mSv)	11.3 ± 2.7
Left ventricle
End diastolic volume	173 ± 60 mL
Ejection fraction	55% ± 17%

MI: Myocardial infarct; DECT: Dual energy computed tomography. PCI: Percutaneous coronary intervention; CABG: Coronary artery bypass graft.

Table 2 Diagnostic accuracy, specificity and sensitivity

	Accuracy	Specificity	Sensitivity	PPV	NPV
Definite
(Grade 3)
Hyperenhancement
100 kVp	90.4%	99.4%	35.2%	90.5%	90.4%
	95%CI (84.3-94.2)	95%CI (97.7-99.8)	95%CI (19.4-55.0)	95%CI (66.5-97.8)	95%CI (83.6-94.5)
140 kVp	84.5%	97.1%	9.1%	33.3%	86.6%
	95%CI (76.1-90.4)	95%CI (92.5-98.8)	95%CI (2.7-26.6)	95%CI (9.4-70.6)	95%CI (77.5-92.4)
Mixed	88.0%	97.6%	29.1%	66.7%	89.4%
	95%CI (81.1-92.6)	95%CI (94.0-99.1)	95%CI (14.0-50.9)	95%CI (35.6-87.8)	95%CI (81.5-94.2)
Iodine Only	85.2%	97.5%	11.1%	42.9%	86.8%
	95%CI (78.3-90.2)	95%CI (94.2-99.0)	95%CI (4.0-27.0)	95%CI (14.8-76.4)	95%CI (79.3-91.9)
Definite or Possible
95%CI (Combined Grades 2 and 3)
Hyperenhancement
100 kVp	86.7%	90.0%	66.7%	52.2%	94.3%
	95%CI (82.4-90.1)	95%CI (85.8-93.1)	95%CI (53.6-77.6)	95%CI (34.7-69.2)	95%CI (89.1-97.1)
140 kVp	75.0%	79.3%	49.1%	28.1%	90.4%
	95%CI (68.0-80.9)	95%CI (71.4-85.4)	95%CI (34.1-64.3)	95%CI (15.6-45.2)	95%CI (82.7-94.9)
Mixed	76.5%	82.7%	38.2%	26.6%	89.1%
	95%CI (69.6-82.2)	95%CI (76.1-87.8)	95%CI (22.7-56.5)	95%CI (13.9-44.9)	95%CI (80.9-94.1)
Iodine Only	83.6%	90.1%	44.4%	42.9%	90.7%
	95%CI (77.3-88.4)	95%CI (83.6-94.2)	95%CI (27.7-62.5)	95%CI (24.6-63.3)	95%CI (84.0-94.8)

PPV: Positive predictive value; NPV: Negative predictive value.