الفهرس 
Gross Anatomy of the left main Coronary ArteryOnly 14 pages are availabe for public view
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Abstract
• The growing burden of coronary artery disease is out of question. Every effort is done in modern medicine to prevent, diagnose, evaluate and adequately treat this serious life threatening condition. In the effort to address proper evaluation for coronary artery disease patients several non invasive tests are being evaluated for their diagnostic accuracy. The current study was concerned with evaluating the accuracy of 64-slice computed tomography in evaluating the coronary anatomy non- invasively.
• Multislice CT is a recent development in the spiral CT. The MSCT scanners are equipped with multiple and thinner detector rows, and has a faster tube rotation speed creating two major advantages; high spatial resolution and short acquisition time that enable high-quality examinations. It is only with this immense increase in the data acquisition volume per unit time, that CT assessment of the coronary arteries has become possible.
• Challenges in evaluating the coronary arteries at CT are the small size and tortuous courses of the vessels and their continuous movements being intimately related to the cardiac chambers. Controlled heart rate and good breath-holding help to reduce cardiac and respiratory motion artifacts respectively. Retrospective ECG gating and proper choice of the reconstruction window would significantly improve the examination quality.
• To date, the central rationale of CT angiography has been the noninvasive detection and grading of coronary artery stenosis and follow up after coronary bypass surgery.
• The current study revealed a very good diagnostic accuracy of the MSCT coronary angiography. This analysis included the non evaluable coronary segments (4% of all segments subjected for evaluation). However, the test preserved its very high NPV. This should be very valuable if the test is viewed as a rule out procedure, ruling out the presence of significant coronary artery stenosis. This result is consistent with several other studies which have elucidated the high NPV of the MSCT coronary angiography.
• Also, the current study revealed that the sensitivity to detect significant coronary artery stenosis increased with the increase in stenosis severity on invasive coronary angiography. from all the scanning parameter, the scanning heart rate was the most important predictor of the diagnostic quality of the study.
• We can reach to a conclusion from this study that the 64- slice CT coronary angiography is a robust test that can be used confidently to diagnose patients with coronary artery disease and more importantly to rule out significant coronary artery disease in patients with intermediate likelihood of having significant coronary stenosis in whom catheterization could be avoided.