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Abstract: Objective: To retrospectively assess the diagnostic efficacy of dual-source CT angiography (DSCTA) in detecting and grading coronary stenosis. Methods: Institutional review board approval and informed consent were obtained. One hundred ten patients were performed with both DSCTA and conventional coronary angiography (CCA) without heart rate or rhythm control in 1 week. Regarding CCA as the gold standard, the assessable rate of coronary arteries and diagnostic value of coronary stenosis using DSCTA were analyzed, respectively. The intermodality agreement between DSCTA and CCA in grading coronary stenosis was assessed using κ test. The value of DSCTA in diagnosing >50% coronary stenoses was also assessed. Results: The overall assessable rate of DSCTA was 98.6% in detecting coronary arteries; there was no significant difference between assessable rates from different groups of heart rate (χ 2=0.45, P > .05). The efficacy of DSCTA was of 97.9% sensitivity, 97.3% specificity, 90.4% positive predictive value, and 99.4% negative predictive value for coronary stenosis; and 94.7% sensitivity, 96.8% specificity, 83.7% positive predictive value, and 99% negative predictive value for >50% stenoses. The intermodality agreement in diagnosing coronary stenosis was satisfactory (k=0.87, u=58.46, P<.01). Conclusions: As an effective noninvasive diagnostic tool, DSCTA yields a promising accuracy and reliability in assessing coronary stenosis. It may be recommended as a valuable screening tool for coronary artery disease, and a potential challenge to CCA as well. [Copyright &y& Elsevier]