Login Register Cart 0
Generic placeholder image

Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

Evaluation of Coronary Artery Diffuse Calcification Stenosis by Corrected Coronary Opacification Difference

Author(s): Fangjie Shen, Jingfeng Huang, Qianjiang Ding, Quanliang Mao, Xinzhong Ruan and Yuning Pan*

Volume 20, 2024

Published on: 13 July, 2023

Article ID: e220523217199 Pages: 7

DOI: 10.2174/1573405620666230522150050

Price: $65

Abstract

Objectives: The artifacts produced by calcification on coronary computed tomographic angiography (CCTA) have a great influence on the diagnosis of coronary stenosis. The purpose of this study is to investigate the value of corrected coronary opacification (CCO) difference in the diagnosis of stenosis in diffusely calcified coronary arteries (DCCAs).

Methods: A total of 84 patients were enrolled. The CCO difference across the diffuse calcification was measured through CCTA. Coronary arteries were grouped according to the extent of stenosis obtained by invasive coronary angiography (ICA). The Kruskal-Wallis H test was used to compare the CCO differences between different groups and a receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of the CCO difference.

Results: Among the 84 patients, 58 patients had one DCCA, 14 patients had 2 DCCAs, and 12 patients had 3 DCCAs. A total of 122 coronary arteries were examined, 16 showed no significant stenosis, 42 had <70% stenosis, and 64 had 70-99% stenosis. The median CCO differences among the 3 groups were 0.064, 0.117, and 0.176, respectively. There were significant differences between the group without stenosis and the group with 70-99% stenosis (H = -3.581, P = 0.001), and between the group with <70% stenosis and the group with 70-99% stenosis (H = -2.430, P = 0.045). The area under the ROC curve was 0.681 and the optimal cut-off point was 0.292. Taking the ICA results as the gold standard, the sensitivity and specificity for the diagnosis of ≥70% coronary stenosis with a cut-off point of 0.292 were 84.4% and 44.8%, respectively.

Conclusion: CCO difference could be useful in the diagnosis of ≥70% severe coronary stenosis in DCCA. Through this non-invasive examination, the CCO difference could be a reference for clinical treatment.

[1]
Myerburg RJ, Interian A Jr, Mitrani RM, Kessler KM, Castellanos A. Frequency of sudden cardiac death and profiles of risk. Am J Cardiol 1997; 80(5): 10F-9F.
[http://dx.doi.org/10.1016/S0002-9149(97)00477-3] [PMID: 9291445]
[2]
Leber AW, Knez A, Becker A, et al. Accuracy of multidetector spiral computed tomography in identifying and differentiating the composition of coronary atherosclerotic plaques. J Am Coll Cardiol 2004; 43(7): 1241-7.
[http://dx.doi.org/10.1016/j.jacc.2003.10.059] [PMID: 15063437]
[3]
Achenbach S, Moselewski F, Ropers D, et al. Detection of calcified and noncalcified coronary atherosclerotic plaque by contrast-enhanced, submillimeter multidetector spiral computed tomography: A segment-based comparison with intravascular ultrasound. Circulation 2004; 109(1): 14-7.
[http://dx.doi.org/10.1161/01.CIR.0000111517.69230.0F] [PMID: 14691045]
[4]
Steigner ML, Mitsouras D, Whitmore AG, et al. Iodinated contrast opacification gradients in normal coronary arteries imaged with prospectively ECG-gated single heart beat 320-detector row computed tomography. Circ Cardiovasc Imaging 2010; 3(2): 179-86.
[http://dx.doi.org/10.1161/CIRCIMAGING.109.854307] [PMID: 20044512]
[5]
Lackner K, Bovenschulte H, Stützer H, Just T, Al-Hassani H, Krug B. In vitro measurements of flow using multislice computed tomography (MSCT). Int J Cardiovasc Imaging 2011; 27(6): 795-804.
[http://dx.doi.org/10.1007/s10554-010-9728-7] [PMID: 20972834]
[6]
Chow BJW, Kass M, Gagné O, et al. Can differences in corrected coronary opacification measured with computed tomography predict resting coronary artery flow? J Am Coll Cardiol 2011; 57(11): 1280-8.
[http://dx.doi.org/10.1016/j.jacc.2010.09.072] [PMID: 21392642]
[7]
Benz DC, Mikulicic F, Gräni C, et al. Diagnostic accuracy of coronary opacification derived from coronary computed tomography angiography to detect ischemia: First validation versus single-photon emission computed tomography. EJNMMI Res 2017; 7(1): 92.
[http://dx.doi.org/10.1186/s13550-017-0342-8] [PMID: 29178006]
[8]
Gao Y, Lu B, Hou ZH, et al. Coronary In-Stent Restenosis: Assessment with Corrected Coronary Opacification Difference across Coronary Stents Measured with CT Angiography. Radiology 2015; 275(2): 403-12.
[http://dx.doi.org/10.1148/radiol.14140820] [PMID: 25521667]
[9]
Ong TK, Chin SP, Liew CK, et al. Accuracy of 64-row multidetector computed tomography in detecting coronary artery disease in 134 symptomatic patients: Influence of calcification. Am Heart J 2006; 152(6): 1323.e1-6.
[http://dx.doi.org/10.1016/j.ahj.2005.12.027] [PMID: 16781246]
[10]
Liu X, Zhao X, Huang J, et al. Comparison of 3D free-breathing coronary MR angiography and 64-MDCT angiography for detection of coronary stenosis in patients with high calcium scores. AJR Am J Roentgenol 2007; 189(6): 1326-32.
[http://dx.doi.org/10.2214/AJR.07.2805] [PMID: 18029867]
[11]
Abdulla J, Pedersen KS, Budoff M, Kofoed KF. Influence of coronary calcification on the diagnostic accuracy of 64-slice computed tomography coronary angiography: A systematic review and meta-analysis. Int J Cardiovasc Imaging 2012; 28(4): 943-53.
[http://dx.doi.org/10.1007/s10554-011-9902-6] [PMID: 21667273]
[12]
Choi JH, Min JK, Labounty TM, et al. Intracoronary transluminal attenuation gradient in coronary CT angiography for determining coronary artery stenosis. JACC Cardiovasc Imaging 2011; 4(11): 1149-57.
[http://dx.doi.org/10.1016/j.jcmg.2011.09.006] [PMID: 22093264]
[13]
Rybicki FJ, Otero HJ, Steigner ML, et al. Initial evaluation of coronary images from 320-detector row computed tomography. Int J Cardiovasc Imaging 2008; 24(5): 535-46.
[http://dx.doi.org/10.1007/s10554-008-9308-2] [PMID: 18368512]
[14]
Serruys PW, Girasis C, Papadopoulou SL, Onuma Y. Non-invasive fractional flow reserve: Scientific basis, methods and perspectives. EuroIntervention 2012; 8(4): 511-9.
[http://dx.doi.org/10.4244/EIJV8I4A79] [PMID: 22581414]
[15]
Nagata K, Tanaka R, Takagi H, Fusazaki T, Morino Y, Yoshioka K. Improved diagnostic performance of transluminal attenuation gradient in combination with morphological evaluation of coronary artery stenosis using 320-row computed tomography. Jpn J Radiol 2018; 36(1): 51-8.
[http://dx.doi.org/10.1007/s11604-017-0699-7] [PMID: 29110130]
[16]
Stuijfzand WJ, Danad I, Raijmakers PG, et al. Additional value of transluminal attenuation gradient in CT angiography to predict hemodynamic significance of coronary artery stenosis. JACC Cardiovasc Imaging 2014; 7(4): 374-86.
[http://dx.doi.org/10.1016/j.jcmg.2013.12.013] [PMID: 24631509]
[17]
Peng K, Xu N, Zhang L, et al. Transluminal attenuation gradient and corrected models in coronary CT angiography for determining stenosis severity: A primary study using dual-source CT. Clin Radiol 2017; 72(6): 508-16.
[http://dx.doi.org/10.1016/j.crad.2017.01.003] [PMID: 28190514]
[18]
Wang R, Renker M, Schoepf UJ, et al. Diagnostic value of quantitative stenosis predictors with coronary CT angiography compared to invasive fractional flow reserve. Eur J Radiol 2015; 84(8): 1509-15.
[http://dx.doi.org/10.1016/j.ejrad.2015.05.010] [PMID: 26022519]
[19]
Wen D, Li J, Zhao H, Li J, Zheng M. Diagnostic performance of two corrected transluminal attenuation gradient metrics in coronary CT angiography for the evaluation of significant in-stent restenosis by dual-source CT: a validation study with invasive coronary angiography. Clin Radiol 2018; 73(6): 592.e1-8.
[http://dx.doi.org/10.1016/j.crad.2018.01.011] [PMID: 29454588]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy