Patterns of Coronary Calcification and Their Impact on the Diagnostic Accuracy of Computed Tomography Coronary Angiography

被引:9
|
作者
Noll, Dariusz [1 ]
Kruk, Mariusz [1 ]
Demkow, Marcin [1 ]
Pregowski, Jerzy [1 ]
Kaczmarska, Edyta [1 ]
Kryczka, Karolina [1 ]
Pracon, Radoslaw [1 ]
Dzielinska, Zofia [1 ]
Sleszycka, Justyna [1 ]
Witkowski, Adam [1 ]
Ruzyllo, Witold [1 ]
Kepka, Cezary [1 ]
机构
[1] Inst Cardiol, Coronary Dis & Struct Heart Dis Dept, Invas Cardiol & Angiol Dept, Warsaw, Poland
关键词
computed tomography; intravascular ultrasound; coronary angiography; coronary artery disease; INTRAVASCULAR ULTRASOUND; ARTERY-DISEASE; CT ANGIOGRAPHY; CALCIUM; THROMBI; LESIONS; TRIAL;
D O I
10.1097/RCT.0000000000000681
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Objective Despite coronary calcifications being a major factor affecting the diagnostic accuracy of coronary computed tomography angiography (CTA), there is a lack of established criteria for categorizing calcifications. We aimed to evaluate patterns of coronary calcification based on quantitative radiodensity and size parameters to provide coronary calcium categories and assess their impact on the accuracy of coronary CTA. Methods and Results We analyzed length, maximum thickness, volume, mean density, and maximum density of coronary calcium and divided each of these parameters into tertiles. Subsequently, we summarized the tertiles for each individual calcification and divided them into 3 equal groups of: mild, moderate, and severe calcification. The accuracy of coronary CTA was defined as the difference between the measurements obtained on coronary CTA versus the reference of intravascular ultrasound (IVUS). We evaluated 252 coronary calcifications within 97 arteries of 60 patients. There was an expected increase in size and density values for mild versus moderate versus severe calcifications, but there was no difference in IVUS measured minimum lumen area among the 3 groups. Of note, coronary CTA significantly underestimated IVUS minimum lumen area measurement by 1.2 1.6 mm(2) (14.6 +/- 23.1%, P < 0.001) for severe calcifications and by 0.5 +/- 2.0 mm(2) (3.7 +/- 32.1%, P = 0.021) for moderate calcifications. Within mild calcifications, the difference was not significant. Conclusion Based on their dimensional and radiodensity characteristics, our analysis revealed patterns of individual coronary artery calcifications that affected the accuracy of coronary CTA measurements; coronary CTA inaccuracy was associated with the presence of moderate or severe calcifications, but not mild calcifications.
引用
收藏
页码:263 / 268
页数:6
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