Intracoronary Transluminal Attenuation Gradient in Coronary CT Angiography for Determining Coronary Artery Stenosis
Intracoronary Transluminal Attenuation Gradient in Coronary CT Angiography for Determining Coronary Artery Stenosis
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DOI：
10.1016/j.jcmg.2011.09.006
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发表时间：
2011-11-01
影响因子：
14
通讯作者：
Choe, Yeon Hyeon
中科院分区：
文献类型：
--
作者：
Choi, Jin-Ho;Min, James K.;Choe, Yeon Hyeon
对钙化或复杂冠状动脉病变进行冠状动脉计算机断层扫描血管造影 (CTA) 评估通常具有挑战性。腔内衰减梯度（TAG）定义为腔内衰减与轴向距离之间的线性回归系数，具有评估冠状动脉狭窄程度的潜力。我们检查了 TAG 在确定 64 层冠状动脉 CTA 狭窄严重程度方面的价值。从 7,263 个 5 毫米长度的间隔中测量了 370 条主要冠状动脉的 TAG 值。与冠状动脉 CTA 和侵入性冠状动脉造影相比，TAG 持续显着下降，每根血管的最大狭窄严重程度从 0% 至 49% 直径狭窄的 -1.91 +/- 4.25 Hounsfield 单位/10mm 到 100% 直径狭窄的 -13.37 +/- 9.81 Hounsfield 单位/10 mm (p < 0.0001)。将 TAG 添加到冠状动脉 CTA 的解释中可提高诊断准确性 (p = 0.001)，特别是在有钙化病变的血管中 (N = 127；净重新分类改善 0.095；p = 0.046)。 TAG 似乎能够有助于改善冠状动脉 CTA 中冠状动脉狭窄严重程度的分类，特别是在严重钙化病变中。 (J Am Coll Cardiol Img 2011;4:1149-57) (C) 2011 年，美国心脏病学会基金会
Coronary computed tomography angiography (CTA) assessment of calcified or complex coronary lesions is frequently challenging. Transluminal attenuation gradient (TAG), defined as the linear regression coefficient between luminal attenuation and axial distance, has a potential to evaluate the degree of coronary stenosis. We examined the value of TAG in determining the stenosis severity on 64-slice coronary CTA. The value of TAG of 370 major coronary arteries was measured from 7,263 intervals of 5-mm length. Compared with coronary CTA and invasive coronary angiography, TAG decreased consistently and significantly with maximum stenosis severity on a per-vessel basis, from -1.91 +/- 4.25 Hounsfield units/10mm for diameter stenosis of 0% to 49% to -13.37 +/- 9.81 Hounsfield units/10 mm for diameter stenosis of 100% (p < 0.0001). Adding TAG to the interpretation of coronary CTA improved diagnostic accuracy (p = 0.001), especially in vessels with calcified lesions (N = 127; net reclassification improvement 0.095; p = 0.046). TAG appears to be able to contribute to improved classification of coronary artery stenosis severity in coronary CTA, especially in severely calcified lesions. (J Am Coll Cardiol Img 2011;4:1149-57) (C) 2011 by the American College of Cardiology Foundation