Improved evaluation of calcified segments on coronary CT angiography: a feasibility study of coronary calcium subtraction
Improved evaluation of calcified segments on coronary CT angiography: a feasibility study of coronary calcium subtraction
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DOI：
10.1007/s10554-013-0316-5
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发表时间：
2013-12-01
影响因子：
2.1
通讯作者：
Ehara, Shigeru
中科院分区：
文献类型：
--
作者：
Tanaka, Ryoichi;Yoshioka, Kunihiro;Ehara, Shigeru
我们以有创冠状动脉造影为金标准，探讨冠状动脉钙减影计算机断层扫描血管造影（CCTA）在高钙评分患者中的可行性。11例钙化评分> 400的患者使用减影方案进行CCTA，然后进行有创冠状动脉造影。除标准重建外，使用专用减影算法获得减影图像。共评价了55个钙化节段的图像质量[使用范围为1（无法解释）至4（良好）的4分量表]和是否存在显著（千分之一）管腔狭窄。以定量冠状动脉造影（QCA）为金标准，比较常规和减影CCTA。常规CCTA的平均图像质量为2.5 ± A0.6，减影CCTA的平均图像质量为3.1 ± A0.6（P < 0.001）。冠状动脉钙化扣除后，评分为1或2的节段百分比从41.8%降至12.7%（P = 0.002）。在QCA上，在16个节段中观察到显著狭窄。在QCA上检测每千日元50%狭窄的受试者工作特征曲线下面积从传统CCTA的0.741 [95%置信区间（CI）0.598-0.885]增加到减影CCTA的0.905（95% CI 0.791-1.000）（P = 0.003）。在接受CCTA的广泛钙化患者中，冠状动脉钙减影可改善钙化节段的评价。
We explore the feasibility of coronary calcium subtraction computed tomography angiography (CCTA) in patients with high calcium scores using invasive coronary angiography as the gold standard. Eleven patients with calcium scores of > 400 underwent CCTA using a subtraction protocol followed by invasive coronary angiography. In addition to standard reconstructions, subtracted images were obtained using a dedicated subtraction algorithm. A total of 55 calcified segments were evaluated for image quality [using a 4-point scale ranging from 1 (uninterpretable) to 4 (good)] and the presence of significant (a parts per thousand yen50 %) luminal stenosis. Conventional and subtracted CCTA were compared using quantitative coronary angiography (QCA) as the gold standard. The average image quality of conventional CCTA was 2.5 +/- A 0.6 versus 3.1 +/- A 0.6 on subtraction CCTA (P < 0.001). The percentage of segments with a score 1 or 2 was reduced from 41.8 to 12.7 % after coronary calcium subtraction (P = 0.002). On QCA, significant stenosis was observed in 16 segments. The area under the receiver operating characteristics curve to detect a parts per thousand yen50 % stenosis on QCA increased from 0.741 [95 % confidence interval (CI) 0.598-0.885] for conventional CCTA to 0.905 (95 % CI 0.791-1.000) for subtraction CCTA (P = 0.003). In patients with extensive calcifications undergoing CCTA, coronary calcium subtraction may improve the evaluation of calcified segments.