Intracoronary Transluminal Attenuation Gradient in Coronary CT Angiography for Determining Coronary Artery Stenosis

被引：172

作者：

Choi, Jin-Ho ^{[1
,2
]}

Min, James K.

Labounty, Troy M. ^{[4
]}

Lin, Fay Y. ^{[4
]}

Mendoza, Dorinna D. ^{[4
]}

Shin, Dae Hee ^{[5
]}

Ariaratnam, Nikki S. ^{[6
]}

Koduru, Sunaina ^{[4
]}

Granada, Juan F. ^{[7
]}

Gerber, Thomas C. ^{[8
]}

Oh, Jae K. ^{[9
]}

Gwon, Hyeon-Cheol ^{[1
]}

Choe, Yeon Hyeon ^{[3
]}

机构：

[1] Sungkyunkwan Univ, Sch Med, Cardiac & Vasc Ctr,Dept Med,Samsung Med Ctr, Cardiovasc Imaging Ctr, Seoul 135710, South Korea

[2] Sungkyunkwan Univ, Dept Emergency Med, Cardiovasc Imaging Ctr,Cardiac & Vasc Ctr, Samsung Med Ctr,Sch Med, Seoul 135710, South Korea

[3] Sungkyunkwan Univ, Dept Radiol, Cardiovasc Imaging Ctr,Cardiac & Vasc Ctr, Samsung Med Ctr,Sch Med, Seoul 135710, South Korea

[4] New York Presbyterian Hosp, Dept Med, Div Cardiol, Weill Cornell Med Coll, New York, NY USA

[5] Univ Ulsan, Sch Med, Dept Cardiol, Kang Reung Asan Med Ctr, Kang Reung, South Korea

[6] New York Presbyterian Hosp, Dept Radiol, Weill Cornell Med Coll, New York, NY USA

[7] Columbia Univ, Med Ctr, Skirball Ctr Cardiovasc Res, Cardiovasc Res Fdn, New York, NY USA

[8] Mayo Clin, Coll Med, Dept Radiol, Rochester, MN USA

[9] Mayo Clin, Coll Med, Dept Internal Med, Div Cardiovasc Dis, Rochester, MN USA

来源：

JACC-CARDIOVASCULAR IMAGING | 2011年 / 4卷 / 11期

关键词：

computed tomography; coronary artery imaging; diagnosis of coronary artery stenosis;

D O I：

10.1016/j.jcmg.2011.09.006

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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

引用

页码：1149 / 1157

页数：9

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