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Patterns of coronary arterial lesion calcification by a novel, cross-sectional CT angiographic assessment.
- Source :
-
The international journal of cardiovascular imaging [Int J Cardiovasc Imaging] 2013 Oct; Vol. 29 (7), pp. 1619-27. Date of Electronic Publication: 2013 May 24. - Publication Year :
- 2013
-
Abstract
- To investigate the patterns and diagnostic implications of coronary arterial lesion calcification by CT angiography (CTA) using a novel, cross-sectional grading method, we studied 371 patients enrolled in the CorE-64 study who underwent CTA and invasive angiography for detecting coronary artery stenoses by quantitative coronary angiography (QCA). The number of quadrants involving calcium on a cross-sectional view for ≥ 30 and ≥ 50 % lesions in 4,511 arterial segments was assessed by CTA according to: noncalcified, mild (one-quadrant), moderate (two-quadrant), severe (three-quadrant) and very severe (four-quadrant calcium). Area under the receiver operating characteristic curve (AUC) were used to evaluate CTA diagnostic accuracy and agreement versus. QCA for plaque types. Only 4 % of ≥ 50 % stenoses by QCA were very severely calcified while 43 % were noncalcified. AUC for CTA to detect ≥ 50 % stenoses by QCA for non-calcified, mildly, moderately, severely, and very severely calcified plaques were 0.90, 0.88, 0.83, 0.76 and 0.89, respectively (P < 0.05). In 198 lesions with severe calcification, the presence or absence of a visible residual lumen by CTA was associated with ≥ 50 % stenosis by QCA in 20.3 and 76.9 %, respectively. Kappa was 0.93 for interobserver variability in evaluating plaque calcification. We conclude that calcification of individual coronary artery lesions can be reliably graded using CTA. Most ≥ 50 % coronary artery stenoses are not or only mildly calcified. If no residual lumen is seen on CTA, calcified lesions are predictive of ≥ 50 % stenoses and vice versa. CTA diagnostic accuracy for detecting ≥ 50 % stenoses is reduced in lesions with more than mild calcification due to lower specificity.
- Subjects :
- Aged
Female
Humans
Male
Middle Aged
Plaque, Atherosclerotic
Predictive Value of Tests
Prognosis
Reproducibility of Results
Severity of Illness Index
Coronary Angiography methods
Coronary Artery Disease diagnostic imaging
Coronary Stenosis diagnostic imaging
Coronary Vessels diagnostic imaging
Multidetector Computed Tomography
Vascular Calcification diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1875-8312
- Volume :
- 29
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- The international journal of cardiovascular imaging
- Publication Type :
- Academic Journal
- Accession number :
- 23702949
- Full Text :
- https://doi.org/10.1007/s10554-013-0240-8