Document Detail


Accuracy of 16-slice multi-detector CT to quantify the degree of coronary artery stenosis: assessment of cross-sectional and longitudinal vessel reconstructions.
MedLine Citation:
PMID:  16442256     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Sixteen-slice multi-detector computed tomography (MDCT) permits reliable noninvasive detection of significant coronary stenosis based on qualitative visual assessment. The purpose of this study was to determine the accuracy of MDCT to quantify the degree of coronary stenosis as compared to quantitative coronary angiography (QCA) using two different reconstruction methods. METHODS: We studied 69 coronary artery lesions from 38 consecutive patients that underwent 16-slice MDCT as a part of research study, which enrolled consecutive subjects scheduled for clinically indicated invasive coronary angiography. Nine coronary artery lesions with motion artifacts, heavily calcified plaques or stents were excluded from the analysis. The degree of stenosis was calculated by two independent readers non-blinded to the location of the stenosis, but blinded to the results of the QCA. MDCT luminal diameters were measured in cross-sectional multi-planar reformatted (CS-MPR) images created perpendicular to the centerline of the vessel and in 5 mm thin-slab maximum intensity projections (MIP) parallel to the long axis of the vessel. Both MDCT methods were compared against QCA. RESULTS: The mean degree of stenosis as measured by MDCT was closely correlated to QCA for both methods (CS-MPR versus QCA: 61 +/- 23% versus 64 +/- 29%; r2 = 0.83, p < 0.001 and MIP versus QCA: 64 +/- 22% versus 64 +/- 29%; r2 = 0.84, p < 0.001 for MIP. Bland-Altman analysis demonstrated a negative bias of the degree of stenosis of -2.8 +/- 12% using CS-MPR and a minimally positive bias of 0.6 +/- 12% for MIP. In stratified analysis for lesion severity (mild, 0-40%; moderate, 41-70% or severe, > 70%) the agreement between both CS-MPR and MIP was high when compared to QCA (kappa = 0.74 and 0.71, respectively). CONCLUSION: Multi-detector spiral CT permits accurate quantitative assessment of the degree of coronary stenosis in selected data sets of sufficient quality using both cross-sectional and longitudinal vessel reconstructions.
Authors:
Ricardo C Cury; Maros Ferencik; Stephan Achenbach; Eugene Pomerantsev; Koen Nieman; Fabian Moselewski; Suhny Abbara; Ik-Kyung Jang; Thomas J Brady; Udo Hoffmann
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2006-01-25
Journal Detail:
Title:  European journal of radiology     Volume:  57     ISSN:  0720-048X     ISO Abbreviation:  Eur J Radiol     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-02-21     Completed Date:  2006-05-18     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8106411     Medline TA:  Eur J Radiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  345-50     Citation Subset:  IM    
Affiliation:
Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, USA. rcury@partners.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Angiography*
Coronary Stenosis / radiography*
Female
Humans
Image Processing, Computer-Assisted*
Male
Middle Aged
Sensitivity and Specificity
Single-Blind Method
Tomography, X-Ray Computed / methods*
Grant Support
ID/Acronym/Agency:
1 T32 HL076136-02/HL/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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