| Quantification of nonculprit coronary lesions: comparison of cardiac 64-MDCT and invasive coronary angiography. | |
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MedLine Citation:
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PMID: 18647913 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The purpose of our study was to evaluate the accuracy of cardiac 64-MDCT to quantify the grade of stenosis of nonculprit lesions. SUBJECTS AND METHODS: Twenty-nine consecutive patients (23 men and six women; mean age, 62 +/- 10 years) presenting with acute coronary syndrome (ACS) had nonculprit coronary lesions of >or= 30% stenosis quantified on quantitative coronary angiography (QCA). Five 64-MDCT postprocessing techniques (maximum intensity projection [MIP], multiplanar reformat [MPR], cross-sectional area [CSA], and diameter and area derived from semiquantitative coronary software) were used to grade lesions. Two separate groups of two independent readers analyzed QCA and cardiac CT images using a 17-segment model. Coronary angiography was the reference standard. RESULTS: Nonculprit lesions were identified in 46 analyzable coronary segments. Subgrouping lesions on the basis of reference vessel diameter resulted in strong correlations for quantifying nonculprit lesions in vessels > 3 mm (R = 0.78-0.91, p < 0.01) but poor correlations for nonculprit lesions in vessels <or= 3 mm (R = 0.1-0.07). Subgrouping lesions on the basis of plaque type resulted in poor correlations for calcified plaques (R = 0.01-0.30) but moderate to strong correlations for mixed (R = 0.58-0.75, p < 0.01) and noncalcified (R = 0.44-0.61, p < 0.01) plaques. The best overall correlation among all CT techniques with QCA was CSA (R = 0.56, p < 0.01). Interobserver agreement (kappa values) for MPR, MIP, coronary software diameter and area were 0.6, 0.7, 0.62, and 0.57, respectively. CONCLUSION: In patients presenting with ACS, 64-MDCT provided an accurate grade of stenosis for nonculprit coronary lesions in proximal coronary segments. Calcified plaques and lesions in coronary segments <or= 3 mm diameter remained difficult to accurately quantify. |
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Authors:
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Jonathan D Dodd; Johannes Rieber; Eugene Pomerantsev; Vithaya Chaithiraphan; Stephan Achenbach; Javier M Moreiras; Suhny Abbara; Udo Hoffmann; Thomas J Brady; Ricardo C Cury |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: AJR. American journal of roentgenology Volume: 191 ISSN: 1546-3141 ISO Abbreviation: AJR Am J Roentgenol Publication Date: 2008 Aug |
Date Detail:
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Created Date: 2008-07-23 Completed Date: 2008-08-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7708173 Medline TA: AJR Am J Roentgenol Country: United States |
Other Details:
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Languages: eng Pagination: 432-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Radiology, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland. j.dodd@st-vincents.ie |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Coronary Syndrome
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radiography*,
therapy Adult Aged Contrast Media Coronary Angiography / methods* Coronary Stenosis / radiography*, therapy Female Humans Iopamidol / diagnostic use Male Middle Aged Radiographic Image Interpretation, Computer-Assisted Stents Tomography, X-Ray Computed / methods* |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media; 62883-00-5/Iopamidol |
| Comments/Corrections | |
Comment In:
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AJR Am J Roentgenol. 2008 Aug;191(2):439-40
[PMID:
18647914
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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