Abstract:
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Purpose: Severe calcified coronary lesions represent high-grade stenoses or not? : Analysis by 16-slice multidetector CT (MDCT).
Methods and Materials: 3D volume data was obtained with Sensation 16 (Siemens AG, Medical Solutions, Erlangen, Germany). Non-ionic contrast medium 370mgI/ml was injected intravenously. The retrospectively ECG-gated reconstruction was performed from 3D volume data of the spiral acquisition with temporal resolution of 105-210msec/image. Sixty-nine male and 3 female patients (age range 51-80, mean age 63.9) with suspected coronary artery stenoses underwent contrast enhanced MDCT. Conventional coronary angiography (CCA) was also performed in all patients within one week. Evaluation of each case was carried out in 15 segments, totaling 1080 segments. Coronary calcifications were quantified by the percentile of the area in the lumen on the short-axis reconstruction images of coronary arteries. Calcification over 75% of the lumen were regarded as severe calcified lesions by MDCT, and subdivided into 2 groups: lesions with or without luminal contrast enhancement. Stenoses over 75% were regarded as high-grade by CCA and image analysis was conducted with CCA as gold standard. Two radiologists independently analyzed the results, and interobserver agreement was calculated using Cohen's kappa test.
Results: Severe calcified lesions were present in 59 segments out of 1080 using MDCT, 33 of which had not luminal enhancement, and 26 showed enhancement of residual lumen. Twenty-six of 33 lesions without luminal enhancement showed high-grade stenoses on CCA but only 3 of 26 with luminal enhancement has high-grade stenoses. Using CCA as the gold standard, the sensitivity in detecting high-grade stenoses was 89.7%, the specificity was 76.7%, and negative predictive value was 88.5%.
Conclusion: Severe calcified lesions without luminal enhancement highly represent high-grade stenoses but the lesions with luminal contrast will not represent high-grade stenoses on coronary CT angiography using 16-slice MDCT.
Questions about this event email: sakuma@jikei.ac.jp
Sakuma MD, T,
Management of Severe Calcified Lesions on Coronary CT Angiography Using 16-slice Multidetector CT: Is Severe Calcified Lesion High-grade Stenosis or Not?. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3103512.html
