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Clinical significance of transluminal attenuation gradient in 320-row area detector coronary CT angiography
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Clinical significance of transluminal attenuation gradient in 320-row area detector coronary CT angiography
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Journal Article
Clinical significance of transluminal attenuation gradient in 320-row area detector coronary CT angiography
2018
Overview
The clinical significance of the transluminal attenuation gradient (TAG) has not been established. We evaluated the incremental diagnostic value of TAG by 320-row area detector computed tomography (320-ADCT). Subjects were 65 patients who underwent one-rotation scanning by 320-ADCT and invasive coronary angiography (ICA) within 3 months. TAG values were obtained for the major epicardial vessels 2 mm or more each in RCA, LAD and LCX using automatic analysis software. Moreover, TAG values that excluded calcified lesions in calculation of the regression line were also evaluated (excluded-TAG). In LAD, 21 intermediate lesions underwent functional flow reserve (FFR), and the incremental diagnostic value for functional stenosis was evaluated. The TAG values in the normal vessels were − 8.3 ± 5.0 (HU/cm) for the RCA (
n
= 32), − 23.3 ± 4.3 for the LAD (
n
= 9) and − 20.6 ± 10.0 for the LCX (
n
= 32). The RCA value was significantly higher (
p
< 0.001). The TAG values with stenosis degrees of ≤ 25%, 26–75%, ≥ 76% on ICA were − 8.3 ± 5.0 (
n
= 32) vs − 10.3 ± 7.2 (
n
= 25) vs − 10.0 ± 5.4 (
n
= 4) in the RCA, − 23.3 ± 4.3 (
n
= 9) vs − 21.0 ± 11.5 (
n
= 35) vs − 23.5 ± 15.3 (
n
= 10) in the LAD and − 21.1 ± 15.1 (
n
= 32) vs − 21.1 ± 15.1 (
n
= 16) vs − 17.7 ± 15.7 (
n
= 6) in the LCX, with no significant difference among the three groups. The excluded-TAG values also showed no significant difference. The area under the curve in the diagnosis of FFR < 0.8 in 21 LAD cases was 0.542 for CT only, 0.694 for CT + TAG, and 0.694 for CT + excluded-TAG. In single time-phase scanning by 320-ADCT, TAG does not offer an incremental diagnostic value.
Publisher
Springer Japan,Springer Nature B.V
Subject
/ Biomedical Engineering and Bioengineering
/ Computed Tomography Angiography - methods
/ Coronary Angiography - methods
/ Coronary Stenosis - diagnosis
/ Coronary Stenosis - physiopathology
/ Coronary Vessels - diagnostic imaging
/ Coronary Vessels - physiopathology
/ Female
/ Fractional Flow Reserve, Myocardial - physiology
/ Humans
/ Lesions
/ Male
/ Medicine
/ Multidetector Computed Tomography - methods
/ Patients
/ Scanning
/ Software
/ Stenosis
