Journal of Cardiovascular Computed Tomography最新文献

英文中文

Computed tomography coronary angiography assessment of left main coronary artery stenosis severity 计算机断层扫描冠状动脉造影术对左冠状动脉主干狭窄严重程度的评估。

IF 5.5 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Computed Tomography

Pub Date : 2024-11-01 DOI: 10.1016/j.jcct.2024.07.005

Udit Thakur , Jason Nogic , Andrea Comella , Nitesh Nerlekar , Jasmine Chan , Timothy Abrahams , Michael Michail , Adam Nelson , Damini Dey , Brian Ko , Sujith Seneviratne , Adam J. Brown

Background

Angiographic assessment of left main coronary artery (LMCA) stenosis severity can be unreliable. In cases of ambiguity, intravascular ultrasound (IVUS) can be utilised with a minimal lumen area (MLA) of ≥6 mm² an accepted threshold for safe deferral of revascularization. We sought to assess whether quantitative computer tomography coronary angiography (CTCA) measures could assist clinicians making LMCA revascularization decisions when compared with IVUS as gold standard.

Methods

Consecutive patients undergoing IVUS assessment of angiographically intermediate LMCA stenosis were included. All patients had undergone 320-slice CTCA <90 days prior to IVUS imaging. Offline quantitative assessment of IVUS- and CT-derived measures were undertaken with the cohort divided into those with significant (s-LMCA) versus non-significant (ns-LMCA) disease using the accepted IVUS threshold.

Results

Fifty-eight patients were included, with no difference in mean age (61.5 ± 12.2 vs. 59.7 ± 11.9 years, p = 0.57), diabetic status (24.2% vs 16.0%, p = 0.44) or other baseline demographics between groups. Patients with ns-LMCA had larger CT luminal area (8.64 ± 3.91 vs. 5.41 ± 1.54 mm², p < 0.001), larger minimal lumen diameter (MLD) (3.25 ± 0.74 vs. 2.56 ± 0.38 mm, p < 0.001) and lower area stenosis (45.74 ± 18.10 vs. 60.93 ± 14.68%, p = 0.001). There was a significant positive correlation between CTCA and IVUS MLA (r = 0.68, p < 0.001) and MLD (r = 0.67, p < 0.001). ROC analysis demonstrated CTCA MLA cut-off <8.29 mm² provides the greatest negative predictive value and sensitivity in predicting the presence of significant LMCA disease.

Conclusion

CTCA derived MLA and MLD have a strong correlation with IVUS. A CTCA derived MLA cut-off <8.29 mm² showed greatest clinical utility for predicting the need for further assessment, based on IVUS gold standard.

背景：左冠状动脉主干（LMCA）狭窄严重程度的血管造影评估可能并不可靠。在不明确的情况下，可以使用血管内超声（IVUS），最小管腔面积（MLA）≥6 平方毫米是安全推迟血管再通的公认阈值。我们试图评估定量计算机断层扫描冠状动脉造影（CTCA）与作为金标准的 IVUS 相比，是否能帮助临床医生做出 LMCA 血管再通的决定：纳入接受 IVUS 评估的 LMCA 中度血管狭窄连续患者。所有患者均接受过 320 片 CTCA 结果：共纳入 58 例患者：纳入的 58 例患者的平均年龄（61.5 ± 12.2 岁 vs. 59.7 ± 11.9 岁，P = 0.57）、糖尿病状态（24.2% vs. 16.0%，P = 0.44）或其他基线人口统计学指标在组间无差异。NS-LMCA患者的CT管腔面积更大（8.64 ± 3.91 vs. 5.41 ± 1.54 mm2，p 2），在预测LMCA是否存在重大疾病方面具有最大的阴性预测价值和灵敏度：结论：CTCA 导出的 MLA 和 MLD 与 IVUS 有很强的相关性。结论：CTCA 导出的 MLA 和 MLD 与 IVUS 有很强的相关性。根据 IVUS 黄金标准，CTCA 导出的 MLA 临界值 2 在预测是否需要进一步评估方面显示出最大的临床实用性。

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引用次数: 0

Differences in total plaque burden between plaque rupture and plaque erosion: A combined computed tomography angiography and optical coherence tomography study 斑块破裂与斑块侵蚀之间斑块总负荷的差异：计算机断层扫描血管造影和光学相干断层扫描联合研究。

IF 5.5 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Computed Tomography

Pub Date : 2024-11-01 DOI: 10.1016/j.jcct.2024.09.007

Takayuki Niida , Eisuke Usui , Keishi Suzuki , Daisuke Kinoshita , Haruhito Yuki , Daichi Fujimoto , Marco Covani , Damini Dey , Hang Lee , Iris McNulty , Maros Ferencik , Taishi Yonetsu , Tsunekazu Kakuta , Ik-Kyung Jang

Backgrounds

Coronary computed tomography angiography (CTA) allows for the assessment of atherosclerotic plaque burden across the entire coronary vasculature. No studies have examined the relationship between the underlying pathology of the culprit lesion and total plaque burden in patients with acute coronary syndromes. The aim of this study was to compare the total plaque burden between patients with plaque rupture versus plaque erosion.

Methods

A total of 232 patients who presented with their first non-ST-segment elevation acute coronary syndrome and underwent both CTA and optical coherence tomography imaging before intervention were selected. Quantitative analysis was performed using semi-automated software (Autoplaque version 3.0, Cedars-Sinai Medical Center). An attenuation of <30 Hounsfield units defined low-density non-calcified plaque (LDNCP). All 3 vessels were assessed using the modified 17-segment American Heart Association model for coronary segment classification.

Results

Among 232 patients, 125 (53.9%) had plaque rupture and 107 (46.1%) had plaque erosion. Total plaque burden (48.2 [39.8–54.9] % vs. 44.1 [38.6–50.0] %, P = 0.006), total non-calcified plaque (NCP) burden (46.6 [39.1–53.3] % vs. 43.0 [37.6–49.2] %, P = 0.013), total LDNCP burden (2.3 [1.4–3.0] % vs. 1.7 [1.2–2.6] %, P = 0.016), and total calcified plaque (CP) burden (0.8 [0.1–1.6] % vs. 0.4 [0.0–1.4] %, P = 0.047) were significantly greater in patients with culprit plaque rupture than in those with culprit plaque erosion.

Conclusion

Patients with plaque rupture, compared with those with plaque erosion, had a greater total plaque burden, NCP burden, LDNCP burden, and CP burden.

Clinical trial registration

URL: https://www.clinicaltrials.gov; Unique identifier: NCT04523194.

背景：冠状动脉计算机断层扫描血管造影术（CTA）可评估整个冠状动脉血管的动脉粥样硬化斑块负荷。目前还没有研究对急性冠状动脉综合征患者的罪魁祸首病变与斑块总负荷之间的关系进行研究。本研究旨在比较斑块破裂与斑块侵蚀患者的斑块总负荷：方法：共选取了 232 例首次出现非 ST 段抬高急性冠状动脉综合征的患者，这些患者在介入治疗前均接受了 CTA 和光学相干断层扫描成像。使用半自动软件（Autoplaque 3.0 版，Cedars-Sinai 医学中心）进行定量分析。结果：在 232 名患者中，125 人（53.9%）有斑块破裂，107 人（46.1%）有斑块侵蚀。斑块总负荷（48.2 [39.8-54.9] % vs. 44.1 [38.6-50.0] %，P = 0.006）、非钙化斑块（NCP）总负荷（46.6 [39.1-53.3] % vs. 43.0 [37.6-49.2] %，P = 0.013）、LDNCP 总负荷（2.3 [1.4-3.0] % vs. 1.7 [1.2-2.6]%，P = 0.016）和总钙化斑块（CP）负荷（0.8 [0.1-1.6] % vs. 0.4 [0.0-1.4] %，P = 0.047）在斑块破裂患者中明显高于斑块侵蚀患者：结论：与斑块侵蚀患者相比，斑块破裂患者的斑块总负荷、NCP负荷、LDNCP负荷和CP负荷更大：URL: https://www.Clinicaltrials: gov; Unique identifier：NCT04523194。

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引用次数: 0

Interscan reproducibility of computed tomography derived coronary plaque volume measurements 计算机断层扫描得出的冠状动脉斑块体积测量的扫描间再现性。

IF 5.5 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Computed Tomography

Pub Date : 2024-11-01 DOI: 10.1016/j.jcct.2024.09.009

Nadia Iraqi , Martin Bødtker Mortensen , Niels Peter Rønnow Sand , Martin Busk , Erik Lerkevang Grove , Damini Dey , Kamilla Bech Pedersen , Helle Kanstrup , Alexandra Uglebjerg Pedersen , Kristian Tækker Madsen MD , Erik Parner , Jesper Møller Jensen , Bjarne Linde Nørgaard

Background

Coronary computed tomography angiography (CCTA) enables detailed quantification and characterization of coronary atherosclerotic plaques, offering diagnostic and prognostic value. Interscan reproducibility studies on plaque volume measurements are limited. This study aims to assess the interscan reproducibility of coronary plaque quantification and the implications of clinical and technical characteristics on interscan reproducibility.

Methods

CCTA was performed twice in 101 patients with known coronary artery disease at a 1-h interval. The scans were conducted using identical CCTA acquisition protocols. Coronary plaque volumes were quantified using a semi-automated software and performed on a per-lesion, per-vessel, and per-patient level.

Results

Median plaque volumes were comparable between the first and second CCTA scan. Interscan correlation was high for total plaque (TP), non-calcified plaque (NCP), and calcified plaque (CP) across all analyses (Pearson's coefficient 0.93–0.99), but lower for low-density non-calcified plaque (LD-NCP) volume measurements (Pearson's coefficient 0.74–0.77). Bland-Altman analyses demonstrated higher interscan agreement on a per-patient level compared to on per-vessel and per-lesion level. Interscan reproducibility on CP volumes was affected by CT image quality with narrower LoA in scans with the highest image quality score (p = 0.003), or lowest image reconstructive iteration level (p < 0.001). Limits of agreement were significantly narrower for TP, NCP, and CP volumes in LAD-lesions and vessels compared to non-LAD lesions and vessels (p ≤ 0.001).

Conclusion

Overall reproducibility of repeated CCTA derived plaque measurements by a semi-automated software was modest, and was influenced by image quality, image reconstruction settings, and lesion location.

背景：冠状动脉计算机断层扫描（CCTA）可对冠状动脉粥样硬化斑块进行详细量化和定性，具有诊断和预后价值。关于斑块体积测量的扫描间重现性研究非常有限。本研究旨在评估冠状动脉斑块量化的扫描间再现性，以及临床和技术特征对扫描间再现性的影响：方法：对 101 名已知患有冠状动脉疾病的患者进行了两次 CCTA 扫描，每次扫描间隔 1 小时。扫描采用相同的 CCTA 采集方案进行。使用半自动软件对冠状动脉斑块体积进行量化，并按每个病变、每个血管和每个患者进行量化：结果：第一次和第二次 CCTA 扫描的斑块体积中位数相当。在所有分析中，总斑块（TP）、非钙化斑块（NCP）和钙化斑块（CP）的扫描间相关性较高（皮尔逊系数 0.93-0.99），但低密度非钙化斑块（LD-NCP）体积测量的相关性较低（皮尔逊系数 0.74-0.77）。Bland-Altman分析表明，与每个血管和每个病灶水平相比，每个患者水平的扫描间一致性更高。CP 容量的扫描间再现性受 CT 图像质量的影响，图像质量得分最高（p = 0.003）或图像重建迭代水平最低（p 结论：CP 容量的扫描间再现性受 CT 图像质量的影响：半自动软件对重复 CCTA 得出的斑块测量结果的总体再现性一般，受图像质量、图像重建设置和病变位置的影响。

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引用次数: 0

First reported Intra-cavitary right-to-left coronary artery collateral in the context of D-TGA 首次报道 D-TGA 情况下腔内右至左冠状动脉侧支。

IF 5.5 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Computed Tomography

Pub Date : 2024-11-01 DOI: 10.1016/j.jcct.2024.09.005

Claire F. Woodworth , Ryan C. Yee , Tim Leiner

引用次数: 0

Cardiac symptomatology and coronary artery disease. A clinical conundrum 心脏症状和冠状动脉疾病。临床难题。

IF 5.5 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Computed Tomography

Pub Date : 2024-11-01 DOI: 10.1016/j.jcct.2024.09.004

Ruurt A. Jukema, Yvemarie BO. Somsen, Roel Hoek, Nick S. Nurmohamed, Roel S. Driessen, Pieter G. Raijmakers, Pim van der Harst, Maarten J. Cramer, Paul Knaapen, Ibrahim Danad

引用次数: 0

Energy-integrating detector based ultra-high-resolution CT with deep learning reconstruction for the assessment of calcified lesions in coronary artery disease 基于能量积分探测器的超高分辨率 CT 与深度学习重建用于评估冠状动脉疾病的钙化病变。

IF 5.5 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Computed Tomography

Pub Date : 2024-11-01 DOI: 10.1016/j.jcct.2024.09.014

Misato Sone , Makoto Orii , Yoshitaka Ota , Takuya Chiba , Joanne D. Schuijf , Naruomi Akino , Kunihiro Yoshioka

Background

The aim of this study to compare of the image quality of calcified lesions in coronary artery disease between deep learning reconstruction (DLR) and model-based iterative reconstruction (MBIR) on energy-integrating detector (EID) based ultra-high-resolution CT (UHRCT).

Methods

We performed a phantom study on EID-based UHRCT using a dedicated insert for calcifications and obtained the derivative values for DLR and MBIR. In the clinical study, the derivative values were compared between DLR and MBIR across 73 calcified lesions in 62 patients. Edge sharpness of calcifications and contrast resolution at the coronary lumen side were quantified by the maximum and minimum derivative values. Two radiologists independently analyzed image quality of the calcified lesions using a 5-point Likert scale.

Results

In the phantom study, the edge sharpness of the 3-mm calcifications on DLR (median, 924 HU/mm; IQR, 580–1741 HU/mm) was significantly higher than on MBIR (median, 835 HU/mm; IQR, 484–1552; p < 0.001). In the clinical study, the image quality of the calcified lesions was significantly better on DLR with significantly reduced reconstruction time (p < 0.001). The contrast resolution at the coronary lumen side on DLR (median, −99.1 HU/mm; IQR, −209 to −34.3 HU/mm) was significantly higher than on MBIR (median, −41.8 HU/mm; IQR, −121 to 22.3 HU/mm, p < 0.001) although the edge sharpness of calcifications was similar between DLR and MBIR (p = 0.794) in the clinical setting.

Conclusion

EID-based UHRCT reconstructed using DLR represents better image quality of calcified lesions in coronary artery disease compared with MBIR, with significantly reduced reconstruction time.

研究背景本研究旨在比较基于能量积分探测器（EID）的超高分辨率 CT（UHRCT）上深度学习重建（DLR）和基于模型的迭代重建（MBIR）对冠状动脉疾病钙化病变的成像质量：我们使用钙化专用插入物对基于 EID 的 UHRCT 进行了模型研究，并获得了 DLR 和 MBIR 的导数值。在临床研究中，我们对 62 名患者的 73 个钙化病灶的 DLR 和 MBIR 的导数值进行了比较。钙化的边缘锐利度和冠状动脉管腔侧的对比分辨率通过最大和最小导数值进行量化。两名放射科医生使用 5 点李克特量表独立分析了钙化病变的图像质量：结果：在模型研究中，DLR（中位数，924 HU/mm；IQR，580-1741 HU/mm）上 3 毫米钙化的边缘锐利度明显高于 MBIR（中位数，835 HU/mm；IQR，484-1552；P 结论：与 MBIR 相比，使用 DLR 重建的基于 EID 的 UHRCT 对冠状动脉疾病钙化病变的成像质量更好，重建时间也明显缩短。

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引用次数: 0

Truncus arteriosus with double aortic arch: A rare case in an unrepaired pregnant patient 伴有双主动脉弓的动脉导管未闭：一例罕见的未修复妊娠患者。

IF 5.5 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Computed Tomography

Pub Date : 2024-11-01 DOI: 10.1016/j.jcct.2024.07.011

Liya Dai , Chenhui Zhou , Yanhua Huang , Fanghong Chen , Chenying Lu

引用次数: 0

Corrigendum to ‘Computed tomography-derived normative values and z-scores of the pulmonary valve annulus and sino-tubular junction in the pediatric population’ [J Cardiovasc Comput Tomogr 18 (2024) 489–493] 小儿肺动脉瓣环和sino-tubular交界处的计算机断层扫描规范值和z值》[J Cardiovasc Comput Tomogr 18 (2024) 489-493]的更正。

IF 5.5 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Computed Tomography

Pub Date : 2024-11-01 DOI: 10.1016/j.jcct.2024.10.005

Natalie Soszyn, Michael Shorofsky, Salvador Rodriguez Franco, Jenny E. Zablah, Gareth J. Morgan

引用次数: 0

Building the bridges – Collaborative spirit of our society 架设桥梁--我们社会的协作精神。

IF 5.5 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Computed Tomography

Pub Date : 2024-11-01 DOI: 10.1016/j.jcct.2024.10.007

Maros Ferencik

引用次数: 0

Table of contents-4C 目录-4C

IF 5.5 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Computed Tomography

Pub Date : 2024-11-01 DOI: 10.1016/S1934-5925(24)00468-4

引用次数: 0

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