Journal of Cardiovascular Computed Tomography最新文献

英文中文

A Comprehensive Analysis Of Clinical Features And Coronary Artery Lesions In Myocardial Bridging Patients Assessed Via Ct Coronary Angiography Ct冠状动脉造影评估心肌桥患者临床特征及冠状动脉病变的综合分析

IF 5.8 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Computed Tomography

Pub Date : 2026-01-01 DOI: 10.1016/j.jcct.2025.11.029

A. Ramdhani, A. Astuti, N. Kusumawardhani

引用次数: 0

Clinical Validation Of Automated Aortic Root Segmentation And Landmark Detection For TAVR Planning 自动主动脉根部分割和标记检测用于TAVR规划的临床验证

IF 5.8 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Computed Tomography

Pub Date : 2026-01-01 DOI: 10.1016/j.jcct.2025.11.016

J. Agris, A. Jog, M. Salvatori, V. S, R. AP, S. Agarwal, D. Guigonis, G. Urrutia, S. Batman, D. Della Latta

引用次数: 0

Reconstruction Parameter Optimization To Assess Noncalcified Coronary Plaques On Ultra-high-resolution Photon-counting Ct 在超高分辨率光子计数Ct上评估非钙化冠状动脉斑块的重建参数优化

IF 5.8 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Computed Tomography

Pub Date : 2026-01-01 DOI: 10.1016/j.jcct.2025.11.041

M. Boussoussou , B. Szilveszter , B. Vattay , B. Sipos , B. Nagy , M. Hagar , T. Emrich , Á. Varga-Szemes , M. Vecsey-Nagy

引用次数: 0

Epicardial Adipose Tissue Of Left Ventricle Is Associated With Ventricular Tachycardia Re-entry In Patients With Non-ischemic Cardiomyopathy 非缺血性心肌病患者左心室心外膜脂肪组织与室性心动过速再入有关

IF 5.8 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Computed Tomography

Pub Date : 2026-01-01 DOI: 10.1016/j.jcct.2025.11.050

L. Xu, T. Liao, D. Callans, F. Marchlinski, S. Nazarian

引用次数: 0

Initial Evaluation Of A Novel Reconstruction Algorithm Using Single-source Photon-counting Detector Ct In Coronary Ct Angiography: Impact On Stair-step Artifacts And Image Quality. 冠状动脉造影中单源光子计数检测器Ct重建算法的初步评估：对阶梯伪影和图像质量的影响。

IF 5.8 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Computed Tomography

Pub Date : 2026-01-01 DOI: 10.1016/j.jcct.2025.11.057

K. Nagy , L. Száraz , J. Shamshodini , S. Beke , B. Baksa , G. Veréb , A. Bartykowszki , M. Vértes , B. Merkely , P. Maurovich-Horvat

引用次数: 0

Diagnostic performance of coronary CT angiography to diagnose acute spontaneous coronary artery dissection 冠状动脉CT血管造影对急性自发性冠状动脉夹层的诊断价值。

IF 5.8 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Computed Tomography

Pub Date : 2026-01-01 DOI: 10.1016/j.jcct.2025.09.002

Lukas J. Moser , Tristan T. Demmert , Konstantin Klambauer , Victor Schweiger , Victor Mergen , Michael Würdinger , Davide Di Vece , Andrea Biondo , Alexander Gotschy , Barbara Stähli , Martin Reiner , Jelena-R. Ghadri , Robert Manka , Matthias Eberhard , Christian Templin , Hatem Alkadhi

Background

The diagnosis of spontaneous coronary artery dissection (SCAD) is made with invasive coronary angiography (ICA). The literature on the diagnostic performance of coronary CT angiography (coronary CTA) is sparse. The purpose of this study was to evaluate the performance of coronary CTA for the diagnosis of acute SCAD.

Methods

This prospective single-center study included 52 patients with SCAD confirmed by ICA and 70 patients with chest pain but without SCAD (control group), who all underwent coronary CTA. Two independent readers evaluated coronary CTA for SCAD, including vessel abnormalities and myocardial hypodensity. Accuracy, sensitivity, and specificity with 95 % confidence intervals (CI) were calculated using ICA as the reference standard. Coronary CTA imaging features of SCAD were correlated with diagnostic confidence using multivariable regression analysis. Interreader agreement was determined by Cohen's Kappa.

Results

Patient-level sensitivity of coronary CTA to diagnose SCAD ranged from 52 % (CI:38 %–66 %)-58 % (CI:43 %–71 %), with a specificity of 97 % (CI:90 %–100 %) and accuracy of 78 % (CI:69 %–85 %) and 80 % (CI:72 %–87 %) for both readers (Kappa = 0.891). Sensitivity and accuracy were higher for proximal (sensitivity 67 % (CI:38 %–88 %) and 73 % (CI:45 %–92 %); accuracy 93 % (CI:87 %–97 %) and 94 % (CI:89 %–98 %)) than for distal SCAD (sensitivity 40 % (CI:26 %–56 %) and 49 % (CI:34 %–64 %); accuracy 76 % (CI:68 %–83 %) and 80 % (CI:71 %–86 %)), while specificity was high irrespective of location (97 %; CI:91 %–99 %, resp.100 %). Additional myocardial hypodensity increased readers’ confidence (beta coefficient −0.38; p = 0.11 for reader 1, and beta coefficient of −0.90; p = 0.004 for reader 2) and sensitivity (71 % (CI:57 %–83 %) and 65 % (CI:51 %–78 %), respectively), while reducing specificity (both 91 %, CI:82 %–97 %).

Conclusion

Coronary CTA has a poor sensitivity for the diagnosis of SCAD, while specificity is high irrespective of SCAD location. Patients with coronary CTA positive for SCAD might be deferred from ICA after careful consideration and when conservative management is intended.

背景：自发性冠状动脉夹层（SCAD）的诊断采用有创冠状动脉造影（ICA）。关于冠状动脉CT血管造影（冠脉CTA）诊断性能的文献很少。本研究的目的是评价冠状动脉CTA在急性SCAD诊断中的表现。方法：本前瞻性单中心研究纳入52例经ICA证实的SCAD患者和70例胸痛但无SCAD的患者（对照组），均行冠状动脉CTA。两位独立读者评估了冠状动脉CTA对SCAD的诊断，包括血管异常和心肌低密度。以ICA作为参考标准，以95%置信区间（CI）计算准确性、灵敏度和特异性。采用多变量回归分析，冠脉CTA影像特征与SCAD的诊断可信度相关。解读协议由科恩的卡帕决定。结果：冠状动脉CTA诊断SCAD的患者水平敏感性为52% (CI: 38% - 66%)- 58% (CI: 43% - 71%)，特异性为97% (CI: 90% - 100%)，准确率为78% （CI: 69% - 85%）和80% (CI: 72% - 87%) （Kappa = 0.891）。近端敏感度和准确度较高(敏感度67% （CI: 38% - 88%）和73% (CI: 45% - 92%)；准确度分别为93% （CI: 87% - 97%）和94% (CI: 89% - 98%)，远端SCAD的灵敏度分别为40% （CI: 26% - 56%）和49% (CI: 34% - 64%)；准确度为76% （CI: 68% - 83%）和80% (CI: 71% - 86%))，而特异性高，与位置无关(97%;CI: 91% - 99%，分别为2。100%)。额外的心肌低密度增加了阅读器的信心（β系数为-0.38，阅读器1的p = 0.11，阅读器2的β系数为-0.90,p = 0.004）和敏感性（分别为71% （CI: 57% - 83%）和65% (CI: 51% - 78%)），同时降低了特异性（均为91%，CI: 82% - 97%）。结论：冠状动脉CTA对SCAD的诊断敏感性较差，而与SCAD的位置无关，特异性较高。冠状动脉CTA SCAD阳性的患者在经过慎重考虑和打算保守治疗后，可能会推迟进行ICA。

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引用次数: 0

Appraising the CCTA-SCAD study: Current challenges and future perspectives in diagnosing acute spontaneous coronary artery dissection 评价CCTA-SCAD研究：诊断急性自发性冠状动脉夹层的当前挑战和未来展望。

IF 5.8 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Computed Tomography

Pub Date : 2026-01-01 DOI: 10.1016/j.jcct.2025.09.010

Weikai Dong, Guangjin Gao, Dayu Shi, Wei Li

引用次数: 0

Remnant cholesterol as a cardiovascular risk modifier in patients with coronary atherosclerosis detected by coronary CT angiography 冠状动脉CT血管造影检测残余胆固醇作为冠状动脉粥样硬化患者心血管危险调节因子。

IF 5.8 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Computed Tomography

Pub Date : 2026-01-01 DOI: 10.1016/j.jcct.2025.12.006

Álvaro Montes Muñiz , Beatriz López-Melgar , Juan José Raposo-López , Victor Navas Moreno , Alberto Cecconi , Paloma Caballero , Susana Hernández , Carmen Benavides , Mónica Marazuela , Luis Jesús Jiménez Borreguero , Fernando Alfonso , Fernando Sebastián-Valles

Introduction

Remnant cholesterol (RC) is an independent predictor of cardiovascular risk (CVR) beyond low-density lipoprotein cholesterol (LDL-C) and has been associated with major adverse cardiovascular events (MACE). However, its prognostic interaction with coronary atherosclerotic burden as assessed by coronary CT angiography (CCTA) remains poorly defined. The aim of this study was to evaluate whether RC acts as an independent factor or as a modulator of the effect of atherosclerotic burden on the risk of death, myocardial infarction, or revascularization in patients without prior coronary events.

Methods

This was a retrospective cohort study including 296 consecutive patients undergoing CCTA for chest pain with no history of coronary events. RC was calculated indirectly and stratified into quartiles. Coronary atherosclerotic burden was assessed using coronary artery calcium (CAC) score, CAD-RADS, segment involvement score (SIS), visual plaque burden, and the presence of high-risk plaques. Adjusted Cox regression models and four-way mediation analyses were employed to evaluate the interaction between RC, plaque burden, and MACE during follow-up.

Results

After a mean follow-up of 6.3 years, 44 MACE occurred in 41 patients (13.3 %). Elevated RC (>30 mg/dL) was associated with an increased risk of MACE (HR 4.16; 95 % CI: 1.2–14.9). No direct association was found between RC and atherosclerotic burden; however, a significant interaction was observed, whereby the likelihood of MACE in patients with higher plaque burden increased more markedly in the presence of elevated RC. These findings were robust and consistent across various models and sensitivity analyses.

Conclusions

RC amplifies the effect of coronary atherosclerosis on the risk of MACE. Its integration with atherosclerotic burden assessment via CCTA may help optimize cardiovascular risk stratification.

残余胆固醇（RC）是除低密度脂蛋白胆固醇（LDL-C）外的心血管风险（CVR）的独立预测因子，并与主要不良心血管事件（MACE）相关。然而，通过冠状动脉CT血管造影（CCTA）评估其与冠状动脉粥样硬化负荷的预后相互作用仍不明确。本研究的目的是评估RC在无冠状动脉事件的患者中，是作为独立因素还是作为动脉粥样硬化负荷对死亡、心肌梗死或血运重建风险影响的调节因子。方法：这是一项回顾性队列研究，包括296例连续接受CCTA治疗胸痛且无冠状动脉事件史的患者。RC是间接计算的，分层为四分位数。通过冠状动脉钙（CAC）评分、CAD-RADS、节段累及评分（SIS）、视觉斑块负担和高危斑块的存在来评估冠状动脉粥样硬化负担。采用调整后的Cox回归模型和四向中介分析来评估RC、斑块负担和MACE在随访期间的相互作用。结果：平均随访6.3年，41例（13.3%）患者发生44例MACE。RC升高（bbb30 mg/dL）与MACE风险增加相关（HR 4.16; 95% CI: 1.2-14.9）。没有发现RC与动脉粥样硬化负荷之间的直接关联；然而，观察到一个显著的相互作用，即在RC升高的情况下，斑块负担较高的患者发生MACE的可能性更显着增加。这些发现在各种模型和敏感性分析中都是稳健和一致的。结论：RC放大了冠状动脉粥样硬化对MACE风险的影响。它与CCTA动脉粥样硬化负担评估相结合，有助于优化心血管风险分层。

{"title":"Remnant cholesterol as a cardiovascular risk modifier in patients with coronary atherosclerosis detected by coronary CT angiography","authors":"Álvaro Montes Muñiz , Beatriz López-Melgar , Juan José Raposo-López , Victor Navas Moreno , Alberto Cecconi , Paloma Caballero , Susana Hernández , Carmen Benavides , Mónica Marazuela , Luis Jesús Jiménez Borreguero , Fernando Alfonso , Fernando Sebastián-Valles","doi":"10.1016/j.jcct.2025.12.006","DOIUrl":"10.1016/j.jcct.2025.12.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Remnant cholesterol (RC) is an independent predictor of cardiovascular risk (CVR) beyond low-density lipoprotein cholesterol (LDL-C) and has been associated with major adverse cardiovascular events (MACE). However, its prognostic interaction with coronary atherosclerotic burden as assessed by coronary CT angiography (CCTA) remains poorly defined. The aim of this study was to evaluate whether RC acts as an independent factor or as a modulator of the effect of atherosclerotic burden on the risk of death, myocardial infarction, or revascularization in patients without prior coronary events.</div></div><div><h3>Methods</h3><div>This was a retrospective cohort study including 296 consecutive patients undergoing CCTA for chest pain with no history of coronary events. RC was calculated indirectly and stratified into quartiles. Coronary atherosclerotic burden was assessed using coronary artery calcium (CAC) score, CAD-RADS, segment involvement score (SIS), visual plaque burden, and the presence of high-risk plaques. Adjusted Cox regression models and four-way mediation analyses were employed to evaluate the interaction between RC, plaque burden, and MACE during follow-up.</div></div><div><h3>Results</h3><div>After a mean follow-up of 6.3 years, 44 MACE occurred in 41 patients (13.3 %). Elevated RC (>30 mg/dL) was associated with an increased risk of MACE (HR 4.16; 95 % CI: 1.2–14.9). No direct association was found between RC and atherosclerotic burden; however, a significant interaction was observed, whereby the likelihood of MACE in patients with higher plaque burden increased more markedly in the presence of elevated RC. These findings were robust and consistent across various models and sensitivity analyses.</div></div><div><h3>Conclusions</h3><div>RC amplifies the effect of coronary atherosclerosis on the risk of MACE. Its integration with atherosclerotic burden assessment via CCTA may help optimize cardiovascular risk stratification.</div></div>","PeriodicalId":49039,"journal":{"name":"Journal of Cardiovascular Computed Tomography","volume":"20 1","pages":"Pages 70-78"},"PeriodicalIF":5.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Voxel-based correction of CT attenuations for accurate quantification of coronary artery calcification in low tube voltage scans with deep learning reconstruction 基于体素的CT衰减校正，在低管电压扫描中精确量化冠状动脉钙化。

IF 5.8 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Computed Tomography

Pub Date : 2026-01-01 DOI: 10.1016/j.jcct.2025.12.008

He Zhang , Shuai Zhang , Aiyun Sun , Dapeng Zhang , Juan Long , Chenzi Wang , Xiaohan Liu , Lixiang Xie , Chunfeng Hu , Cunjie Sun , Kai Xu , Yankai Meng

Background

Low-kilovolt (kV), low-dose scanning combined with deep learning-based image reconstruction (DLIR) is increasingly adopted in clinical practice. However, it often introduces biases in the quantification and risk stratification of coronary artery calcification (CAC).

Objective

This study proposes a voxel-based CT attenuation correction method to enable accurate CAC assessment under low-kV imaging.

Methods

Phantom scans containing various inserts were acquired using a standard protocol (120 kVp with filtered back projection, STD group) and a low-kV protocol (80 kVp with DLIR, low-kV group). A linear regression model was established to derive a correction formula mapping CT attenuation from the low-kV to the STD. Subsequently, patients referred for CAC scoring were prospectively enrolled. Each patient underwent two scans (STD and low-kV). Voxel-wise CT attenuations in the low-kV images were corrected using the phantom-derived calibration formula. Automated CAC analysis software was used to compute calcified volume, equivalent mass, and Agatston score, followed by risk stratification into standard categories (0, 10, 100, 400). Corrected low-kV measurements were compared to those from the STD. Objective image quality was assessed through CT attenuation, standard deviation (SD) and signal-to-noise ratio (SNR). Subjective quality was evaluated using a 5-point Likert scale.

Results

A total of 190 patients were included. The low-kV group achieved a 77.6 % reduction in radiation dose compared to the STD group. Prior to correction, the low-kV group significantly overestimated calcified volume, equivalent mass, Agatston score, and risk category (all P < 0.05). After voxel-based correction, no statistically significant differences remained compared to the STD group (all P > 0.05). The bias in calcified volume, equivalent mass, and Agatston score were reduced from 48.14 ± 73.66, 19.48 ± 33.44, and 62.44 ± 94.46 to 6.63 ± 23.56, −0.44 ± 6.68, and 3.05 ± 28.25, respectively. The risk stratification misclassification rate decreased from 20.53 % to 5.79 %. The low-kV group outperformed the STD group in objective image assessments, showing superior CT attenuation, SD and SNR. There were no significant differences in subjective image assessments.

Conclusion

The proposed voxel-based correction method effectively mitigates the overestimation bias introduced by low-kV protocols in CAC assessment.

背景：低千伏（kV）、低剂量扫描结合基于深度学习的图像重建（DLIR）技术越来越多地应用于临床实践。然而，它经常在冠状动脉钙化（CAC）的量化和风险分层中引入偏差。目的：提出一种基于体素的CT衰减校正方法，实现低kv成像下CAC的准确评估。方法：采用标准方案（120 kVp带滤波后投影，STD组）和低kv方案（80 kVp带DLIR，低kv组）获得包含各种插入的幻影扫描。建立线性回归模型，推导出从低kv到STD的CT衰减的校正公式。随后，前瞻性地纳入了CAC评分的患者。每位患者接受两次扫描（性病和低kv）。低kv图像中的体素级CT衰减使用幻像衍生校准公式进行校正。使用自动化CAC分析软件计算钙化体积、等效质量和Agatston评分，然后将风险分层为标准类别（0,10,100,400）。通过CT衰减、标准差（SD）和信噪比（SNR）评估客观图像质量。主观质量采用5分李克特量表进行评估。结果：共纳入190例患者。与性病组相比，低千伏组的辐射剂量减少了77.6%。校正前，低kv组明显高估钙化体积、等效质量、Agatston评分和风险类别（均P < 0.05）。经体素校正后，与STD组比较，差异无统计学意义（P < 0.05）。钙化体积、等效质量和Agatston评分的偏差分别从48.14±73.66、19.48±33.44和62.44±94.46降至6.63±23.56、-0.44±6.68和3.05±28.25。风险分层错分率由20.53%降至5.79%。低kv组在客观图像评价上优于STD组，表现出更好的CT衰减、SD和信噪比。主观形象评价差异无统计学意义。结论：提出的基于体素的校正方法有效地减轻了低kv协议在CAC评估中引入的高估偏差。

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Masthead-4C Masthead-4C

IF 5.8 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Computed Tomography

Pub Date : 2026-01-01 DOI: 10.1016/S1934-5925(26)00023-7

引用次数: 0

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