Journal of cardiovascular computed tomography最新文献

英文中文

A novel pendulum-based impulse method to measure CT temporal resolution. 一种基于钟摆脉冲的CT时间分辨率测量新方法。

Journal of cardiovascular computed tomography

Pub Date : 2026-01-16 DOI: 10.1016/j.jcct.2026.01.001

Naoki Nagasawa, Satoshi Nakamura, Jun Matsuo, Kengo Hashizume, Mana Deguchi, Akio Yamazaki, Kakuya Kitagawa

Background: High temporal resolution (TR) in CT is essential for reducing motion artifacts from rapidly moving structures like the heart. Although the conventional impulse method can measure TR, it requires specialized equipment to accelerate a sphere, which limits its practicality.

Objectives: This study aimed to develop and validate a simplified pendulum method for TR measurement and validate that it provides equivalent measurements to the conventional approach.

Methods: TR was measured using the proposed pendulum method and the conventional slingshot method. Fifty scans were acquired for each method at pitch factors (PF) of 0.8 and 1.2. TR was quantified using full width at half maximum (FWHM) and full width at tenth maximum (FWTM). Equivalence was evaluated with the two one-sided tests (TOST).

Results: The pendulum method demonstrated statistical equivalence to the slingshot method across all tested parameters. For PF 0.8, the FWHM was 0.55 ± 0.03 s for the pendulum method versus 0.54 ± 0.04 s for the slingshot method (TOST, p = 0.005). At PF of 1.2, the FWHM was 0.15 ± 0.01 s for both methods, which were also statistically equivalent (TOST, p = 0.021).

Conclusion: The pendulum method provides a simple, reproducible approach for TR measurement, facilitating parameter optimization in clinical and research imaging.

背景：CT的高时间分辨率（TR）对于减少快速运动结构（如心脏）的运动伪影至关重要。虽然传统的脉冲法可以测量TR，但需要专门的设备来加速球体，这限制了它的实用性。目的：本研究旨在建立和验证一种简化的摆法测量TR，并验证其提供与传统方法等效的测量结果。方法：采用所提出的摆法和传统的弹弓法分别进行了TR测量。在音调因子（PF）为0.8和1.2时，每种方法获得50次扫描。TR采用半最大全宽（FWHM）和十分之一最大全宽（FWTM）进行量化。用两个单侧检验（TOST）评价等效性。结果：在所有测试参数上，摆锤法与弹弓法具有统计等效性。当PF为0.8时，摆锤法的FWHM为0.55±0.03 s，而弹弓法的FWHM为0.54±0.04 s （TOST, p = 0.005）。在PF为1.2时，两种方法的FWHM均为0.15±0.01 s，两者在统计学上也相当（TOST, p = 0.021）。结论：钟摆法是一种简便、重复性好的TR测量方法，便于临床和研究影像学参数优化。

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引用次数: 0

Carotid perivascular adipose tissue attenuation predicts stroke and TIA in symptomatic carotid artery disease patients. 颈动脉血管周围脂肪组织衰减预测症状性颈动脉疾病患者的卒中和TIA。

Journal of cardiovascular computed tomography

Pub Date : 2026-01-09 DOI: 10.1016/j.jcct.2025.12.009

Juul Bierens, Nora Jerkovic, Alida A Postma, Daniel Bos, Pim A de Jong, Paul J Nederkoorn, Werner H Mess, Luca Saba, Luc J M Smits, Robert J van Oostenbrugge, M Eline Kooi

Background: Vascular inflammation is a key aspect of plaque vulnerability. Cross-sectional studies suggest that increased carotid perivascular adipose tissue (PVAT) attenuation on CTA, which is thought to reflect vascular inflammation, is associated with stroke.

Objectives: We investigated the predictive value of carotid PVAT attenuation for ischemic stroke and TIA in a longitudinal study of symptomatic patients with carotid plaque.

Methods: We included patients with recent TIA or stroke and a ≥2 mm carotid plaque with <70 % stenosis who underwent CTA and MRI and were clinically followed-up for 5 years. Mean PVAT attenuation (-190 to -30 Hounsfield Units (HU)) was quantified within a radial distance from the outer vessel wall equal to the vessel diameter on the CTA slice containing the thickest plaque. Cox proportional hazards models assessed associations with ipsilateral stroke and TIA risk. Predictive value was compared with intraplaque hemorrhage (IPH) and the European Carotid Surgery Trial (ECST) score using the C-index.

Results: Among 159 patients (74 % men; 69 (63-73) years), 11 ischemic strokes and 10 TIAs occurred over 5.1 (3.1-5.6) years. Increased PVAT attenuation was independently associated with ischemic stroke or TIA (HR: 3.21 per 10 HU increase, 95%CI:1.70-6.05) and ischemic stroke alone (HR: 5.60, 95%CI:1.93-16.31). PVAT attenuation alone predicted ischemic stroke or TIA (C-index: 0.71, 95%CI:0.70-0.73) and ischemic stroke alone (C-index: 0.78, 95%CI:0.63-0.93). Adding PVAT attenuation improved prediction beyond IPH (C-index: 0.66-0.68 to 0.81-0.84) and the ECST score (0.64-0.75 to 0.75-0.86, respectively).

Conclusion: In symptomatic patients, PVAT attenuation is an independent marker for ischemic stroke and TIA risk.

背景：血管炎症是斑块易感性的一个关键方面。横断面研究表明，颈动脉血管周围脂肪组织（PVAT）在CTA上的衰减增加被认为是血管炎症的反映，与中风有关。目的：通过对有症状的颈动脉斑块患者进行纵向研究，研究颈动脉PVAT衰减对缺血性卒中和TIA的预测价值。方法：我们纳入了近期TIA或卒中且颈动脉斑块≥2mm的患者，结果：159例患者（74%男性；69（63-73）岁），11例缺血性卒中和10例TIA发生在5.1（3.1-5.6）年。PVAT衰减增加与缺血性卒中或TIA （HR: 3.21 / 10 HU升高，95%CI:1.70-6.05）和单独缺血性卒中（HR: 5.60, 95%CI:1.93-16.31）独立相关。单独PVAT衰减预测缺血性卒中或TIA （C-index: 0.71, 95%CI:0.70-0.73）和单独缺血性卒中（C-index: 0.78, 95%CI:0.63-0.93）。增加PVAT衰减可以改善IPH （C-index: 0.66-0.68至0.81-0.84）和ECST评分（分别为0.64-0.75至0.75-0.86）之后的预测。结论：在有症状的患者中，PVAT衰减是缺血性卒中和TIA风险的独立标志。

{"title":"Carotid perivascular adipose tissue attenuation predicts stroke and TIA in symptomatic carotid artery disease patients.","authors":"Juul Bierens, Nora Jerkovic, Alida A Postma, Daniel Bos, Pim A de Jong, Paul J Nederkoorn, Werner H Mess, Luca Saba, Luc J M Smits, Robert J van Oostenbrugge, M Eline Kooi","doi":"10.1016/j.jcct.2025.12.009","DOIUrl":"https://doi.org/10.1016/j.jcct.2025.12.009","url":null,"abstract":"Background: Vascular inflammation is a key aspect of plaque vulnerability. Cross-sectional studies suggest that increased carotid perivascular adipose tissue (PVAT) attenuation on CTA, which is thought to reflect vascular inflammation, is associated with stroke.Objectives: We investigated the predictive value of carotid PVAT attenuation for ischemic stroke and TIA in a longitudinal study of symptomatic patients with carotid plaque.Methods: We included patients with recent TIA or stroke and a ≥2 mm carotid plaque with <70 % stenosis who underwent CTA and MRI and were clinically followed-up for 5 years. Mean PVAT attenuation (-190 to -30 Hounsfield Units (HU)) was quantified within a radial distance from the outer vessel wall equal to the vessel diameter on the CTA slice containing the thickest plaque. Cox proportional hazards models assessed associations with ipsilateral stroke and TIA risk. Predictive value was compared with intraplaque hemorrhage (IPH) and the European Carotid Surgery Trial (ECST) score using the C-index.Results: Among 159 patients (74 % men; 69 (63-73) years), 11 ischemic strokes and 10 TIAs occurred over 5.1 (3.1-5.6) years. Increased PVAT attenuation was independently associated with ischemic stroke or TIA (HR: 3.21 per 10 HU increase, 95%CI:1.70-6.05) and ischemic stroke alone (HR: 5.60, 95%CI:1.93-16.31). PVAT attenuation alone predicted ischemic stroke or TIA (C-index: 0.71, 95%CI:0.70-0.73) and ischemic stroke alone (C-index: 0.78, 95%CI:0.63-0.93). Adding PVAT attenuation improved prediction beyond IPH (C-index: 0.66-0.68 to 0.81-0.84) and the ECST score (0.64-0.75 to 0.75-0.86, respectively).Conclusion: In symptomatic patients, PVAT attenuation is an independent marker for ischemic stroke and TIA risk.","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Novel deep learning CCTA-FFR for detecting functionally significant coronary stenosis: Comparison with iFR. 新型深度学习CCTA-FFR检测功能显著的冠状动脉狭窄：与iFR的比较。

Journal of cardiovascular computed tomography

Pub Date : 2026-01-09 DOI: 10.1016/j.jcct.2025.12.007

Mona P Roshan, Grayson V Gigliotti, Jeffrey Gonzalez, Ricardo A Cury, Chrisnel Lamy, Karl Sayegh, Ricardo C Cury

Background: Deep learning-based fractional flow reserve derived from coronary CT angiography (CT-FFR) enables noninvasive assessment of lesion-specific ischemia. Onsite CT-FFR systems provide near-real-time physiologic evaluation at the workstation, potentially reducing unnecessary invasive testing. This study evaluated the diagnostic performance of a novel onsite deep learning CT-FFR algorithm compared with invasive instantaneous wave-free ratio (iFR).

Methods: We retrospectively analyzed 44 patients (44 lesions) who underwent clinically indicated coronary CT angiography (CCTA) and invasive iFR. CT-FFR values were generated using an onsite deep learning algorithm (cFFR v6) 1-2 cm distal to visually identified stenoses. Physiologic significance was defined as CT-FFR ≤0.80 or iFR ≤0.89. Diagnostic performance metrics were calculated overall and within CCTA stenosis strata (<50 %, 50-70 %, >70 %). ROC analysis and Pearson correlation assessed discriminative ability and linear association. Additional comparative analyses evaluated diagnostic accuracy of CCTA ≥50 % and ≥70 % thresholds relative to iFR and quantified incremental diagnostic value of CT-FFR over CCTA alone.

Results: Of 44 lesions, 28 (63.6 %) were iFR-positive and 30 (68.2 %) were CT-FFR-positive. CT-FFR demonstrated a sensitivity of 89.3 %, specificity of 68.8 %, positive predictive value of 83.3 %, negative predictive value of 78.6 %, and accuracy of 81.8 %; the area under the ROC curve was 0.79 (95 % CI, 0.66-0.92). CT-FFR and iFR showed a modest but significant correlation (r ≈ 0.37). Performance remained favorable in moderate (40-70 %) stenoses (AUC 0.73) and severe (>70 %) stenoses (AUC 0.84). In contrast, CCTA ≥50 % and ≥70 % thresholds showed limited discriminatory ability versus iFR (AUC 0.44 and 0.52, respectively). Compared with CCTA alone, CT-FFR improved both sensitivity and specificity and substantially increased AUC across both thresholds.

Conclusion: The onsite deep learning CT-FFR algorithm demonstrated good diagnostic agreement with invasive iFR and maintained performance across stenosis severity categories, while providing clear incremental value over CCTA stenosis assessment alone. These findings support the feasibility of rapid, workstation-integrated physiologic assessment during CCTA interpretation. Larger multicenter studies are needed to validate these results and clarify the clinical role of onsite CT-FFR.

背景：基于深度学习的冠状动脉CT血管造影（CT- ffr）的分数血流储备能够无创地评估病变特异性缺血。现场CT-FFR系统在工作站提供近实时的生理评估，潜在地减少了不必要的侵入性测试。本研究评估了一种新型现场深度学习CT-FFR算法与有创瞬时无波比（iFR）的诊断性能。方法：我们回顾性分析44例（44个病变）行临床指示的冠状动脉CT血管造影（CCTA）和有创iFR的患者。CT-FFR值使用现场深度学习算法（cFFR v6）在视觉识别的狭窄远端1-2 cm处生成。生理意义定义为CT-FFR≤0.80或iFR≤0.89。总体和CCTA狭窄层（70%）内计算诊断性能指标。ROC分析及Pearson相关评估判别能力及线性关联。另外的比较分析评估了CCTA相对于iFR≥50%和≥70%阈值的诊断准确性，以及CT-FFR相对于单独CCTA的量化增量诊断价值。结果：44例病灶中ifr阳性28例（63.6%），ct - ffr阳性30例（68.2%）。CT-FFR的敏感性为89.3%，特异性为68.8%，阳性预测值为83.3%，阴性预测值为78.6%，准确率为81.8%；ROC曲线下面积为0.79 （95% CI, 0.66 ~ 0.92）。CT-FFR与iFR相关性不显著（r≈0.37）。中度（40- 70%）狭窄（AUC 0.73）和重度（50 - 70%）狭窄（AUC 0.84）的表现仍然良好。相比之下，CCTA≥50%和≥70%阈值与iFR相比显示有限的区分能力（AUC分别为0.44和0.52）。与单独CCTA相比，CT-FFR提高了敏感性和特异性，并大大增加了两个阈值的AUC。结论：现场深度学习CT-FFR算法与有创iFR具有良好的诊断一致性，并在不同的狭窄严重程度类别中保持良好的表现，同时比单独的CCTA狭窄评估提供了明确的增量价值。这些发现支持在CCTA解释过程中快速、工作站集成的生理评估的可行性。需要更大规模的多中心研究来验证这些结果，并阐明现场CT-FFR的临床作用。

{"title":"Novel deep learning CCTA-FFR for detecting functionally significant coronary stenosis: Comparison with iFR.","authors":"Mona P Roshan, Grayson V Gigliotti, Jeffrey Gonzalez, Ricardo A Cury, Chrisnel Lamy, Karl Sayegh, Ricardo C Cury","doi":"10.1016/j.jcct.2025.12.007","DOIUrl":"https://doi.org/10.1016/j.jcct.2025.12.007","url":null,"abstract":"Background: Deep learning-based fractional flow reserve derived from coronary CT angiography (CT-FFR) enables noninvasive assessment of lesion-specific ischemia. Onsite CT-FFR systems provide near-real-time physiologic evaluation at the workstation, potentially reducing unnecessary invasive testing. This study evaluated the diagnostic performance of a novel onsite deep learning CT-FFR algorithm compared with invasive instantaneous wave-free ratio (iFR).Methods: We retrospectively analyzed 44 patients (44 lesions) who underwent clinically indicated coronary CT angiography (CCTA) and invasive iFR. CT-FFR values were generated using an onsite deep learning algorithm (cFFR v6) 1-2 cm distal to visually identified stenoses. Physiologic significance was defined as CT-FFR ≤0.80 or iFR ≤0.89. Diagnostic performance metrics were calculated overall and within CCTA stenosis strata (<50 %, 50-70 %, >70 %). ROC analysis and Pearson correlation assessed discriminative ability and linear association. Additional comparative analyses evaluated diagnostic accuracy of CCTA ≥50 % and ≥70 % thresholds relative to iFR and quantified incremental diagnostic value of CT-FFR over CCTA alone.Results: Of 44 lesions, 28 (63.6 %) were iFR-positive and 30 (68.2 %) were CT-FFR-positive. CT-FFR demonstrated a sensitivity of 89.3 %, specificity of 68.8 %, positive predictive value of 83.3 %, negative predictive value of 78.6 %, and accuracy of 81.8 %; the area under the ROC curve was 0.79 (95 % CI, 0.66-0.92). CT-FFR and iFR showed a modest but significant correlation (r ≈ 0.37). Performance remained favorable in moderate (40-70 %) stenoses (AUC 0.73) and severe (>70 %) stenoses (AUC 0.84). In contrast, CCTA ≥50 % and ≥70 % thresholds showed limited discriminatory ability versus iFR (AUC 0.44 and 0.52, respectively). Compared with CCTA alone, CT-FFR improved both sensitivity and specificity and substantially increased AUC across both thresholds.Conclusion: The onsite deep learning CT-FFR algorithm demonstrated good diagnostic agreement with invasive iFR and maintained performance across stenosis severity categories, while providing clear incremental value over CCTA stenosis assessment alone. These findings support the feasibility of rapid, workstation-integrated physiologic assessment during CCTA interpretation. Larger multicenter studies are needed to validate these results and clarify the clinical role of onsite CT-FFR.","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ethnic differences in left ventricular myocardial volume assessed by coronary computed tomography angiography in asymptomatic adults. 无症状成人冠状动脉ct血管造影评估左心室心肌容量的种族差异。

Journal of cardiovascular computed tomography

Pub Date : 2026-01-03 DOI: 10.1016/j.jcct.2025.12.010

Sahar Zahraee, Iskander Beshoy, April Kinninger, Song Shou Mao, Matthew J Budoff

引用次数: 0

Deep Learning-Based denoising improves myocardial late enhancement imaging with spectral photon-counting CT. 基于深度学习的去噪改进了光谱光子计数CT心肌后期增强成像。

Journal of cardiovascular computed tomography

Pub Date : 2025-12-26 DOI: 10.1016/j.jcct.2025.12.002

José Osoria-Velasquez, Giuseppe Tremamunno, Tilman Emrich, James Ira Griggers, Sardi Hyska, Dmitrij Kravchenko, Fabian Bamberg, Moritz C Halfmann, Milán Vecsey-Nagy, Akos Varga-Szemes, Muhammad Taha Hagar

引用次数: 0

Coronary computed Tomography-Based surveillance for coronary allograft vasculopathy in pediatric heart transplant recipients: The role of CT-derived fractional flow reserve. 冠状动脉计算机断层扫描监测儿童心脏移植受者冠状动脉异体移植血管病变：ct衍生的血流储备分数的作用。

Journal of cardiovascular computed tomography

Pub Date : 2025-12-24 DOI: 10.1016/j.jcct.2025.12.001

Sanja Dzelebdzic, Pavithra Kolla, Tayaba Miah, Ryan Davies, Gerald F Greil, Drishti Tolani, Jonathon Leipsic, Nathanya Baez Hernandez, Ryan Butts, Tarique Hussain, Munes Fares

引用次数: 0

Giant coronary button aneurysms two decades after Bentall procedure in Marfan syndrome: A CT perspective. 马凡氏综合征本特尔手术后20年巨大冠状动脉钮扣动脉瘤的CT观察。

Journal of cardiovascular computed tomography

Pub Date : 2025-12-17 DOI: 10.1016/j.jcct.2025.12.004

Haolin Yin, Yu Jiang, Qiyong Gong

引用次数: 0

Accuracy of on-site CT-μFR analyses for evaluation of intermediate coronary stenoses in patients undergoing TAVI. 现场CT μ fr分析评价TAVI患者中度冠状动脉狭窄的准确性。

Journal of cardiovascular computed tomography

Pub Date : 2025-12-04 DOI: 10.1016/j.jcct.2025.11.082

Adrian Bednarek, Natan Adamów, Krzysztof Badura, Marta Mazur, Julia Białecka, Magdalena Dobrolińska, Paweł Siuciak, Krzysztof Milewski, Jarosław Drożdż, Miłosz Jaguszewski, Wojciech Wojakowski, Zenon Huczek, Janusz Kochman, Mariusz Tomaniak

引用次数: 0

Corrigendum to "Applying dual energy computed tomography to postmortem coronary computed tomographic angiography" [J Cardiovasc Comput Tomogr (in press)]. “双能量计算机断层扫描在死后冠状动脉计算机断层血管造影中的应用”的勘误表[J]心血管计算机断层（已出版）。

Journal of cardiovascular computed tomography

Pub Date : 2025-11-26 DOI: 10.1016/j.jcct.2025.11.003

Nadia Solomon, Matthew Hoerner, Billy Vermillion, Sun-Joo Jang, Harold Sanchez, Babina Gosangi, Lawrence Staib, Stephanie L Thorn, Chi Liu, Albert J Sinusas

引用次数: 0

Assessment of calcium characteristics in chronic total occlusion using computed tomography coronary angiogram and implications for percutaneous coronary intervention. 利用计算机断层冠状动脉造影评估慢性全闭塞患者的钙特征及经皮冠状动脉介入治疗的意义。

Journal of cardiovascular computed tomography

Pub Date : 2025-11-25 DOI: 10.1016/j.jcct.2025.11.079

Vinoda Sharma, Ahmed Hassan, Saba Kouser, Leong Lee, Sandeep Basavarajaiah, Sohail Khan, Abdul Mozid, Francis Joshi, Aadil Shaukat, Vivek Kodoth, Andrew Ladwiniec, Jawad Khan

Background: Calcification in a chronic total occlusion (CTO) is better visualised on Computed Tomography Coronary Angiography (CTCA) than invasive angiography.

Objectives: The authors sought to assess the characteristics of calcification of a CTO on CTCA and correlate with CTO percutaneous coronary intervention (PCI) outcome.

Methods: Retrospective analysis of the PCI database was performed (April 2017-April 2024) (clinical trials registration: NCT06414551). Patients who underwent both CTO PCI and CTCA were grouped into successful CTO PCI and any failed attempt of CTO PCI and compared for characteristics of calcification on CTCA: site of calcification, density of calcification in Hounsfield Units (HU) and quantity of calcification in % of cross section of the vessel.

Results: Out of 499 CTO PCIs performed, 82 patients had undergone CTCA. 51/82 (62.2 %) patients had analysable CTCAs. Mean age was 68.5 (±10.9) years and 19.6 % were female. Patients in the failed group were more likely to have calcification in the proximal cap (failed 65.4 % vs. success 24 %, p = 0.003), more dense calcification in the proximal cap (failed: 611.8 (±517) HU vs. success: 177.6 (±356) HU; p = 0.001) and proximal cap calcification quantity ≥50 % (failed: 75 % vs. success 16.7 %, p = 0.03). Proximal cap calcification ≥50 % was an independent predictor of CTO PCI failure (OR, 3.21, 95 % CI 1.29 to 7.98, p = 0.012).

Conclusions: Proximal cap calcification density and quantity on CTCA was associated with CTO PCI failure. Assessment of the proximal cap calcification may help with procedure planning in CTO PCI. Larger, prospective multicentre studies are required to corroborate these findings.

背景：慢性全闭塞（CTO）的钙化在ct冠状动脉造影（CTCA）上比有创血管造影更清晰。目的：作者试图评估CTO在CTCA上的钙化特征及其与CTO经皮冠状动脉介入治疗（PCI）结果的相关性。方法：回顾性分析2017年4月至2024年4月PCI数据库（临床试验注册号：NCT06414551）。同时接受CTO PCI和CTCA的患者被分为成功的CTO PCI和失败的CTO PCI，并比较CTCA上的钙化特征：钙化部位、Hounsfield单位（HU）的钙化密度和血管横截面百分比的钙化量。结果：在499例CTO pci中，82例患者行CTCA。51/82（62.2%）患者有可分析的ctca。平均年龄68.5（±10.9）岁，女性占19.6%。失败组患者更容易发生近端冠钙化（失败65.4% vs成功24%，p = 0.003），近端冠钙化更致密(失败：611.8（±517）HU vs成功：177.6（±356）HU；P = 0.001)，近端帽钙化量≥50%（失败75% vs成功16.7%,P = 0.03）。近端帽钙化≥50%是CTO PCI失败的独立预测因子（OR, 3.21, 95% CI 1.29至7.98,p = 0.012）。结论：CTCA近端钙化密度和数量与CTO PCI失败相关。评估近端帽钙化可能有助于CTO PCI的手术计划。需要更大规模的前瞻性多中心研究来证实这些发现。

{"title":"Assessment of calcium characteristics in chronic total occlusion using computed tomography coronary angiogram and implications for percutaneous coronary intervention.","authors":"Vinoda Sharma, Ahmed Hassan, Saba Kouser, Leong Lee, Sandeep Basavarajaiah, Sohail Khan, Abdul Mozid, Francis Joshi, Aadil Shaukat, Vivek Kodoth, Andrew Ladwiniec, Jawad Khan","doi":"10.1016/j.jcct.2025.11.079","DOIUrl":"https://doi.org/10.1016/j.jcct.2025.11.079","url":null,"abstract":"Background: Calcification in a chronic total occlusion (CTO) is better visualised on Computed Tomography Coronary Angiography (CTCA) than invasive angiography.Objectives: The authors sought to assess the characteristics of calcification of a CTO on CTCA and correlate with CTO percutaneous coronary intervention (PCI) outcome.Methods: Retrospective analysis of the PCI database was performed (April 2017-April 2024) (clinical trials registration: NCT06414551). Patients who underwent both CTO PCI and CTCA were grouped into successful CTO PCI and any failed attempt of CTO PCI and compared for characteristics of calcification on CTCA: site of calcification, density of calcification in Hounsfield Units (HU) and quantity of calcification in % of cross section of the vessel.Results: Out of 499 CTO PCIs performed, 82 patients had undergone CTCA. 51/82 (62.2 %) patients had analysable CTCAs. Mean age was 68.5 (±10.9) years and 19.6 % were female. Patients in the failed group were more likely to have calcification in the proximal cap (failed 65.4 % vs. success 24 %, p = 0.003), more dense calcification in the proximal cap (failed: 611.8 (±517) HU vs. success: 177.6 (±356) HU; p = 0.001) and proximal cap calcification quantity ≥50 % (failed: 75 % vs. success 16.7 %, p = 0.03). Proximal cap calcification ≥50 % was an independent predictor of CTO PCI failure (OR, 3.21, 95 % CI 1.29 to 7.98, p = 0.012).Conclusions: Proximal cap calcification density and quantity on CTCA was associated with CTO PCI failure. Assessment of the proximal cap calcification may help with procedure planning in CTO PCI. Larger, prospective multicentre studies are required to corroborate these findings.","PeriodicalId":94071,"journal":{"name":"Journal of cardiovascular computed tomography","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145644105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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