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- Title
Quantification of three-dimensional computed tomography angiography for evaluating coronary luminal stenosis using digital subtraction angiography as the standard of reference.
- Authors
Wei Guo; Xin Liu; Zhifan Gao; Pirbhulal, Sandeep; Wenhua Huang; Wan-Hua Lin; Heye Zhang; Ning Tan; Yuan-Ting Zhang
- Abstract
Objective: We sought to evaluate the accuracy of quantitative three-dimensional (3D) CT angiography (CTA) for the assessment of coronary luminal stenosis using digital subtraction angiography (DSA) as the standard of reference. Method: Twenty-three patients with 54 lesions were referred for CTA followed by DSA. The CTA scans were performed with 256-slice spiral CT. 3D CTA were reconstructed from two-dimensional CTA imaging sequences in order to extract the following quantitative indices: minimal lumen diameter, percent diameter stenosis (%DS), minimal lumen area, and percent area stenosis (%AS). Correlation and limits of agreement were calculated using Pearson correlation and Bland-Altman analysis, respectively. The diagnostic performance and the diagnostic concordance of 3D CTA-derived anatomic parameters (%DS, %AS) for the detection of severe coronary arterial stenosis (as assessed by DSA) were presented as sensitivity, specificity, diagnostic accuracy, and Kappa statistics. Of which vessels with %DS >50% or with %AS >75% were identified as severe coronary arterial lesions. Result: The correlations of the anatomic parameters between 3D CTA and DSA were significant (r = 0.51-0.74, P < 0.001). Bland-Altman analysis confirmed that the mean differences were small (from -1.11 to 27.39%), whereas the limits of agreement were relatively wide (from ±28.07 to ±138.64%). Otherwise, the diagnostic accuracy (74.1% with 58.3% sensitivity and 86.7% specificity for DS%; 74.1% with 45.8% sensitivity and 96.7% specificity for %AS) and the diagnostic concordance (k = 0.46 for DS%; 0.45 for %AS) of 3D CTA-derived anatomic parameters for the detection of severe stenosis were moderate. Conclusion: 3D advanced imaging reconstruction technique is a helpful tool to promote the use of CTA as an alternative to assess luminal stenosis in clinical practice.
- Subjects
DIGITAL angiography; STENOSIS; THREE-dimensional imaging; ARTERIAL stenosis; COMPUTED tomography; DIAGNOSIS
- Publication
BioMedical Engineering OnLine, 2015, Vol 14, Issue 1, p1
- ISSN
1475-925X
- Publication type
Article
- DOI
10.1186/s12938-015-0048-y