Department of Radiology, University of Verona, Policlinico GB Rossi, P.le LA Scuro 10, 37134, Verona, Italy.
Radiol Med. 2011 Dec;116(8):1203-16. doi: 10.1007/s11547-011-0719-0. Epub 2011 Sep 2.
Coronary angiography with multidetector-row computed tomography (MDCT-CA) allows quantification of coronary artery stenosis with a high level of accuracy; however, a better estimation of stenosis can be achieved by using appropriate reformatting filters, especially in stents and calcified segments. Quantitative computed tomography angiography (QCTA) is intended to overcome the limitations of the visual score. The aim of this study was to evaluate the accuracy of QCTA with different filters in comparison with quantitative coronary angiography (QCA) and visual score.
Two blinded operators visually scored 17 consecutive patients referred for MDCT-CA with a per-segment analysis. The degree of stenosis was classified as 0-20%, 20-50% (wall irregularities), 50-70% (significant disease) and 70-100% (vessel occlusion). Each segment was then analysed using the electronic callipers of the QCTA system with 15 different filters. No contour editing was performed. Data were compared with QCA and conventional coronary angiography (CCA). Comparison between QCTA, visual score and QCA were performed using Spearman's rank correlation.
Of 25 segments analysed (mean 1.4 diseased segment per patient), 375 measurements were considered. Good correlation was found between the visual score and QCA [Pearson correlation coefficient (rho=0.852; p<0.0001)] and between QCA and CCA (rho=0.804; p<0.0001). Moderate correlation was found between QCA and QCTA only using two filters (rho=0.444; p<0.0001 for YA filter and rho=0.450; p<0.0001 for YB filter).
Overall QCTA accuracy is low if contour editing is not applied, especially in calcified vessels. Certain filters can help to better estimate the exact percentage of stenosis.
多排螺旋 CT 冠状动脉造影（MDCT-CA）可对冠状动脉狭窄程度进行高度准确的定量评估；然而，通过使用适当的重建滤波器可以实现更准确的狭窄评估，尤其是在支架和钙化段。定量 CT 血管造影（QCTA）旨在克服可视评分的局限性。本研究旨在评估不同滤波器的 QCTA 的准确性，并与定量冠状动脉造影（QCA）和可视评分进行比较。
两名观察者对 17 名连续接受 MDCT-CA 检查的患者进行了分段分析。狭窄程度分为 0-20%、20-50%（管壁不规则）、50-70%（显著病变）和 70-100%（血管闭塞）。然后，使用 QCTA 系统的电子卡尺对每个节段进行分析，使用 15 种不同的滤波器。未进行轮廓编辑。将数据与 QCA 和常规冠状动脉造影（CCA）进行比较。使用 Spearman 秩相关分析比较 QCTA、可视评分和 QCA。
在分析的 25 个节段（每个患者平均 1.4 个病变节段）中，共考虑了 375 个测量值。可视评分与 QCA 之间存在良好的相关性（Pearson 相关系数（rho）=0.852；p<0.0001），与 CCA 之间也存在良好的相关性（rho）=0.804；p<0.0001）。仅使用两种滤波器（YA 滤波器的 rho=0.444；p<0.0001 和 YB 滤波器的 rho=0.450；p<0.0001）时，QCA 与 QCTA 之间存在中度相关性。
如果不进行轮廓编辑，QCTA 的整体准确性较低，尤其是在钙化血管中。某些滤波器可以帮助更好地估计狭窄的确切百分比。
