Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea.
Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Eur Heart J Cardiovasc Imaging. 2015 Dec;16(12):1358-65. doi: 10.1093/ehjci/jev100. Epub 2015 Apr 29.
We sought to evaluate whether coronary computed tomographic angiography (CCTA) could accurately and reproducibly delineate the lumen and vessel contours of coronary arteries.
One hundred coronary stenotic lesions representing 91 patients with stable angina who received both CCTA and intravascular ultrasound (IVUS) were analysed. Three segments with minimal lumen cross-sectional area (CSA), proximal reference, and distal reference on IVUS images were selected for each lesion. Five observers measured lumen and vessel CSAs at three matching segments on CCTA images. These CSAs were compared with the IVUS-measured CSAs as a reference standard. All five observers underestimated lumen CSA at the three selected segments by CCTA. The minimal lumen CSA assessed by CCTA exhibited very weak correlations with those obtained by IVUS (r =0.23, 0.24, 0.15, 0.25, and 0.28, respectively). In contrast to the lumen CSA, the vessel CSA at the three segments was overestimated by all observers when assessed by CCTA. At the segment with minimal lumen CSA, the vessel CSA obtained by CCTA showed weak correlations with those assessed by IVUS (r = 0.43, 0.33, 0.44, 0.37, and 0.42, respectively). Moreover, intra-class correlation coefficients ranged from 0.44 to 0.73 among the five observers for lumen or vessel CSA measurements by CCTA at the segment with minimal lumen CSA.
CCTA has potential limitations in the accurate delineation of lumen and vessel contours in patients with angina, as there was a high level of discordance with the IVUS-measured lumen and vessel CSAs and high inter-observer variability.
我们旨在评估冠状动脉计算机断层血管造影（CCTA）是否能准确、可重复地描绘冠状动脉的管腔和血管轮廓。
本研究纳入了 91 例稳定性心绞痛患者的 100 个狭窄病变，这些患者均接受了 CCTA 和血管内超声（IVUS）检查。在 IVUS 图像上，为每个病变选择三个具有最小管腔横截面积（CSA）的节段、近端参考节段和远端参考节段。5 位观察者在 CCTA 图像的三个匹配节段测量管腔和血管 CSA。将这些 CSA 与 IVUS 测量的 CSA 作为参考标准进行比较。所有 5 位观察者均低估了 CCTA 三个选定节段的管腔 CSA。CCTA 评估的最小管腔 CSA 与 IVUS 获得的 CSA 相关性非常弱（r 分别为 0.23、0.24、0.15、0.25 和 0.28）。与管腔 CSA 相反，所有观察者在 CCTA 评估时均高估了三个节段的血管 CSA。在最小管腔 CSA 节段，CCTA 获得的血管 CSA 与 IVUS 评估的 CSA 相关性较弱（r 分别为 0.43、0.33、0.44、0.37 和 0.42）。此外，在最小管腔 CSA 节段，5 位观察者的 CCTA 管腔或血管 CSA 测量的组内相关系数范围为 0.44 至 0.73。
在有症状的患者中，CCTA 在准确描绘管腔和血管轮廓方面存在局限性，因为与 IVUS 测量的管腔和血管 CSA 存在高度不一致性，且观察者间的变异性较大。
