Centro Cardiologico Monzino IRCCS, Department of Cardiovascular Imaging, Via Parea 4, 20100 Milan, Italy.
Centrum voor hart en vaatziekten, University of Brussel, Brussel, Belgium.
Eur Heart J Cardiovasc Imaging. 2020 Feb 1;21(2):191-201. doi: 10.1093/ehjci/jez089.
The emerging role of coronary computed tomography angiography (CCTA) as a non-invasive tool for atherosclerosis evaluation is supported by data reporting a good correlation between CCTA and intravascular ultrasound (IVUS) for plaque volume quantification. Aim of the present study was to evaluate whether a last generation CT-scanner may improve coronary plaque volume assessment using IVUS as standard-of-reference.
From a registry of 1915 consecutive, all-comers, patients who underwent a clinically indicated IVUS evaluation we enrolled 59 patients who underwent CCTA with a 64-slice CT (Group 1) and 59 patients who underwent CCTA with whole-heart coverage CT scanner (Group 2). Patients who underwent CCTA with unfavourable heart rhythm were not excluded from the analysis. Image quality (4-point Likert scale) focused on plaque analysis was evaluated. Plaque volume quantification by CCTA was compared to IVUS. No difference in clinical characteristics was found between Group 1 and Group 2. Plaque volume quantification by CCTA was considered not feasible in 11 plaques of Group 1 and in 4 plaques of Group 2 (P = 0.09). Higher correlation for plaque volume quantification by CCTA vs. IVUS was demonstrated in Group 2 when compared with Group 1 (r = 0.9888 vs. 0.9499; P < 0.0001). The Bland-Altman analysis showed plaque volume overestimation by CCTA of 11.9 mm3 in Group 1 and 4 mm2 in Group 2 (P < 0.001). Effective radiation dose of CCTA was significantly lower in Group 2 vs. Group 1 (2.7 ± 0.9 vs. 8.1 ± 3.6 mSv, respectively; P < 0.001).
CCTA using a new scanner generation showed to be an accurate non-invasive tool to assess and quantify coronary plaque volume.
冠状动脉计算机断层扫描血管造影（CCTA）作为一种评估动脉粥样硬化的非侵入性工具的新作用得到了数据的支持，这些数据表明 CCTA 与血管内超声（IVUS）在斑块体积定量方面具有良好的相关性。本研究的目的是评估新一代 CT 扫描仪是否可以通过以 IVUS 作为标准参考来改善冠状动脉斑块体积评估。
从一个 1915 例连续、所有患者的注册数据库中，我们入选了 59 例接受 64 层 CT 冠状动脉 CT 血管造影（CCTA）（第 1 组）和 59 例接受全心覆盖 CT 扫描仪 CCTA（第 2 组）的患者。未排除心律不齐的患者进行 CCTA 分析。采用 4 分李克特量表评估斑块分析的图像质量。将 CCTA 测量的斑块体积与 IVUS 进行比较。第 1 组和第 2 组之间的临床特征无差异。第 1 组的 11 个斑块和第 2 组的 4 个斑块的 CCTA 斑块体积定量不可行（P=0.09）。与第 1 组相比，第 2 组 CCTA 与 IVUS 相比，斑块体积定量的相关性更高（r=0.9888 与 0.9499；P<0.0001）。Bland-Altman 分析显示，第 1 组 CCTA 斑块体积高估 11.9mm3，第 2 组高估 4mm2（P<0.001）。与第 1 组相比，第 2 组 CCTA 的有效辐射剂量显著降低（分别为 2.7±0.9 与 8.1±3.6 mSv；P<0.001）。
使用新扫描仪代次的 CCTA 被证明是一种准确的非侵入性工具，可用于评估和定量冠状动脉斑块体积。
