Sakrana Amal Abdelsattar, El Atta Heba M Abou, Mohammad Goda, Bayoumi Dalia
Department of Diagnostic and Interventional Radiology, Mansoura University Hospital, Egypt.
Department of Radiology, Student Hospital, Mansoura University, Egypt.
Pol J Radiol. 2022 Nov 8;87:e606-e612. doi: 10.5114/pjr.2022.121434. eCollection 2022.
An investigation of coronary computed tomography angiography (CCTA)-derived quantitative parameters to determine CAD-RADS 4 versus CAD-RADS 3 of coronary lesions with moderate to severe calcification.
The study included 150 coronary lesions proven to have moderate or severe stenosis by invasive coronary angiography and showing moderate to severe calcification in CCTA. Various CCTA-quantitative parameters were correlated to the degree of stenosis (moderately versus severely stenosed lesions). Their sensitivity and specificity to detect severe stenosis (supposed to be corresponding to CAD-RADS 4) were examined at multiple cut-off points.
The calcification remodelling index (CRI) was the only statistically significant independent computed tomo-graphy angiography-derived predictor of severe stenosis versus moderate stenosis on multivariate regression analysis. The best cut-off value was ≤ 0.84, with 77.78% sensitivity and 86.46% specificity.
From all quantitative-derived CCTA parameters, CRI ≤ 0.84 was the predictor with the highest diagnostic performance for severe versus moderate stenosis in moderately to severely calcified coronary lesions. Accordingly, CRI can help to determine CAD-RADS 4 versus CAD-RADS 3.
研究冠状动脉计算机断层扫描血管造影（CCTA）得出的定量参数，以确定中度至重度钙化的冠状动脉病变的CAD-RADS 4与CAD-RADS 3。
该研究纳入了150例经有创冠状动脉造影证实有中度或重度狭窄且在CCTA中显示中度至重度钙化的冠状动脉病变。将各种CCTA定量参数与狭窄程度（中度与重度狭窄病变）相关联。在多个临界点检查它们检测严重狭窄（假定对应于CAD-RADS 4）的敏感性和特异性。
在多变量回归分析中，钙化重塑指数（CRI）是唯一具有统计学意义的独立的由计算机断层扫描血管造影得出的重度狭窄与中度狭窄的预测指标。最佳临界点值为≤0.84，敏感性为77.78%，特异性为86.46%。
在所有由CCTA得出的定量参数中，CRI≤0.84是中度至重度钙化冠状动脉病变中重度与中度狭窄诊断性能最高的预测指标。因此，CRI有助于确定CAD-RADS 4与CAD-RADS 3。
