Watanabe Ryota, Saito Yuichi, Tokimasa Satoshi, Takaoka Hiroyuki, Kitahara Hideki, Yamanouchi Masato, Kobayashi Yoshio
Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba 260-8670, Chiba, Japan.
Department of Cardiology, Chiba Rosai Hospital, Ichihara 290-0003, Chiba, Japan.
J Clin Med. 2024 Apr 12;13(8):2255. doi: 10.3390/jcm13082255.
Coronary artery calcification score (CACS) on electrocardiography (ECG)-gated computed tomography (CT) is used for risk stratification of atherosclerotic cardiovascular disease, which requires dedicated analytic software. In this study, we evaluated the diagnostic ability of manual calcification length assessment on non-ECG-gated CT for epicardial coronary artery disease (CAD). A total of 100 patients undergoing both non-ECG-gated plain CT scans with a slice interval of 1.25 mm and invasive coronary angiography were retrospectively included. We manually measured the length of the longest calcified lesions of coronary arteries on each branch. The relationship between the number of coronary arteries with the length of coronary calcium > 5, 10, or 15 mm and the presence of epicardial CAD on invasive angiography was evaluated. Standard CACS was also evaluated using established software. Of 100 patients, 49 (49.0%) had significant epicardial CAD on angiography. The median standard CACS was 346 [7, 1965]. In both manual calcium assessment and standard CACS, the increase in calcium burden was progressively associated with the presence of epicardial CAD on angiography. The receiver operating characteristic curve analysis showed similar diagnostic abilities of the two diagnostic methods. The best cut-off values for CAD were 2, 1, and 1 for the number of vessels with calcium > 5, 10, and 15 mm, respectively. Overall, the diagnostic ability of manual calcium assessment was similar to that of standard CACS > 400. Manual assessment of coronary calcium length on non-ECG-gated plain CT provided similar diagnostic ability for the presence of significant epicardial CAD on invasive angiography, as compared to standard CACS.
心电图（ECG）门控计算机断层扫描（CT）的冠状动脉钙化评分（CACS）用于动脉粥样硬化性心血管疾病的风险分层，这需要专用的分析软件。在本研究中，我们评估了在非ECG门控CT上手动评估钙化长度对心外膜冠状动脉疾病（CAD）的诊断能力。回顾性纳入了100例同时接受层厚为1.25 mm的非ECG门控平扫CT扫描和有创冠状动脉造影的患者。我们手动测量了每个分支上冠状动脉最长钙化病变的长度。评估了冠状动脉钙化长度>5、10或15 mm的冠状动脉数量与有创血管造影上心外膜CAD存在情况之间的关系。还使用既定软件评估了标准CACS。100例患者中，49例（49.0%）在血管造影上有显著的心外膜CAD。标准CACS的中位数为346[7,1965]。在手动钙化评估和标准CACS中，钙化负荷的增加都与血管造影上心外膜CAD的存在逐渐相关。受试者工作特征曲线分析显示两种诊断方法的诊断能力相似。CAD的最佳截断值分别为：钙化长度>5、10和15 mm的血管数量对应的截断值分别为2、1和1。总体而言，手动钙化评估的诊断能力与标准CACS>400时相似。与标准CACS相比，在非ECG门控平扫CT上手动评估冠状动脉钙化长度对有创血管造影上显著的心外膜CAD存在情况具有相似的诊断能力。
