Implications of coronary calcification on the assessment of plaque pathology: a comparison of computed tomography and multimodality intravascular imaging.

IF 4.7 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
European Radiology Pub Date : 2025-04-01 Epub Date: 2024-08-22 DOI:10.1007/s00330-024-10996-x
Nathan Angelo Lecaros Yap, Anantharaman Ramasamy, Ibrahim Halil Tanboga, Xingwei He, Murat Cap, Retesh Bajaj, Medeni Karaduman, Ajay Jain, Pieter Kitslaar, Alexander Broersen, Xiaotong Zhang, Hessam Sokooti, Johan H C Reiber, Jouke Dijkstra, Mick Ozkor, Patrick W Serruys, James C Moon, Anthony Mathur, Andreas Baumbach, Ryo Torii, Francesca Pugliese, Christos V Bourantas
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引用次数: 0

Abstract

Objectives: This study aimed to investigate the impact of calcific (Ca) on the efficacy of coronary computed coronary angiography (CTA) in evaluating plaque burden (PB) and composition with near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) serving as the reference standard.

Materials and methods: Sixty-four patients (186 vessels) were recruited and underwent CTA and 3-vessel NIRS-IVUS imaging (NCT03556644). Expert analysts matched and annotated NIRS-IVUS and CTA frames, identifying lumen and vessel wall borders. Tissue distribution was estimated using NIRS chemograms and the arc of Ca on IVUS, while in CTA Hounsfield unit cut-offs were utilized to establish plaque composition. Plaque distribution plots were compared at segment-, lesion-, and cross-sectional-levels.

Results: Segment- and lesion-level analysis showed no effect of Ca on the correlation of NIRS-IVUS and CTA estimations. However, at the cross-sectional level, Ca influenced the agreement between NIRS-IVUS and CTA for the lipid and Ca components (p-heterogeneity < 0.001). Proportional odds model analysis revealed that Ca had an impact on the per cent atheroma volume quantification on CTA compared to NIRS-IVUS at the segment level (p-interaction < 0.001). At lesion level, Ca affected differences between the modalities for maximum PB, remodelling index, and Ca burden (p-interaction < 0.001, 0.029, and 0.002, respectively). Cross-sectional-level modelling demonstrated Ca's effect on differences between modalities for all studied variables (p-interaction ≤ 0.002).

Conclusion: Ca burden influences agreement between NIRS-IVUS and CTA at the cross-sectional level and causes discrepancies between the predictions for per cent atheroma volume at the segment level and maximum PB, remodelling index, and Ca burden at lesion-level analysis.

Clinical relevance statement: Coronary calcification affects the quantification of lumen and plaque dimensions and the characterization of plaque composition coronary CTA. This should be considered in the analysis and interpretation of CTAs performed in patients with extensive Ca burden.

Key points: Coronary CT Angiography is limited in assessing coronary plaques by resolution and blooming artefacts. Agreement between dual-source CT angiography and NIRS-IVUS is affected by a Ca burden for the per cent atheroma volume. Advanced CT imaging systems that eliminate blooming artefacts enable more accurate quantification of coronary artery disease and characterisation of plaque morphology.

Abstract Image

冠状动脉钙化对斑块病理评估的影响:计算机断层扫描与多模态血管内成像的比较。
研究目的本研究旨在探讨钙化(Ca)对冠状动脉计算机冠状动脉造影(CTA)评估斑块负荷(PB)和组成的效果的影响,并以近红外光谱仪-血管内超声(NIRS-IVUS)作为参考标准:招募了 64 名患者(186 个血管),对他们进行了 CTA 和 3 个血管 NIRS-IVUS 成像检查(NCT03556644)。专家分析师对 NIRS-IVUS 和 CTA 图像进行匹配和注释,确定管腔和血管壁边界。利用 NIRS 化学图和 IVUS 上的钙弧估计组织分布,而在 CTA 中则利用 Hounsfield 单位截断值确定斑块成分。对斑块分布图进行了分段、病变和横截面层面的比较:结果:分段和病变层面的分析表明,钙对 NIRS-IVUS 和 CTA 估算值的相关性没有影响。然而,在横断面层面,钙对 NIRS-IVUS 和 CTA 在脂质和钙成分上的一致性有影响(p-异质性 结论:钙对 NIRS-IVUS 和 CTA 的一致性有影响:钙负荷会影响 NIRS-IVUS 和 CTA 在横断面层面的一致性,并导致在节段层面预测的动脉粥样斑块体积百分比与病变层面分析的最大 PB、重塑指数和钙负荷之间存在差异:冠状动脉钙化会影响冠状动脉 CTA 对管腔和斑块尺寸的量化以及斑块成分的定性。在对有广泛钙化负荷的患者进行 CTA 分析和解释时应考虑到这一点:要点:冠状动脉 CT 血管造影在评估冠状动脉斑块时受到分辨率和模糊伪影的限制。双源 CT 血管造影与 NIRS-IVUS 之间的一致性受动脉粥样斑块体积百分比的钙负荷影响。先进的 CT 成像系统可以消除花纹伪影,从而更准确地量化冠状动脉疾病和描述斑块形态。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
European Radiology
European Radiology 医学-核医学
CiteScore
11.60
自引率
8.50%
发文量
874
审稿时长
2-4 weeks
期刊介绍: European Radiology (ER) continuously updates scientific knowledge in radiology by publication of strong original articles and state-of-the-art reviews written by leading radiologists. A well balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes ER an indispensable source for current information in this field. This is the Journal of the European Society of Radiology, and the official journal of a number of societies. From 2004-2008 supplements to European Radiology were published under its companion, European Radiology Supplements, ISSN 1613-3749.
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