eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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1/2013
vol. 9
 
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abstract:

Original paper
Lumen and calcium characteristics within calcified coronary lesions. Comparison of computed tomography coronary angiography intravascular ultrasound

Dariusz Noll
,
Mariusz Kruk
,
Jerzy Pręgowski
,
Edyta Kaczmarska
,
Karolina Kryczka
,
Radosław Pracoń
,
Mirosław Skwarek
,
Zofia Dzielińska
,
Joanna Petryka
,
Mateusz Śpiewak
,
Barbara Lubiszewska
,
Bożena Norwa-Otto
,
Maksymilian Opolski
,
Adam Witkowski
,
Marcin Demkow
,
Witold Rużyłło
,
Cezary Kępka

Postep Kardiol Inter 2013; 9, 1 (31): 1–8
DOI: https://doi.org/10.5114/pwki.2013.34022
Online publish date: 2013/03/21
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Introduction: Computed tomography coronary angiography (CTCA) is a diagnostic method used for exclusion of coronary artery disease. However, lower accuracy of CTCA in assessment of calcified lesions is a significant factor impeding applicability of CTCA for assessment of coronary atherosclerosis.

Aim: To provide insight into lumen and calcium characteristics assessed with CTCA, we compared these parameters to the reference of intravascular ultrasound (IVUS).

Material and methods: Two hundred and fifty-two calcified lesions within 97 arteries of 60 patients (19 women, age 63 ±10 years) underwent assessment with both 2 × 64 slice CT (Somatom Definition, Siemens) and IVUS (s5, Volcano Corp.). Coronary lumen and calcium dimensions within calcified lesions were assessed with CTCA and compared to the reference measurements made with IVUS.

Results: On average CTCA underestimated mean lumen diameter (2.8 ±0.7 mm vs. 2.9 ±0.8 mm for IVUS), lumen area (6.4 ±3.4 mm2 vs. 7.0 ±3.7 mm2 for IVUS, p < 0.001) and total calcium arc (52 ±35° vs. 83 ±54°). However, analysis of tertiles of the examined parameters revealed that the mean lumen diameter, lumen area and calcium arc did not significantly differ between CTCA and IVUS within the smallest lumens (1st tertile of mean lumen diameter at 2.1 mm, and 1st tertile of lumen area at 3.7 mm2) and lowest calcium arc (mean of 40°).

Conclusions: Although, on average, CTCA underestimates lumen diameter and area

as well as calcium arc within calcified lesions, the differences are not significant within the smallest vessels and calcium arcs. The low diagnostic accuracy of CTCA within calcified lesions may be attributed to high variance and not to systematic error of measurements.
keywords:

computed tomography, intravascular ultrasound, coronary angiography, coronary artery disease
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