Visual and automatic grading of coronary artery stenoses with 64-slice CT angiography in reference to invasive angiography

被引:47
|
作者
Busch, Stephanie
Johnson, Thorsten R. C.
Nikolaou, Konstantin
von Ziegler, Franz
Knez, Andreas
Reiser, Maximilian F.
Becker, Christoph R.
机构
[1] Univ Munich, Dept Clin Radiol, D-81377 Munich, Germany
[2] Univ Munich, Med Clin 1, Dept Cardiol, Munich, Germany
关键词
coronary angiography; computed tomography; coronary stenosis; computer aided diagnosis;
D O I
10.1007/s00330-006-0512-y
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
The aim of this study was to assess the performance of a software tool for quantitative coronary artery analysis of computed tomography coronary angiography (CT-QCA) in comparison with invasive coronary angiography with quantitative analysis (CAG-QCA) as standard of reference. Two radiologists reviewed the CT angiography data sets (Siemens Sensation 64) of 25 patients, grading coronary artery stenoses visually and with a software tool (Circulation, Siemens). Twenty-three data sets with sufficient image quality were included in the final analysis. CAG revealed a total of 30 wall irregularities and 28 stenoses, of which 17 were graded as moderate and nine as hemodynamically significant. CT-QCA showed a better agreement to CAG-QCA, with a systematic overestimation of the degree of stenosis of 6.1% and limits of agreement of +36.1% and -23.9; the correlation coefficient was 0.82 (p < 0.0001). Using CT-QCA, sensitivity, specificity, and positive and negative predictive value were 89%, 100%, 89%, and 100%, respectively, for significant area stenoses greater than 75%. The positive predictive value for the visual assessment amounted to 53%. Interobserver variability between CT-QCA and visual assessment showed a kappa value of 0.72. In conclusion, software-supported CT-QCA makes it possible to quantify significant coronary artery stenoses automatically, with good agreement to CAG-QCA.
引用
收藏
页码:1445 / 1451
页数:7
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