Quantification of left coronary bifurcation angles and plaques by coronary computed tomography angiography for prediction of significant coronary stenosis: A preliminary study with dual-source CT

Abstract

PurposeTo evaluate the diagnostic performance of left coronary bifurcation angles and plaque characteristics for prediction of coronary stenosis by dual-source CT.Methods106 patients suspected of coronary artery disease undergoing both coronary computed tomography angiography (CCTA) and invasive coronary angiography (CAG) within three months were included. Left coronary bifurcation angles including the angles between the left anterior descending artery and left circumflex artery (LAD-LCx), left main coronary artery and left anterior descending artery (LM-LAD), left main coronary artery and left circumflex artery (LM-LCx) were measured on CT images. CCTA plaque parameters were calculated by plaque analysis software. Coronary stenosis ≥ 50% by CAG was defined as significant.Results106 patients with 318 left coronary bifurcation angles and 126 vessels were analyzed. The bifurcation angle of LAD-LCx was significantly larger in left coronary stenosis ≥ 50% than stenosis < 50%, and significantly wider in the non-calcified plaque group than calcified. Multivariable analyses showed the bifurcation angle of LAD-LCx was an independent predictor for significant left coronary stenosis (OR = 1.423, P = 0.002). In ROC curve analysis, LAD-LCx predicted significant left coronary stenosis with a sensitivity of 66.7%, specificity of 78.4%, positive predictive value of 85.2% and negative predictive value of 55.8%. The lipid plaque volume improved the diagnostic performance of CCTA diameter stenosis (AUC: 0.854 vs. 0.900, P = 0.045) in significant coronary stenosis.ConclusionsThe bifurcation angle of LAD-LCx could predict significant left coronary stenosis. Wider LAD-LCx is related to non-calcified lesions. Lipid plaque volume could improve the diagnostic performance of CCTA for coronary stenosis prediction.

Application of double low dose combined low flow injection in coronary dual‐source coronary computed tomography angiography

“…1,2 Accumulating evidences have demonstrated that noninvasive CCTA was the preferred examination method of coronary artery disease (CAD). 1,2 Accumulating evidences have demonstrated that noninvasive CCTA was the preferred examination method of coronary artery disease (CAD).…”

“…Coronary computed tomography angiography (CCTA) has been wellknown as a noninvasive, strong security, and convenient technique providing visualized and reliable pathological results for clinical diagnosis. 1,2 Accumulating evidences have demonstrated that noninvasive CCTA was the preferred examination method of coronary artery disease (CAD). It had the advantage of high sensitivity and specificity as well as negative predictive value in comparison with invasive CCTA which was served as the standard of reference for the detection of CAD due to its high temporal resolution and spatial resolution.…”

An investigation of correlation between left coronary bifurcation angle and hemodynamic changes in coronary stenosis by coronary computed tomography angiography-derived computational fluid dynamics

“…Left coronary artery branches form different bifurcation angles, including bifurcation angles between left main stem and LAD/LCx, and bifurcation angle between LAD and LCx. The bifurcation angle between LAD and LCx was used in this study as this is most commonly used to assess the CAD ( Figure 1) (9,(16)(17)(18)(19). Measurements were performed on CCTA and ICA images by a radiologist with more than 10 years of experience in cardiac CT imaging.…”

“…Another approach to overcome this limitation is to measure the left coronary bifurcation angle and determine the significance of CAD. Diagnostic value of CCTA with use of left bifurcation angle has been shown in a number of studies with improved diagnostic performance reported when compared to the coronary lumen assessment (16)(17)(18)(19)(20)(21).…”

A framework for automated and objective modification of tubular structures: Application to the internal carotid artery

“…To achieve this goal, we created the open‐source framework morphMan , where we implemented the six algorithms presented here for robust, objective, automatic, and reproducible modification. Four of the algorithms were motivated by morphological features that have been found to correlate with, or are the definition of, cardiovascular diseases: bifurcation angles, cross‐sectional area, curvature and torsion, and the shape of a bend . The two remaining algorithms provide additional flexibility and robustness of the tools and can control the surface roughness, and location and angle of smaller branches.…”