Journal List > J Korean Soc Radiol > v.62(2) > 1086704

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Kim, Ko, Kim, Choi, Seon, Jeong, Park, and Kang: Calcified Plaque of Coronary Artery: Factors Influencing Overestimation of Coronary Artery Stenosis on Coronary CT Angiography
Cardiovascular Radiology
Original Article

Journal of the Korean Society of Radiology 2010; 62(2): 105-112.

Published online: 28 February 2010

DOI: https://doi.org/10.3348/jksr.2010.62.2.105

Calcified Plaque of Coronary Artery: Factors Influencing Overestimation of Coronary Artery Stenosis on Coronary CT Angiography

Mok Hee Kim, M.D., Joon Seok Ko, M.D.2, Yun-Hyeon Kim, M.D.1, 3, Song Choi, M.D., Hyun Ju Seon, M.D., Gwang Woo Jeong, M.D.1, 3, Jin Gyoon Park, M.D.1, 3, Heoung Keun Kang, M.D.1, 3

1Department of Radiology, Chonnam National University Hospital, Korea.

2Department of Radiology, Gwangju Veterans Hospital, Korea.

3Department of Radiology and Research Institute of Medical Science, Chonnam National University Medical School, Korea.

Address reprint requests to: Yun-Hyeon Kim, M.D., Ph.D., Department of Radiology, Chonnam National University Hospital, Research Institute of Medical Science, Chonnam National University Medical School 671, Jebongno, Dong-gu Gwangju 501-757, Korea. Tel. 82-62-220-5747, Fax. 82-62-226-4380, yhkim001@jnu.ac.kr

Received 6 July 2009       Accepted 25 August 2009

Copyright © 2010 The Korean Society of Radiology

Abstract

Purpose

To assess the influence of calcified plaque characteristics on the overestimation of coronary arterial stenosis on a coronary CT angiography (CCTA).

Materials and Methods

The study included 271 coronary arteries with calcified plaques identified by CCTA, and based on 928 coronary arteries from 232 patients who underwent both CCTA and invasive coronary angiography (ICA). Individual coronary arteries were classified into two groups by agreement based on the degree of stenosis from each CCTA and ICA: 1) group A includes patients with concordant CCTA and ICA results and, 2) group B includes patients with an overestimation of CCTA compared to ICA. Parameters including total calcium score, calcium score of an individual coronary artery, calcium burden number of an individual coronary artery, and the density of each calcified plaque (calcium score/number of calcium burden) for each individual coronary artery were compared between the two groups.

Results

Of the 271 coronary arteries, 164 (60.5%) were overestimated on CCTA. The left anterior descending artery (LAD) had a significantly low rate of overestimation (47.1%) compared to the other coronary arteries (p=0.001). No significant differences for total calcium score, calcium score of individual coronary artery, and the density of each calcified plaque from individual coronary arteries between two groups was observed. However, a decreasing tendency for the rate of overestimation on CCTA was observed with an increase in calcium burden of individual coronary arteries (p<0.05).

Conclusion

The evaluation of coronary arteries suggests that the degree of coronary arterial stenosis had a tendency to be overestimated by calcified plaques on CCTA. However, the rate of overestimation for the degree of coronary arterial stenosis by calcified plaques was not significantly influenced by total calcium score, calcium score of individual coronary artery, and density of each calcified plaque.

Keywords: Coronary Artery Disease, Tomography, X-Ray Computed, Calcification, Physiologic, Coronary Angiography

Figures and Tables

Fig. 1

A 76-year-old woman with chest pain.

A. Screenshot of calcium scoring displays number of calcium burden as number of lesion.
B. Precontrast CT image shows multiple calcified plaques in proximal & mid-left circumflex artery.
C. Curved multiplanar reformation of coronary CT angiography (CCTA) image shows significant stenosis (arrows) at proximal & mid-left circumflex artery.
D. Invasive coronary angiography shows corresponding results (arrows) with CCTA.
jksr-62-105-g001
Fig. 2

A 65-year-old man with chest pain.

A. Screenshot of calcium scoring displays number of calcium burden as number of lesion.
B. Precontrast CT scan shows dense calcified plaques in proximal left anterior descending artery.
C. Curved multiplanar reformation of coronary CT angiography image shows significant stenosis (arrow) at left anterior descending artery.
D. Invasive coronary angiography shows insignificant (<50%) luminal narrowing (arrow) at proximal left anterior descending artery.
jksr-62-105-g002
Table 1

The Number of Vessels and Parameters Related with Calcified Plaques of Matched (A) and Overestimated (B) Groups on Coronary CT Angiography (CCTA) according to Location of Calcified Plaques, on Comparison between CCTA and Invasive Coronary Angiography

jksr-62-105-i001

Note.─ LM= left main coronary artery, LAD= left anterior descending artery, LCX= left circumflex artery, RCA= right coronary artery, TCS= Total calcium score, NCB= Number of calcified plaque, VCS= Vascular calcium score, DCP= Density of calcified plaque, *p < 0.01

Table 2

Comparison of the Number of Vessels between Matched (A) and Overestimated (B) Groups on CCTA according to Ranked Total Calcium Score as Quartile

jksr-62-105-i002

*p = 0.13

Table 3

Comparison of the Number of Vessels between Matched (A) and Overestimated (B) Group on CCTA according to Ranked Each Vascular Calcium Score as Quartile

jksr-62-105-i003

*p = 0.29

Table 4

Comparison the Number of Vessels between Matched (A) and Overestimated (B) Group on CCTA according to Ranked Number of Calcium Burden as Quartile

jksr-62-105-i004

*p = 0.04

Table 5

Comparison the Number of Vessels between Matched (A) and Overestimated (B) Group on CCTA according to Ranked Density* of Calcified Plaques as Quartile

jksr-62-105-i005

*: Each vascular calcium score / Number of calcium burden,

†p = 0.36

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