Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Imaging
Ultra-High-Resolution Computed Tomography Angiography for Assessment of Coronary Artery Stenosis
Sadako MotoyamaHajime ItoMasayoshi SaraiYasuomi NagaharaKeiichi MiyajimaRyota MatsumotoYujiro DoiYumi KataokaHiroshi TakahashiYukio OzakiHiroshi ToyamaKazuhiro Katada
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2018 Volume 82 Issue 7 Pages 1844-1851

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Abstract

Background:Limitations of coronary computed tomography (CTA) include false-positive stenosis at calcified lesions and assessment of in-stent patency. A prototype of ultra-high resolution computed tomography (U-HRCT: 1,792 channels and 0.25-mm slice thickness×128 rows) with improved spatial resolution was developed. We assessed the diagnostic accuracy of coronary artery stenosis using U-HRCT.

Methods and Results:Seventy-nine consecutive patients who underwent CTA using U-HRCT were prospectively included. Coronary artery stenosis was graded from 0 (no plaque) to 5 (occlusion). Stenosis grading at 102 calcified lesions was compared between U-HRCT and conventional-resolution CT (CRCT: 896 channels and 0.5-mm slice thickness×320 rows). Median stenosis grading at calcified plaque was significantly improved on U-HRCT compared with CRCT (1; IQR, 1–2 vs. 2; IQR, 1–3, P<0.0001). Assessability of in-stent lumen was evaluated on U-HRCT in 79 stents. Stent strut thickness and luminal diameter were quantitatively compared between U-HRCT and CRCT. Of 79 stents, 83.5% were assessable on U-HRCT; 80% of stents with diameter 2.5 mm were regarded as assessable. On U-HRCT, stent struts were significantly thinner (median, 0.78 mm; IQR, 0.7–0.83 mm vs. 0.83 mm; IQR, 0.75–0.92 mm, P=0.0036), and in-stent lumens were significantly larger (median, 2.08 mm; IQR, 1.55–2.51 mm vs. 1.74 mm; IQR, 1.31–2.06 mm, P<0.0001) than on CRCT.

Conclusions:U-HRCT with improved spatial resolution visualized calcified lesions with fewer artifacts. The in-stent lumen of stents with diameter ≥2.5 mm was assessable on U-HRCT.

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© 2018 THE JAPANESE CIRCULATION SOCIETY
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