Yuehua Li1, Mengmeng Yu1, Jiayin Zhang2, Minghua Li1, Zhigang Lu3, Meng Wei3. 1. Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No.600, Yishan Rd, Shanghai, 200233, China. 2. Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No.600, Yishan Rd, Shanghai, 200233, China. andrewssmu@msn.com. 3. Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, #600, Yishan Rd, Shanghai, China.
Abstract
OBJECTIVES: To study the diagnostic value of transluminal attenuation gradient (TAG) measured by coronary computed tomography angiography (CCTA) for identifying relevant dynamic compression of myocardial bridge (MB). METHODS: Patients with confirmed MB who underwent both CCTA and ICA within one month were retrospectively included. TAG was defined as the linear regression coefficient between luminal attenuation and distance. The TAG of MB vessel, length and depth of MB were measured and correlated with the presence and degree of dynamic compression observed at ICA. Systolic compression ≧50 % was considered significant. RESULTS: 302 patients with confirmed MB lesions were included. TAG was lowest (-17.4 ± 6.7 HU/10 mm) in patients with significant dynamic compression and highest in patients without MB compression (-9.5 ± 4.3 HU/10 mm, p < 0.001). Linear correlation revealed relation between the percentage of systolic compression and TAG (Pearson correlation, r = -0.52, p < 0.001) and no significant relation between the percentage of systolic compression and MB depth or length. ROC curve analysis determined the best cut-off value of TAG as -14.8HU/10 mm (area under curve = 0.813, 95 % confidence interval = 0.764-0.855, p < 0.001), which yielded high diagnostic accuracy (82.1 %, 248/302). CONCLUSIONS: The degree of ICA-assessed systolic compression of MB significantly correlates with TAG but not MB depth or length. KEY POINTS: • TAG is associated with the extent of dynamic compression of MB. • TAG is superior to depth and length for identifying dynamic compression. • Cut-off value of TAG as -14.8HU/10 mm yielded high predictive value.
OBJECTIVES: To study the diagnostic value of transluminal attenuation gradient (TAG) measured by coronary computed tomography angiography (CCTA) for identifying relevant dynamic compression of myocardial bridge (MB). METHODS:Patients with confirmed MB who underwent both CCTA and ICA within one month were retrospectively included. TAG was defined as the linear regression coefficient between luminal attenuation and distance. The TAG of MB vessel, length and depth of MB were measured and correlated with the presence and degree of dynamic compression observed at ICA. Systolic compression ≧50 % was considered significant. RESULTS: 302 patients with confirmed MB lesions were included. TAG was lowest (-17.4 ± 6.7 HU/10 mm) in patients with significant dynamic compression and highest in patients without MB compression (-9.5 ± 4.3 HU/10 mm, p < 0.001). Linear correlation revealed relation between the percentage of systolic compression and TAG (Pearson correlation, r = -0.52, p < 0.001) and no significant relation between the percentage of systolic compression and MB depth or length. ROC curve analysis determined the best cut-off value of TAG as -14.8HU/10 mm (area under curve = 0.813, 95 % confidence interval = 0.764-0.855, p < 0.001), which yielded high diagnostic accuracy (82.1 %, 248/302). CONCLUSIONS: The degree of ICA-assessed systolic compression of MB significantly correlates with TAG but not MB depth or length. KEY POINTS: • TAG is associated with the extent of dynamic compression of MB. • TAG is superior to depth and length for identifying dynamic compression. • Cut-off value of TAG as -14.8HU/10 mm yielded high predictive value.
Authors: Daniel Jodocy; Iman Aglan; Guy Friedrich; Ammar Mallouhi; Otmar Pachinger; Werner Jaschke; Gudrun M Feuchtner Journal: Eur J Radiol Date: 2008-11-26 Impact factor: 3.528
Authors: Michel T Corban; Olivia Y Hung; Parham Eshtehardi; Emad Rasoul-Arzrumly; Michael McDaniel; Girum Mekonnen; Lucas H Timmins; Jerre Lutz; Robert A Guyton; Habib Samady Journal: J Am Coll Cardiol Date: 2014-02-26 Impact factor: 24.094
Authors: Ernst R Schwarz; Rajiv Gupta; Philipp K Haager; Juergen vom Dahl; Heinrich G Klues; Juergen Minartz; Barry F Uretsky Journal: Cardiology Date: 2008-06-25 Impact factor: 1.869
Authors: Fan Zhou; Chun Xiang Tang; U Joseph Schoepf; Christian Tesche; Maximilian J Bauer; Brian E Jacobs; Chang Sheng Zhou; Jing Yan; Meng Jie Lu; Guang Ming Lu; Long Jiang Zhang Journal: Eur Radiol Date: 2018-10-30 Impact factor: 5.315