PMID- 16845284
OWN - NLM
STAT- MEDLINE
DCOM- 20060831
LR  - 20190814
IS  - 0363-8715 (Print)
IS  - 0363-8715 (Linking)
VI  - 30
IP  - 4
DP  - 2006 Jul-Aug
TI  - Vessel density ratio: A novel approach to identify "culprit" coronary lesion by 
      spiral computed tomography.
PG  - 564-8
AB  - BACKGROUND AND OBJECTIVE: We hypothesized that a "culprit" lesion in acute 
      coronary syndrome (ACS) should have low overall vessel lumen and plaque density 
      on multidetector computed tomography-assisted coronary angiography (MDCTA) 
      because of lower calcification and the presence of occlusive thrombus. However, 
      thrombi and calcification both can themselves blur the demarcation between vessel 
      wall and lumen. If we calculated a "vessel density ratio" (VDR) obtained by 
      measuring the mean density of contrast-enhancement within a region of interest 
      (ROI), which includes the vessel wall, lumen, plaque, and thrombus, and comparing 
      that with the aortic root mean density acting as a reference point, this ratio 
      may be more convenient, standardized, and reproducible to test the feasibility of 
      VDR in identifying "culprit" lesions in ACS. METHODS: Sixty-four patients-21 
      exertional angina; 17 unstable angina/non-ST elevation myocardial infarction 
      (NSTEMI); 26 ST elevation myocardial infarction (STEMI)-provided 188 diseased 
      segments on conventional angiography. All underwent MDCTA within a week of 
      angiography. ROI was mapped out from maximum intensity projections of diseased 
      segments in planar view. RESULTS: One hundred seventy-four segments were 
      evaluated. Patients who presented with ACS (STEMI and unstable angina/non-ST 
      elevation myocardial infarction) had lower mean VDR compared to patients with 
      exertional angina (0.58 vs. 0.66 vs. 0.81; P < 0.001). Culprit lesions in ACS 
      patients also had the lowest mean VDR when compared to nonculprit lesions and 
      lesions in patients without ACS (0.51 vs. 0.68 vs. 0.81; P < 0.001). CONCLUSIONS: 
      VDR is a new, convenient, and standardized approach in identifying "culprit" 
      lesions by MDCTA.
FAU - Chin, Bernard Sze-Piaw
AU  - Chin BS
AD  - Department of Cardiology, Sarawak General Hospital, Kuching, Malaysia. 
      chin.sze.piaw@health.gov.my
FAU - Ong, Tiong-Kiam
AU  - Ong TK
FAU - Seyfarth, Tobias M
AU  - Seyfarth TM
FAU - Liew, Chee-Khoon
AU  - Liew CK
FAU - Chan, Wei-Ling
AU  - Chan WL
FAU - Rapaee, Annuar
AU  - Rapaee A
FAU - Liew, Houng-Bang
AU  - Liew HB
FAU - Ang, Choon-Kiat
AU  - Ang CK
FAU - Sim, Kui-Hian
AU  - Sim KH
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Comput Assist Tomogr
JT  - Journal of computer assisted tomography
JID - 7703942
RN  - 0 (Contrast Media)
RN  - 4419T9MX03 (Iohexol)
SB  - IM
MH  - Acute Disease
MH  - Analysis of Variance
MH  - Angina Pectoris/*diagnostic imaging
MH  - Angina, Unstable/diagnostic imaging
MH  - Calcinosis/diagnostic imaging
MH  - Contrast Media
MH  - Coronary Angiography
MH  - Coronary Artery Disease/*diagnostic imaging
MH  - Female
MH  - Humans
MH  - Iohexol
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*diagnostic imaging
MH  - Severity of Illness Index
MH  - Syndrome
MH  - *Tomography, Spiral Computed
EDAT- 2006/07/18 09:00
MHDA- 2006/09/01 09:00
CRDT- 2006/07/18 09:00
PHST- 2006/07/18 09:00 [pubmed]
PHST- 2006/09/01 09:00 [medline]
PHST- 2006/07/18 09:00 [entrez]
AID - 00004728-200607000-00002 [pii]
AID - 10.1097/00004728-200607000-00002 [doi]
PST - ppublish
SO  - J Comput Assist Tomogr. 2006 Jul-Aug;30(4):564-8. doi: 
      10.1097/00004728-200607000-00002.