Computed tomography angiography (CTA) of anomalous aortic origin of a coronary artery (AAOCA): Which measurements are accurate and reliable?
The variation and accuracy of computed tomography angiography (CTA) features of anomalous aortic origin of a coronary artery (AAOCA) have not been completely characterized. We evaluated anomalous right (AAORCA) and left (AAOLCA) coronary arteries by CTA, with an emphasis on reproducibility, comparis...
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| Veröffentlicht in: | Journal of cardiovascular computed tomography 2023-03, Vol.17 (2), p.130-137 |
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| creator | Ferraro, Alessandra M. Uslenghi, Alessandro Lu, Minmin Newburger, Jane W. Nathan, Meena Quinonez, Luis G. Beroukhim, Rebecca S. |
| description | The variation and accuracy of computed tomography angiography (CTA) features of anomalous aortic origin of a coronary artery (AAOCA) have not been completely characterized. We evaluated anomalous right (AAORCA) and left (AAOLCA) coronary arteries by CTA, with an emphasis on reproducibility, comparison with surgical measurements, and effect of nitroglycerin.
CTAs were interpreted for location of coronary origin & exit from the aorta, course, and dominance; minor & major diameters of the proximal & distal coronaries; shape of orifice; and intramural length. Relationships between vessel measurements, body surface area (BSA), and nitroglycerin use were evaluated. Comparisons between CTA and surgical measurements included intramural length, surgical probe size pre-intervention vs. CTA proximal AAOCA diameter, and surgical probe size post-intervention vs. CTA distal AAOCA diameter.
Of 104 patients [81 (78%) AAORCA], all but 1 were intramural. Compared to AAOLCA, AAORCA patients were more likely to have a high origin (91% vs. 31%, p |
| doi_str_mv | 10.1016/j.jcct.2023.02.003 |
| format | Article |
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CTAs were interpreted for location of coronary origin & exit from the aorta, course, and dominance; minor & major diameters of the proximal & distal coronaries; shape of orifice; and intramural length. Relationships between vessel measurements, body surface area (BSA), and nitroglycerin use were evaluated. Comparisons between CTA and surgical measurements included intramural length, surgical probe size pre-intervention vs. CTA proximal AAOCA diameter, and surgical probe size post-intervention vs. CTA distal AAOCA diameter.
Of 104 patients [81 (78%) AAORCA], all but 1 were intramural. Compared to AAOLCA, AAORCA patients were more likely to have a high origin (91% vs. 31%, p < 0.01), and slit-like orifice (58% vs. 26%, p < 0.01). When CTAs with nitroglycerin were compared to those without, no difference in proximal AAOCA dimensions was identified; however distal AAOCA and normal-origin coronary dimensions were larger in scans with nitroglycerin. Aside from slit-like orifice, reliability of coronary CTA measurements, including proximal AAOCA minor diameter and intramural length, was moderate to good between readers. In a subgroup of 54 patients, proximal AAOCA minor diameter and intramural length had good agreement and correlation with surgery.
Proximal AAOCA dimensions and intramural length are reproducible variables. The lack of difference in proximal AAOCA dimensions with nitroglycerin may reflect abnormal vessel mechanics. Multicenter studies are an important next step in understanding the generalizability of our findings.
Table of Contents Summary: In this study we evaluated 104 CT angiograms on patients with anomalous origin of the coronary arteries (AAOCA; 81 right and 23 left), with an emphasis on clinically useful measurements that have high reliability (intra-rater, inter-rater, and comparison with surgical measurements). We found that measurements of the intramural segment (e.g., proximal AAOCA dimensions and intramural length) had moderate-good reliability. The lack of difference in these measurements with/without nitroglycerin at the time of CTA (versus evidence of dilation in the non-intramural vessel) supports their clinical utility as measures of potential ischemic risk.</description><identifier>ISSN: 1934-5925</identifier><identifier>EISSN: 1876-861X</identifier><identifier>DOI: 10.1016/j.jcct.2023.02.003</identifier><identifier>PMID: 36804387</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Anomalous aortic origin of a coronary artery ; Aorta ; Children ; Computed tomography ; Computed Tomography Angiography - methods ; Coronary Angiography - methods ; Coronary artery ; Coronary Vessel Anomalies - diagnostic imaging ; Coronary Vessel Anomalies - surgery ; Coronary Vessels - diagnostic imaging ; Coronary Vessels - surgery ; Humans ; Intramural ; Nitroglycerin ; Predictive Value of Tests ; Reproducibility of Results ; Retrospective Studies</subject><ispartof>Journal of cardiovascular computed tomography, 2023-03, Vol.17 (2), p.130-137</ispartof><rights>2023 Society of Cardiovascular Computed Tomography</rights><rights>Copyright © 2023 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-eb151113cd542ca0b3c68998388e67263e6c23b2c79c6730ee5f458d0eef0d5b3</citedby><cites>FETCH-LOGICAL-c356t-eb151113cd542ca0b3c68998388e67263e6c23b2c79c6730ee5f458d0eef0d5b3</cites><orcidid>0000-0003-4053-8932</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36804387$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ferraro, Alessandra M.</creatorcontrib><creatorcontrib>Uslenghi, Alessandro</creatorcontrib><creatorcontrib>Lu, Minmin</creatorcontrib><creatorcontrib>Newburger, Jane W.</creatorcontrib><creatorcontrib>Nathan, Meena</creatorcontrib><creatorcontrib>Quinonez, Luis G.</creatorcontrib><creatorcontrib>Beroukhim, Rebecca S.</creatorcontrib><title>Computed tomography angiography (CTA) of anomalous aortic origin of a coronary artery (AAOCA): Which measurements are accurate and reliable?</title><title>Journal of cardiovascular computed tomography</title><addtitle>J Cardiovasc Comput Tomogr</addtitle><description>The variation and accuracy of computed tomography angiography (CTA) features of anomalous aortic origin of a coronary artery (AAOCA) have not been completely characterized. We evaluated anomalous right (AAORCA) and left (AAOLCA) coronary arteries by CTA, with an emphasis on reproducibility, comparison with surgical measurements, and effect of nitroglycerin.
CTAs were interpreted for location of coronary origin & exit from the aorta, course, and dominance; minor & major diameters of the proximal & distal coronaries; shape of orifice; and intramural length. Relationships between vessel measurements, body surface area (BSA), and nitroglycerin use were evaluated. Comparisons between CTA and surgical measurements included intramural length, surgical probe size pre-intervention vs. CTA proximal AAOCA diameter, and surgical probe size post-intervention vs. CTA distal AAOCA diameter.
Of 104 patients [81 (78%) AAORCA], all but 1 were intramural. Compared to AAOLCA, AAORCA patients were more likely to have a high origin (91% vs. 31%, p < 0.01), and slit-like orifice (58% vs. 26%, p < 0.01). When CTAs with nitroglycerin were compared to those without, no difference in proximal AAOCA dimensions was identified; however distal AAOCA and normal-origin coronary dimensions were larger in scans with nitroglycerin. Aside from slit-like orifice, reliability of coronary CTA measurements, including proximal AAOCA minor diameter and intramural length, was moderate to good between readers. In a subgroup of 54 patients, proximal AAOCA minor diameter and intramural length had good agreement and correlation with surgery.
Proximal AAOCA dimensions and intramural length are reproducible variables. The lack of difference in proximal AAOCA dimensions with nitroglycerin may reflect abnormal vessel mechanics. Multicenter studies are an important next step in understanding the generalizability of our findings.
Table of Contents Summary: In this study we evaluated 104 CT angiograms on patients with anomalous origin of the coronary arteries (AAOCA; 81 right and 23 left), with an emphasis on clinically useful measurements that have high reliability (intra-rater, inter-rater, and comparison with surgical measurements). We found that measurements of the intramural segment (e.g., proximal AAOCA dimensions and intramural length) had moderate-good reliability. The lack of difference in these measurements with/without nitroglycerin at the time of CTA (versus evidence of dilation in the non-intramural vessel) supports their clinical utility as measures of potential ischemic risk.</description><subject>Anomalous aortic origin of a coronary artery</subject><subject>Aorta</subject><subject>Children</subject><subject>Computed tomography</subject><subject>Computed Tomography Angiography - methods</subject><subject>Coronary Angiography - methods</subject><subject>Coronary artery</subject><subject>Coronary Vessel Anomalies - diagnostic imaging</subject><subject>Coronary Vessel Anomalies - surgery</subject><subject>Coronary Vessels - diagnostic imaging</subject><subject>Coronary Vessels - surgery</subject><subject>Humans</subject><subject>Intramural</subject><subject>Nitroglycerin</subject><subject>Predictive Value of Tests</subject><subject>Reproducibility of Results</subject><subject>Retrospective Studies</subject><issn>1934-5925</issn><issn>1876-861X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UU1v1DAUtBAVbbf8AQ7Ix-0hwR9rx0FIVRRRQKrUS6tysxznZderJF5sB4n_wI_Gy7YcOb3RezMjzRuE3lFSUkLlh325tzaVjDBeElYSwl-hC6oqWShJv7_OuOabQtRMnKPLGPeEiIoS9Qadc6nIhqvqAv1u_XRYEvQ4-clvgznsfmEzb90LXrcPzTX2Q176yYx-idj4kJzFPritm_-esPXBzyZkaUiQx7pp7tvm-iN-2jm7wxOYuASYYE5ZHgAba5dgUgZzjwOMznQj3Fyhs8GMEd4-zxV6vP380H4t7u6_fGubu8JyIVMBHRWUUm57sWHWkI5bqepacaVAVkxykJbxjtmqtrLiBEAMG6H6DAbSi46v0Prkewj-xwIx6clFC-NoZsgBNasqVVfiaLVC7ES1wccYYNCH4KacVFOijy3ovT62oI8taMJ0biGL3j_7L90E_T_Jy9sz4dOJADnlTwdBR-tgttC7ANms9-5__n8AqNSZhA</recordid><startdate>202303</startdate><enddate>202303</enddate><creator>Ferraro, Alessandra M.</creator><creator>Uslenghi, Alessandro</creator><creator>Lu, Minmin</creator><creator>Newburger, Jane W.</creator><creator>Nathan, Meena</creator><creator>Quinonez, Luis G.</creator><creator>Beroukhim, Rebecca S.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4053-8932</orcidid></search><sort><creationdate>202303</creationdate><title>Computed tomography angiography (CTA) of anomalous aortic origin of a coronary artery (AAOCA): Which measurements are accurate and reliable?</title><author>Ferraro, Alessandra M. ; Uslenghi, Alessandro ; Lu, Minmin ; Newburger, Jane W. ; Nathan, Meena ; Quinonez, Luis G. ; Beroukhim, Rebecca S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-eb151113cd542ca0b3c68998388e67263e6c23b2c79c6730ee5f458d0eef0d5b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Anomalous aortic origin of a coronary artery</topic><topic>Aorta</topic><topic>Children</topic><topic>Computed tomography</topic><topic>Computed Tomography Angiography - methods</topic><topic>Coronary Angiography - methods</topic><topic>Coronary artery</topic><topic>Coronary Vessel Anomalies - diagnostic imaging</topic><topic>Coronary Vessel Anomalies - surgery</topic><topic>Coronary Vessels - diagnostic imaging</topic><topic>Coronary Vessels - surgery</topic><topic>Humans</topic><topic>Intramural</topic><topic>Nitroglycerin</topic><topic>Predictive Value of Tests</topic><topic>Reproducibility of Results</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ferraro, Alessandra M.</creatorcontrib><creatorcontrib>Uslenghi, Alessandro</creatorcontrib><creatorcontrib>Lu, Minmin</creatorcontrib><creatorcontrib>Newburger, Jane W.</creatorcontrib><creatorcontrib>Nathan, Meena</creatorcontrib><creatorcontrib>Quinonez, Luis G.</creatorcontrib><creatorcontrib>Beroukhim, Rebecca S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiovascular computed tomography</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ferraro, Alessandra M.</au><au>Uslenghi, Alessandro</au><au>Lu, Minmin</au><au>Newburger, Jane W.</au><au>Nathan, Meena</au><au>Quinonez, Luis G.</au><au>Beroukhim, Rebecca S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Computed tomography angiography (CTA) of anomalous aortic origin of a coronary artery (AAOCA): Which measurements are accurate and reliable?</atitle><jtitle>Journal of cardiovascular computed tomography</jtitle><addtitle>J Cardiovasc Comput Tomogr</addtitle><date>2023-03</date><risdate>2023</risdate><volume>17</volume><issue>2</issue><spage>130</spage><epage>137</epage><pages>130-137</pages><issn>1934-5925</issn><eissn>1876-861X</eissn><abstract>The variation and accuracy of computed tomography angiography (CTA) features of anomalous aortic origin of a coronary artery (AAOCA) have not been completely characterized. We evaluated anomalous right (AAORCA) and left (AAOLCA) coronary arteries by CTA, with an emphasis on reproducibility, comparison with surgical measurements, and effect of nitroglycerin.
CTAs were interpreted for location of coronary origin & exit from the aorta, course, and dominance; minor & major diameters of the proximal & distal coronaries; shape of orifice; and intramural length. Relationships between vessel measurements, body surface area (BSA), and nitroglycerin use were evaluated. Comparisons between CTA and surgical measurements included intramural length, surgical probe size pre-intervention vs. CTA proximal AAOCA diameter, and surgical probe size post-intervention vs. CTA distal AAOCA diameter.
Of 104 patients [81 (78%) AAORCA], all but 1 were intramural. Compared to AAOLCA, AAORCA patients were more likely to have a high origin (91% vs. 31%, p < 0.01), and slit-like orifice (58% vs. 26%, p < 0.01). When CTAs with nitroglycerin were compared to those without, no difference in proximal AAOCA dimensions was identified; however distal AAOCA and normal-origin coronary dimensions were larger in scans with nitroglycerin. Aside from slit-like orifice, reliability of coronary CTA measurements, including proximal AAOCA minor diameter and intramural length, was moderate to good between readers. In a subgroup of 54 patients, proximal AAOCA minor diameter and intramural length had good agreement and correlation with surgery.
Proximal AAOCA dimensions and intramural length are reproducible variables. The lack of difference in proximal AAOCA dimensions with nitroglycerin may reflect abnormal vessel mechanics. Multicenter studies are an important next step in understanding the generalizability of our findings.
Table of Contents Summary: In this study we evaluated 104 CT angiograms on patients with anomalous origin of the coronary arteries (AAOCA; 81 right and 23 left), with an emphasis on clinically useful measurements that have high reliability (intra-rater, inter-rater, and comparison with surgical measurements). We found that measurements of the intramural segment (e.g., proximal AAOCA dimensions and intramural length) had moderate-good reliability. The lack of difference in these measurements with/without nitroglycerin at the time of CTA (versus evidence of dilation in the non-intramural vessel) supports their clinical utility as measures of potential ischemic risk.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>36804387</pmid><doi>10.1016/j.jcct.2023.02.003</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-4053-8932</orcidid></addata></record> |
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| subjects | Anomalous aortic origin of a coronary artery Aorta Children Computed tomography Computed Tomography Angiography - methods Coronary Angiography - methods Coronary artery Coronary Vessel Anomalies - diagnostic imaging Coronary Vessel Anomalies - surgery Coronary Vessels - diagnostic imaging Coronary Vessels - surgery Humans Intramural Nitroglycerin Predictive Value of Tests Reproducibility of Results Retrospective Studies |
| title | Computed tomography angiography (CTA) of anomalous aortic origin of a coronary artery (AAOCA): Which measurements are accurate and reliable? |
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