Fig 1.
Volume rendering (VR) image of the coronary artery tree showed the left coronary bifurcation angles (A). The left coronary bifurcation angles of LAD-LCx (B), LM-LAD (C) and LM-LCx (D) were 72.7°, 146.9° and 173.0° on MPR images in a 62 year-old man with mild LAD stenosis. LM = left main coronary artery; LAD = left anterior descending artery; LCx = left circumflex artery; MPR = multiplanar reformation.
Fig 2.
The left coronary bifurcation angles were showed by VR image (A). The left coronary bifurcation angles of LAD-LCx (B), LM-LAD (C) and LM-LCx (D) were 107.2°, 137.3° and 112.4° on MPR images in a 60 year-old man with proximal LAD stenosis of 55%. VR = volume rendering; LM = left main coronary artery; LAD = left anterior descending artery; LCx = left circumflex artery; MPR = multiplanar reformation.
Fig 3.
Invasive coronary angiography showed a serious lesion (arrow) in the proximal LAD with a stenosis of 80% (A). The CPR image showed a non-calcified plaque (arrow) in the proximal LAD (B). The semi-automatic plaque analysis software showed the lipid (red), fibrous (blue) and calcified (yellow) plaque through tracking of LAD (C). The CCTA plaque parameters were automatically measured and displayed in the images. LAD = left anterior descending artery; CPR = curved planar reformation; CCTA = coronary computed tomography angiography.
Table 1.
Baseline characteristics of the study population.
Table 2.
Left coronary bifurcation angle in different degrees of left coronary stenosis severity determined by CAG.
Table 3.
Comparison of left coronary bifurcation angles between systole and diastole.
Fig 4.
There was mild correlation between the bifurcation angle of LAD-LCx and left coronary stenosis severity at systole (A) and diastole (B). The bifurcation angle of LM-LAD and LM-LCx showed no significant association with left coronary stenosis severity at both systole (C, E) and diastole (D, F).
Table 4.
Comparison of left coronary bifurcation angles between the non-calcified plaque and calcified plaque groups.
Table 5.
Multivariate logistic regression analysis of CCTA parameters for predicting coronary stenosis by CAG.
Table 6.
Diagnostic performance of left coronary bifurcation angles and plaque characteristics for identifying CAG-determined coronary stenosis.
Fig 5.
Receiver operating characteristic (ROC) curve analysis showed bifurcation angle of LAD-LCx for prediction of significant left coronary artery stenosis in total (A) and non-calcified (B) left coronary artery.
AUC = area under the receiver-operating characteristics curve; CI = confidence interval; LAD = left anterior descending artery; LCx = left circumflex artery.
Table 7.
Clinical data analysis of different bifurcation angles.
Table 8.
Per-vessel CCTA characteristics in coronary stenosis by CAG.
Fig 6.
Receiver operating characteristic (ROC) curve analysis showed diameter stenosis (DS), lipid plaque volume and diameter stenosis + lipid plaque volume for identifying significant coronary artery stenosis.
AUC = area under the receiver-operating characteristics curve; CI = confidence interval.