title: Coronary artery assessment on electrocardiogram-gated thoracoabdominal multidetector computed tomographic angiography for aortic evaluation.
abstract: OBJECTIVE
  The objective of this study was to evaluate coronary image quality, stenosis grade, and diagnostic confidence in patients undergoing electrocardiogram-gated thoracoabdominal multidetector computed tomographic angiography (CTA) for aortic evaluation.
  
  
  METHODS
  Seventy-five consecutive patients underwent retrospectively electrocardiogram-gated thoracoabdominal CTA reconstructed at each 12.5% of the R wave to R wave (R-R) interval. Two observers in consensus scored the coronary arteries per segment (15-segment American Heart Association model) for image quality, stenosis grade, and stenosis-assessment confidence.
  
  
  RESULTS
  Nondiagnostic image quality prohibited coronary evaluation in 14 patients. In the remaining patients, 2% of segments was scored absent, 24% was scored nondiagnostic, 12% was scored diagnostically limited, and 61% was scored at least acceptable. Acceptable or higher image quality was seen in 82% of the proximal and middle segments. Significant stenosis (>50%) was seen in 57% of the patients. Stenosis-severity scoring confidence was moderate to high in 79% of 673 assessable segments.
  
  
  CONCLUSIONS
  Electrocardiogram-gated thoracoabdominal CTA allows concomitant assessment of the proximal and middle coronary arteries and may serve as a combined tool for aortic-disease workup. Aortic CTA showed significant coronary artery stenosis in 57% of the patients evaluated for aortic pathology.
authors.affiliation: From the Departments of *Radiology, †Cardiology, and ‡Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Willemink
authors.forename: Matthijs F L
authors.initials: MF
authors.lastname: Meijs
authors.forename: Maarten J
authors.initials: MJ
authors.lastname: Cramer
authors.forename: Anthony S
authors.initials: AS
authors.lastname: Thijssen
authors.forename: Frans L
authors.initials: FL
authors.lastname: Moll
authors.forename: Pim A
authors.initials: PA
authors.lastname: de Jong
authors.forename: Tim
authors.initials: T
authors.lastname: Leiner
authors.forename: Ricardo P J
authors.initials: RP
authors.lastname: Budde
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging*; D001018:Aortic Diseases / Q000000981:diagnostic imaging*; D055424:Cardiac-Gated Imaging Techniques; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide