Value of transluminal attenuation gradient of stress CCTA for diagnosis of haemodynamically significant coronary artery stenosis using wide-area detector CT in patients with coronary artery disease: Comparison with stress perfusion CMR

Hee Yeong Kim, Hwan-Seok Yong, Eun-Young Kang, Eung Ju Kim, Bo Kyoung Seo

Research output: Contribution to journalArticle


Introduction: This study aimed to evaluate the value of transluminal attenuation gradient (TAG) of stress coronary computed tomography angiography (CCTA), using a widearea detector CT in patients with coronary artery disease, compared to stress perfusion cardiac magnetic resonance (CMR) imaging. Methods: This prospective study from May 2012 to January 2015 included 21 patients with moderate coronary stenosis on invasive coronary angiography. All patients underwent adenosine stress single-shot CCTA with a rest CCTA scan using a wide-area detector CT. Coronary artery stenosis was evaluated on both stress and rest CCTA images, and TAG was manually obtained for all vessels. Stress perfusion CMR was used as a reference standard. A TAG cut-off value of-15.1 HU/10 mm was applied for diagnosing haemodynamically significant stenosis. The diagnostic accuracies of TAG and CMR were estimated and compared. Results: TAG of stress CCTA in all coronary arteries had a sensitivity, specificity, and positive and negative predictive values of 90.5, 90.0, 86.4 and 93.1%, respectively. Corresponding values for TAG of rest CCTA in all coronary arteries were 42.9, 83.3, 64.3 and 67.6%, respectively, whereas those for TAG of coronary arteries with moderate stenosis on stress CCTA were 93.3, 100, 100 and 92.3%, respectively. Mean effective radiation doses for stress and rest CCTA were 10.6 ± 2.6 mSv and 2.3 ± 1.3 mSv, respectively. Conclusions: TAG of CCTA provided high diagnostic accuracy for detecting haemodynamically significant coronary artery stenosis. TAG of stress CCTA was more diagnostically accurate, especially in coronary arteries with moderate stenosis.

Original languageEnglish
Pages (from-to)16-21
Number of pages6
JournalJournal of Private Equity
Issue number1
Publication statusPublished - 2018 Jan 1



  • Computerised tomography
  • Coronary artery disease
  • Magnetic resonance imaging
  • Transluminal attenuation gradient

ASJC Scopus subject areas

  • Finance
  • Economics and Econometrics

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