Intracoronary transluminal attenuation gradient in coronary CT angiography for determining coronary artery stenosis Academic Article uri icon


MeSH Major

  • Coronary Angiography
  • Coronary Stenosis
  • Radiographic Image Interpretation, Computer-Assisted
  • Tomography, X-Ray Computed
  • Vascular Calcification


  • Coronary computed tomography angiography (CTA) assessment of calcified or complex coronary lesions is frequently challenging. Transluminal attenuation gradient (TAG), defined as the linear regression coefficient between luminal attenuation and axial distance, has a potential to evaluate the degree of coronary stenosis. We examined the value of TAG in determining the stenosis severity on 64-slice coronary CTA. The value of TAG of 370 major coronary arteries was measured from 7,263 intervals of 5-mm length. Compared with coronary CTA and invasive coronary angiography, TAG decreased consistently and significantly with maximum stenosis severity on a per-vessel basis, from -1.91 ± 4.25 Hounsfield units/10 mm for diameter stenosis of 0% to 49% to -13.37 ± 9.81 Hounsfield units/10 mm for diameter stenosis of 100% (p < 0.0001). Adding TAG to the interpretation of coronary CTA improved diagnostic accuracy (p = 0.001), especially in vessels with calcified lesions (N = 127; net reclassification improvement 0.095; p = 0.046). TAG appears to be able to contribute to improved classification of coronary artery stenosis severity in coronary CTA, especially in severely calcified lesions.

publication date

  • November 2011



  • Academic Article



  • eng

Digital Object Identifier (DOI)

  • 10.1016/j.jcmg.2011.09.006

PubMed ID

  • 22093264

Additional Document Info

start page

  • 1149

end page

  • 57


  • 4


  • 11