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Coronary CTA

Yoriaki Matsumoto, Takanori Masuda, Yukari Yamashita, Takayuki Oku, Hirofumi Uyama, Tomoyasu Sato, Naoyuki Imada
PURPOSE: The purpose of this study was to investigate the association of vessel visibility and radiation dose using contrast-to-noise ratio (CNR) method with low tube voltage in coronary computed tomography angiography (c-CTA). METHODS: We performed electrocardiogram-gated scan of 2.0-mm diameter simulated vessel in the center of the cardiac phantom by the use of a 64-detector CT scanner. Reference CNR was calculated from the target coronary CT number (CTnumberA; 350 Hounsfield units [HU]), epicardial fat CT number (CTnumberB; -100 HU), and target epicardial fat standard deviation (SD) number (SDB; 25 HU) at the 120 kV...
2016: Nihon Hoshasen Gijutsu Gakkai Zasshi
Sara Gaur, Charles A Taylor, Jesper M Jensen, Hans Erik Bøtker, Evald H Christiansen, Anne K Kaltoft, Niels R Holm, Jonathon Leipsic, Christopher K Zarins, Stephan Achenbach, Sophie Khem, Alan Wilk, Hiram G Bezerra, Jens F Lassen, Bjarne L Nørgaard
OBJECTIVES: This study sought to determine the diagnostic performance of noninvasive fractional flow reserve (FFR) derived from coronary computed tomography angiography (CTA) (FFRCT) for the diagnosis of lesion-specific ischemia in nonculprit vessels of patients with recent in ST-segment elevation myocardial infarction (STEMI). BACKGROUND: In patients with stable angina, FFRCT has high diagnostic performance in identification of ischemia-causing lesions. The potential value of FFRCT for assessment of multivessel disease in patients with recent STEMI has not been evaluated...
October 6, 2016: JACC. Cardiovascular Imaging
J Tobias Kühl, Thomas S Kristensen, Anna F Thomsen, Louise Hindsø, Kristoffer L Hansen, Olav W Nielsen, Henning Kelbæk, Klaus F Kofoed
BACKGROUND: Signs of pulmonary congestion obtained from cardiac computed tomography angiographic (coronary CTA) images have not previously been related to clinical congestion or outcome and the clinical value is, therefore, unknown. Our objective was to test the hypothesis that signs of pulmonary congestion predict clinical heart failure and adverse outcome in patients with myocardial infarction. METHODS: Coronary CTA was performed before invasive treatment in 400 prospectively included patients with non ST segment elevation myocardial infarction in an observational study...
September 15, 2016: Journal of Cardiovascular Computed Tomography
Futoshi Yamanaka, Koki Shishido, Tomoki Ochiai, Noriaki Moriyama, Kazuki Tobita, Tomoyuki Tani, Kyosuke Furuhashi, Kazuya Sugitatsu, Daisuke Hachinohe, Tadashi Wada, Shingo Mizuno, Hidetaka Suenaga, Yutaka Tanaka, Masato Murakami, Junya Matsumi, Saeko Takahashi, Takeshi Akasaka, Shinji Tanaka, Shigeru Saito
OBJECTIVE: Multi-slice computed tomography (MSCT) coronary angiography has been reported as an effective alternative to invasive conventional coronary angiography (CCA) for the diagnosis of coronary artery disease (CAD). However, in previous reports, the diagnostic accuracy of MSCT has not been significant enough to be of benefit in symptomatic patients. The aim of this study was to identify the usefulness of 320-slice computed tomography coronary angiography (320-CTA) for symptomatic patients in terms of the diagnostic accuracy of 320-CTA and the prevalence of vasospastic angina pectoris (VSAP) within the study cohort...
September 29, 2016: European Journal of Internal Medicine
Richard A P Takx, Radko Krissak, Christian Fink, Valentin Bachmann, Thomas Henzler, Mathias Meyer, John W Nance, Stefan O Schoenberg, Paul Apfaltrer
OBJECTIVES: To investigate the relationship between image quality and patient size at 100 kilovoltage (kV) compared to 120 kV ECG-gated Triple-Rule-Out CT angiography (TRO-CTA). METHODS: We retrospectively included 73 patients (age 64 ± 14 years) who underwent retrospective ECG-gated chest CTA. 40 patients were scanned with 100 kV while 33 patients with 120 kV. Body mass index (BMI), patients' chest circumference (PC) and thoracic surface area (TSA) were recorded...
September 29, 2016: European Radiology
Chong-Fu Jia, Yi-Nong Jiang, Zhi-Qiang Yang, Xi-Xia Sun, Yang Yu, Hao Wang, Yan Lu, Ai-Jun Chen, Zhao-Qian Wang
BACKGROUND: A new feature of coronary computed tomography angiography (CTA) is to estimate ascending aortic elasticity without additional cost, but its applicable benefit for prehypertension patients is still unclear. The aim of this study is to discuss the characteristic of ascending aortic elasticity for specific prehypertension patients and its risk factors. METHODS: Coronary CTA examinations of 398 participants were performed using a 128 slicer CT scanner. The differences of 3 ascending aortic elasticity related indices, including aortic distensibility (AD), aortic compliance (AC), and aortic stiffness (ASI), and anatomical measurements were analyzed among the normal, prehypertension, and primary hypertension groups...
September 29, 2016: American Journal of Hypertension
Xi Chen, Yang Gao, Bin Lu, Xinwei Jia, Liang Zhong, Ghassan S Kassab, Wenchang Tan, Yunlong Huo
Serial segmental narrowing frequently occurs in humans, which alters coronary hemodynamics and further affects atherosclerotic progression and plaque formation. The objective of this study was to understand the distribution of hemodynamic parameters in the epicardial left main coronary arterial (LMCA) tree with serial stenoses reconstructed from patient computer tomography angiography (CTA) images. A finite volume method was used in conjunction with the inlet pressure wave and outlet flow resistance. The time-averaged wall shear stress (TAWSS) and oscillatory shear index (OSI) were determined from the flow field...
2016: PloS One
Stefanie Mangold, Julian L Wichmann, U Joseph Schoepf, Damiano Caruso, Christian Tesche, Daniel H Steinberg, Akos Varga-Szemes, Andrew C Stubenrauch, Richard R Bayer, Matthew Biancalana, Konstantin Nikolaou, Carlo N De Cecco
PURPOSE: To investigate diagnostic accuracy of 3(rd)-generation dual-source CT (DSCT) coronary angiography in obese and non-obese patients. METHODS: We retrospectively analyzed 76 patients who underwent coronary CT angiography (CCTA) and invasive coronary angiography. Prospectively ECG-triggered acquisition was performed with automated tube voltage selection (ATVS). Patients were dichotomized based on body mass index in groups A (<30 kg/m(2), n = 37) and B (≥30 kg/m(2), n = 39) and based on tube voltage in groups C (<120 kV, n = 46) and D (120 kV, n = 30)...
September 28, 2016: European Radiology
Ravi T Mathai, Dalia M Fahmy, Hanaa L Sadek, Waleed M Renno
BACKGROUND: Congenital anomalies of the coronary arteries(CAs) are rare and are often diagnosed incidentally during a conventional coronaryangiography. Recently, the incidence of these congenital defects is on the rise particularly after the introduction of the electrocardiography (ECG) gated coronary computed tomographic angiography (CCTA). This innovative radiological screening modality has led to the most precise mapping of the course of the CAs on Computed Tomographic Scan. The aim of the study is to determine the prevalence and describe theCAscongenital anomalies and their variations in Kuwaiti population at a single institution experience...
October 6, 2016: Folia Morphologica (Warsz)
Brian B Ghoshhajra, Richard A P Takx, Luke L Stone, Erin E Girard, Emmanouil S Brilakis, William L Lombardi, Robert W Yeh, Farouc A Jaffer
OBJECTIVES: The purpose of this study was to demonstrate the feasibility of real-time fusion of coronary computed tomography angiography (CTA) centreline and arterial wall calcification with x-ray fluoroscopy during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS: Patients undergoing CTO PCI were prospectively enrolled. Pre-procedural CT scans were integrated with conventional coronary fluoroscopy using prototype software. We enrolled 24 patients who underwent CTO PCI using the prototype CT fusion software, and 24 consecutive CTO PCI patients without CT guidance served as a control group...
September 23, 2016: European Radiology
Huanhuan Wang, Yin Zhang, Yanbo Xie, Hongyue Wang, Jinqing Yuan
INTRODUCTION: Coronary artery aneurysm (CAA) is defined as coronary dilatation which exceeds the diameter of the normal adjacent artery segments or the diameter of the patient's largest coronary artery by 1.5 times. The incidence of giant CAA is difficult to be determined, since only few reports have been described in the literature. METHODS AND RESULTS: A 65-year-old man was referred to our hospital because of a "mass" in the right heart detected on echocardiography at a regular medical health examination, while he experienced no any symptoms...
September 2016: Medicine (Baltimore)
Zhongyi Chen, Irina Boldeanu, Simon Nepveu, Madeleine Durand, Anne S Chin, Claude Kauffmann, Samer Mansour, Gilles Soulez, Cécile Tremblay, Carl Chartrand-Lefebvre
BACKGROUND: Coronary computed tomography angiography (CTA) allows the evaluation of coronary plaque volume and low attenuation (lipid-rich) component, for plaque vulnerability assessment. PURPOSE: To determine the effect of iterative reconstruction (IR) on coronary plaque volume and composition. MATERIAL AND METHODS: Consecutive patients without coronary artery disease were prospectively enrolled for 256-slice CT. Images were reconstructed with both filtered back projection (FBP) and a hybrid IR algorithm (iDose(4), Philips) levels 1, 3, 5, and 7...
September 19, 2016: Acta Radiologica
Aimee E Moores, Michael S Cahill, Todd C Villines
Aortic mycotic aneurysms are a rare but life-threatening potential complication of infective endocarditis. Rapid deterioration of the vascular wall in highly focal areas makes these pseudoaneurysms particularly prone to rupture, resulting in uncontrolled aortic hemorrhage. While computed tomography angiography (CTA) is the imaging modality of choice for the evaluation of mycotic aneurysms, it is not routinely performed in patients with known or suspected infective endocarditis (IE). However, current valvular heart disease guidelines support the use of cardiac CTA in cases of IE and suspected perivalvular extension when there is inadequate or ambiguous visualization on echocardiography...
2016: Case Reports in Medicine
Se Hun Kang, Gyung-Min Park, Seung-Whan Lee, Sung-Cheol Yun, Young-Hak Kim, Young-Rak Cho, Hyun Woo Park, Jon Suh, Dong Hyun Yang, Joon-Won Kang, Tae-Hwan Lim, Chang Hee Jung, Eun Hee Koh, Woo Je Lee, Min-Seon Kim, Ki-Up Lee, Joong-Yeol Park
OBJECTIVES: This study sought to evaluate the long-term prognostic value of coronary computed tomography angiography (CTA) in asymptomatic patients with type 2 diabetes mellitus. BACKGROUND: There are limited data on the long-term prognostic impact of coronary CTA in asymptomatic patients with type 2 diabetes mellitus. METHODS: This study analyzed clinical outcomes of 591 consecutive asymptomatic patients with type 2 diabetes mellitus who underwent coronary CTA (mean age 62...
September 9, 2016: JACC. Cardiovascular Imaging
Ricardo C Cury, Suhny Abbara, Stephan Achenbach, Arthur Agatston, Daniel S Berman, Matthew J Budoff, Karen E Dill, Jill E Jacobs, Christopher D Maroules, Geoffrey D Rubin, Frank J Rybicki, U Joseph Schoepf, Leslee J Shaw, Arthur E Stillman, Charles S White, Pamela K Woodard, Jonathon A Leipsic
The intent of CAD-RADS - Coronary Artery Disease Reporting and Data System is to create a standardized method to communicate findings of coronary CT angiography (coronary CTA) in order to facilitate decision-making regarding further patient management. The suggested CAD-RADS classification is applied on a per-patient basis and represents the highest-grade coronary artery lesion documented by coronary CTA. It ranges from CAD-RADS 0 (Zero) for the complete absence of stenosis and plaque to CAD-RADS 5 for the presence of at least one totally occluded coronary artery and should always be interpreted in conjunction with the impression found in the report...
September 2016: JACC. Cardiovascular Imaging
Kavitha M Chinnaiyan, Gilbert L Raff
Acute chest pain (ACP) represents a clinical as well as economic challenge, often resulting in time-consuming, expensive evaluations to avoid missed diagnosis of acute coronary syndromes (ACSs). Coronary CT angiography (CTA) is an attractive noninvasive technique for use in the emergency department (ED) due to its high accuracy and negative predictive value. Recent studies have demonstrated that coronary CTA can aid in safe, rapid, and cost-efficient triage of these patients. Additional applications of plaque characterization, fractional flow analysis, and CT perfusion imaging hold promise in providing incremental data in patients with suspected ACS...
October 2016: Current Treatment Options in Cardiovascular Medicine
Jinling Zhang, Zhehao Lv, Deli Zhao, Lili Liu, Yong Wan, Tingting Fan, Huimin Li, Ying Guan, Bailu Liu, Qi Yang
Little is known regarding plaque distribution, composition, and the association with inflammation in type 2 diabetes mellitus (DM2). This study aimed to assess the relationship between coronary plaque subtypes and high-sensitivity C-reactive protein levels. Coronary CTA were performed in 98 symptomatic DM2 patients and 107 non-DM2 patients using a 256-slice CT. The extent and types of plaque as well as luminal narrowing were evaluated. Patients with DM2 were more likely to have significant stenosis (>50%) with calcified plaques in at least one coronary segment (p < 0...
2016: Journal of Diabetes Research
Qiyong Wu, Yong Wang, Huihua Kai, Tao Wang, Xiaoqiang Tang, Xiaoqin Wang, Changjie Pan
BACKGROUND AND AIM: To evaluate image quality and radiation dosage in coronary CT angiography using 80-kVp tube voltage combined with low-concentration contrast media (CM) and iterative reconstruction (IR) for coronary CT angiography (CCTA) and employing dual-source CT without heart-rate control. METHODS: 154 patients were randomly assigned to Group A (Control Group, 120-kVp tube voltage, high-concentration CM and filtered back projection reconstruction) and Group B (Low-Dose Group, 80 kVp, low-concentration CM and iterative construction)...
September 2016: International Journal of Clinical Practice
Yaqi Shen, Xuemei Hu, Xianlun Zou, Di Zhu, Zhen Li, Daoyu Hu
BACKGROUND: Imaging communities have already reached a consensus that the radiation dose of computed tomography (CT) should be reduced as much as reasonably achievable to lower population risks. Increasing attention is being paid to iodinated contrast media (CM) induced nephrotoxicity (CIN); a decrease in the intake of iodinated CM is required by increasingly more radiologists. Theoretically, the radiation dose varies with the tube current time and square of the tube voltage, with higher iodine contrast at low photon energies (Huda et al...
September 2016: International Journal of Clinical Practice
Erin P Ward, Daniele Shiavazzi, Divya Sood, Allison Marsden, John Lane, Erik Owens, Andrew Barleben
BACKGROUND: Currently, the gold standard diagnostic examination for significant aortoiliac lesions is angiography. Fractional flow reserve (FFR) has a growing body of literature in coronary artery disease as a minimally invasive diagnostic procedure. Improvements in numerical hemodynamics have allowed for an accurate and minimally invasive approach to estimating FFR, utilizing cross-sectional imaging. We aim to demonstrate a similar approach to aortoiliac occlusive disease (AIOD). METHODS: A retrospective review evaluated 7 patients with claudication and cross-sectional imaging showing AIOD...
August 26, 2016: Annals of Vascular Surgery
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