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1.
Christophe?T.?Arendt Patricia?Tischendorf Julian?L.?Wichmann Michael?Messerli Lucas?J?rg Niklas?Ehl Robin?F.?Gohmann Simon?Wildermuth Thomas?J.?Vogl Ralf?W.?Bauer
Objectives
We investigated the potential reduction of patient exposure during invasive coronary angiography (ICA) if the procedure had only been directed to the vessel with at least one ≥ 50% stenosis as described in the CT report.Methods
Dose reports of 61 patients referred to ICA because of at least one ≥ 50% stenosis on coronary CT angiography (CCTA) were included. Dose–area product (DAP) was documented separately for left (LCA) and right coronary arteries (RCA) by summing up the single DAP for each angiographic projection. The study population was subdivided as follows: coronary intervention of LCA (group 1) or RCA (group 2) only, or of both vessels (group 3), or further bypass grafting (group 4), or no further intervention (group 5).Results
57.4% of the study population could have benefitted from reduced exposure if catheterization had been directly guided to the vessel of interest as described on CCTA. Mean relative DAP reductions were as follows: group 1 (n = 18), 11.2%; group 2 (n = 2), 40.3%; group 3 (n = 10), 0%; group 4 (n = 3), 0%; group 5 (n = 28), 28.8%.Conclusions
Directing ICA to the vessel with stenosis as described on CCTA would reduce intraprocedural patient exposure substantially, especially for patients with single-vessel stenosis.Key points
? Patients with CAD can benefit from decreased radiation exposure during coronary angiography. ? ICA should be directed solely to significant stenoses as described on CCTA. ? Severely calcified plaques remain a limitation of CCTA leading to unnecessary ICA referrals.2.
Junghoon?Kim Hyon?Joo?Kwag Seung?Min?Yoo Jin?Young?Yoo In-Ho?Chae Dong-Ju?Choi Min-Jae?Park Mani?Vembar Eun?Ju?Chun
Objectives
To evaluate the clinical significance of discrepant lesions between coronary computed tomography angiography (CCTA) and invasive coronary angiography (ICA) in a longitudinal study.Methods
In 220 patients with suspected coronary artery disease (CAD) who underwent both 256-row CCTA and ICA, the obstructive CAD (≥ 50% stenosis) on CCTA was compared with that on ICA as the reference standard. We analysed the causes of the discrepancy between CCTA and ICA. During a 40-month follow-up period, major adverse cardiac events (MACE) were assessed.Results
Discordance between CCTA and ICA was observed in 121 of the 3166 coronary artery segments (3.8%). Common causes were calcification (45.9%) and positive remodelling (PR) (29.6%) in 83 false positive lesions, and noise (40.0%) and motion artefact (37.8%) in 38 false negative lesions. MACE occurred in seven lesions among the discrepant lesions; six among the 29 PR lesions (20.7%) and one among the 53 calcified lesions (1.9%). With respect to the prediction power of MACE in an intermediate stenosis, the CCTA-related value including PR was higher than the ICA-related value.Conclusions
PR was a frequent cause of MACE among the false positive lesions on CCTA. Therefore, the presence of PR on CCTA may suggest clinical significance, although it can be missed by ICA.Key Points
? Compared to ICA, PR in CCTA may be cause of false positive lesion. ? CCTA-related value including PR shows higher prediction power of MACE than ICA-related value. ? PR reflects atherosclerotic burden that can be related to cardiac events. ? PR in CCTA should be observed carefully, even if it is false positive.3.
Objectives
To investigate the progression of coronary atherosclerosis burden by coronary CT angiography (CCTA) and to demonstrate its association with the incidence of major adverse cardiac events (MACE).Methods
We retrospectively studied patients with stable angina who had undergone repeat CCTA due to recurrent or worsening symptoms. Lipid-rich, fibrous, calcified and total plaque burden as well as coronary diameter stenosis were quantitatively analysed. The incidence of MACE during follow-up was determined.Results
The final cohort consisted of 268 patients (mean age 52.9 ± 9.8 years, 71 % male) with a mean follow-up period of 4.6 ± 0.9 years. Patients with lipid-rich, fibrous, calcified and total plaque burden (%) progression, as well as coronary diameter stenosis (%) progression had a significantly higher incidence of MACE than those without (all p < 0.05). The progression of lipid-rich plaque (HR = 1.601, p = 0.021), total plaque burden (HR = 2.979, p = 0.043) and coronary diameter stenosis (HR = 4.327, p <0.001) were independent predictors of MACE (all p < 0.05).Conclusions
Patients presenting with recurrent or worsening symptoms associated with coronary artery disease who have coronary atherosclerosis progression on CCTA are at an increased risk of future MACE.Key Points
? Repeat CCTA can provide information regarding the progression of coronary atherosclerosis. ? Coronary atherosclerosis progression at CCTA is independently associated with MACE. ? CCTA findings could serve as incremental predictors of MACE.4.
Amir Imanzadeh Elizabeth George Takeshi Kondo Shinichi Takase Makoto Amanuma Frank J. Rybicki Kanako K. Kumamaru 《Japanese journal of radiology》2016,34(2):140-147
Purpose
To evaluate the role of coronary artery calcium scoring (CACS) and/or coronary CT angiography (CCTA) in asymptomatic elderly patients with high pretest probability for coronary artery disease (CAD).Materials and methods
Forty-eight consecutive asymptomatic elderly (>65 years) subjects who had a high pretest probability and underwent CACS/CCTA were included. Each CCTA was evaluated for adequacy for assessment of coronary stenosis. Significant stenosis (>50 % diameter narrowing) was assessed on evaluable CT images and by invasive catheter angiography (ICA).Results
All subjects were men with mean CACS of 880 ± 1779. Among those with low (0–99), intermediate (100–399), and high (400–999) CACS, ICA-verified significant stenosis was present in 8 % (1/13), 23 % (2/13), and 67 % (8/12), respectively. Among those with very high CACS (≥1000) (n = 10), 90 % of CCTAs were not evaluable for stenosis.Conclusion
In asymptomatic elderly subjects with high pretest probability, CACS followed by CCTA may be considered for those with intermediate to high CACS.5.
S.M. Shehata F.M. Zaiton M.H. Abo Warda 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(2):329-337
Objective
The aim of this study was to clarify the association between epicardial fat volume and coronary atherosclerosis.Materials and methods
A total of 90 patients with clinically suspected coronary artery disease underwent MDCT coronary angiography. The images were interpreted for Calcium score, quantification of epicardial adipose tissue (EAT) volume, and coronary artery disease (CAD) which was classified according to the number of affected vessels, location, extension, component of the lesion and degree of obstruction. EAT was correlated to CAD and Calcium score using 125?cm3 as a cutoff value for acceptable EAT volume.Results
The patients were classified into 3 groups: patients with 1-normal CCTA, 2-non-significant CAD and 3-significant CAD. A high statistical significant difference was found among the 3 groups regarding mean coronary calcium score (P value?=?0.00) and mean EAT volume; Group 1 (125.14?±?56.88?cm3), in group 2 (217.38?±?56.88?cm3) and the largest EAT volume was seen in group 3 (327.94?±?90.17?cm3), (P value: 0.00).Conclusion
The estimation of EAT volume could be considered as a screening test for any patients suspicious for CAD. 相似文献6.
Roberta Green Valeria Cantoni Mario Petretta Wanda Acampa Mariarosaria Panico Pietro Buongiorno Giorgio Punzo Marco Salvatore Alberto Cuocolo 《Journal of nuclear cardiology》2018,25(5):1588-1597
Background
Comparing the prognostic value of a negative finding by stress single-photon emission computed tomography myocardial perfusion imaging (MPI) and coronary computed tomography angiography (CCTA) may be useful to evaluate how better identify low-risk patients. We performed a meta-analysis to compare the long-term negative predictive value (NPV) of normal stress MPI and normal CCTA in subjects with suspected coronary artery disease (CAD).Methods and Results
Studies published between January 2000 and November 2016 were identified by database search. We included MPI and CCTA studies that followed-up ≥100 subjects for ≥5 years and providing data on clinical outcome for patients with negative tests. Summary risk estimates for normal perfusion at MPI or <50% coronary stenosis at CCTA were derived in random effect regression analysis, and causes of heterogeneity were determined in meta-regression analysis. We identified 12 eligible articles (6 MPI and 6 CCTA) including 33,129 patients (26,757 in MPI and 6372 in CCTA studies) with suspected CAD. The pooled annualized event rate (AER) for occurrence of hard events (death and nonfatal myocardial infarction) was 1.06 (95% confidence interval, CI 0.49-1.64) in MPI and 0.61 (95% CI 0.35-0.86) in CCTA studies. The pooled NPV was 91% (95% CI 86-96) in MPI and 96 (95% CI 95-98) in CCTA studies. The summary rates between MPI and CCTA were not statistically different. At meta-regression analysis, no significant association between AER and clinical and demographical variables considered was found for overall studies.Conclusions
Stress MPI and CCTA have a similar ability to identify low-risk patients with suspected CAD.7.
Mohammed M. Dawoud Alsiagy A. Salama Tarek Abdelmoneim El-Diasty Mohamed Alhefnawy 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(1):232-238
Objectives
To evaluate accuracy of computed tomography angiography (CTA) in evaluation of post traumatic renal vascular injury.Patients and methods
38 patients were presented with post traumatic intermittent or persistent hematuria. Renal CTA and digital subtraction angiography (DSA) were done for all patients.Results
CTA demonstrated pseudoaneurysm (PA) in 30 patients (78.9%) and no vascular lesions in 8 patient (21.1%). CTA had 86.11% sensitivity and 50% specificity in detection of post traumatic renal pseudoaneurysms, CTA missed diagnosis of renal arteriovenous fistula (RAVF) in 10 patients which discovered later by DSA.Conclusion
CTA with MIP as non invasive technique widely replaced renal DSA in detection of posttraumatic renal pseudoaneurysm. Renal DSA is still best modality in detection of RAVF and also has the upper hand in planning of selective renal artery embolization for the management of persistent or delayed hemorrhage from renal vessels. 相似文献8.
Objectives
To validate a method for performing myocardial segmentation based on coronary anatomy using coronary CT angiography (CCTA).Methods
Coronary artery-based myocardial segmentation (CAMS) was developed for use with CCTA. To validate and compare this method with the conventional American Heart Association (AHA) classification, a single coronary occlusion model was prepared and validated using six pigs. The unstained occluded coronary territories of the specimens and corresponding arterial territories from CAMS and AHA segmentations were compared using slice-by-slice matching and 100 virtual myocardial columns.Results
CAMS more precisely predicted ischaemic area than the AHA method, as indicated by 95% versus 76% (p?<?0.001) of the percentage of matched columns (defined as percentage of matched columns of segmentation method divided by number of unstained columns in the specimen). According to the subgroup analyses, CAMS demonstrated a higher percentage of matched columns than the AHA method in the left anterior descending artery (100% vs. 77%; p?<?0.001) and mid- (99% vs. 83%; p?=?0.046) and apical-level territories of the left ventricle (90% vs. 52%; p?=?0.011).Conclusions
CAMS is a feasible method for identifying the corresponding myocardial territories of the coronary arteries using CCTA.Key Points
? CAMS is a feasible method for identifying corresponding coronary territory using CTA ? CAMS is more accurate in predicting coronary territory than the AHA method ? The AHA method may underestimate the ischaemic territory of LAD stenosis9.
Hossam Mansour Abd El-Rahman Tamir A. Hassan Muhammad M. Elfawal Basheir A. Hassan Al shymaa A. Ali Hend M. Abdel-Rahman 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(3):581-591
Purpose
To investigate the value and highlight the role of multi slice computed tomography (MSCT) angiography in evaluation of extra-cardiac intra thoracic vascular anomalies in children.Patients and methods
This study included 24 patients (13 males and 11 females) with an age range of 1 month–13 years. All of these patients were clinically diagnosed to have congenital heart disease with suspected extracardiac vascular anomalies. All underwent prospective ECG-gated MSCT angiography after trans-thoracic echocardiography (TTE). Iterative reconstruction techniques were applied to reduce the radiation dose in MSCT angiography with the mean radiation dose of (4 mSv). The diagnostic accuracy and sensitivity of MSCT angiography and TTE were compared in comparison with surgical outcome.Results
The most common congenital extra cardiac vascular anomalies are PDA (45.8%) and aortic coarctation (37.5%). The major CT angiographic findings missed by TTE were coronary artery anomalies, absence of a pulmonary artery and pulmonary artery stenosis. The overall sensitivity of the MSCT angiography in diagnosis of the extra-cardiac vascular anomalies was 98.1% which was higher than that of TTE 80%.Conclusion
CG gated MSCT angiography is an accurate modality for demonstrating extra cardiac structures in complex CHD. It provides important complementary information to TTE with regard to extra cardiac vascular structures and coronary artery anatomy. This modality may reduce the need for high radiation dose invasive diagnostic cardiac catheterization. 相似文献10.
Youssriah Y. Sabri Mona A.F. Hafez Khaled M. Kamel Dina A. Abbas 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(4):986-992
Objective
to establish the role of transthoracic ultrasound as a bed-side, available, and affordable technique for imaging chest trauma patients and compared its sensitivity, specificity and accuracy for detecting chest trauma sequelae and complications to those of CT.Patients and methods
This study included 107 cases. All patients had chest trauma or polytrauma with chest involvement. Transthoracic ultrasound and MSCT of the chest were evaluated. The results were assessed and compared by statistical analysis.Results
Of the injuries, 13.1% were penetrating, and 86.9% were blunt trauma. With CT as the standard, the most common injury US detected injury was pleural in 60.7% of patients, with diagnostic accuracy of 93.4%. Parenchymal lesions were found in 39.3% of patients with a 64.4% US diagnostic accuracy. Chest wall lesions were found in 15.9% of patients with an 89.7% accuracy, and mediastinal lesions were detected in 9.3% with a 94.3% accuracy.Conclusion
Chest ultrasonography has significant value for diagnosing complications of blunt and penetrating chest trauma with acceptable sensitivity and high specificity, particularly for pleural lesions and rib fractures. Ultrasound overcomes the difficulties involved in radiological examinations of small children and uncooperative patients. 相似文献11.
Aimin Ding Guoqing Qiu Wensheng Lin Ling Hu Guangliang Lu Xiang Long Xin Hong Yaohua Chen Xiaoping Luo Qinqin Tang Dongqin Deng 《Japanese journal of radiology》2016,34(12):795-808
Purpose
Fractional flow reserve based on coronary computed tomographic angiography (CCTA; FFRCT) can evaluate functional severity in coronary artery disease (CAD). This study investigated the diagnostic value of FFRCT for determining CAD severity.Materials and methods
Medline, Cochrane, EMBASE, and Google Scholar databases were searched until June 16, 2016 using the following search terms: fractional flow reserve, coronary computed tomography angiography, myocardial ischemia. Randomized controlled trials, two-arm prospective studies, and retrospective studies were included in the analysis.Results
Twenty-one studies were included with a total of 2216 subjects and 2798 vessels. FFRCT, sensitivity per-vessel and per-patient were ≥82% and specificity was ≥73% for diagnosis of ischemia. FFRCT had better diagnostic accuracy and discrimination than CCTA.Conclusion
This study indicates that FFRCT may be a good tool for screening and diagnosing of myocardial ischemia in patients with CAD.12.
Valeria Cantoni Roberta Green Wanda Acampa Mario Petretta Domenico Bonaduce Marco Salvatore Alberto Cuocolo 《Journal of nuclear cardiology》2016,23(2):185-197
Background
We conducted a meta-analysis to compare the long-term prognostic value of stress single-photon emission computed tomography myocardial perfusion imaging (MPI) and coronary computed tomography angiography (CCTA) for adverse cardiovascular events in subjects with suspected or known coronary artery disease.Methods and Results
We searched PubMed, Cochrane, Web of Science, and Scopus database between January 2000 and December 2014 for stress MPI and CCTA studies that followed up ≥ 100 subjects for ≥ 2.5 years and provided the unadjusted and/or adjusted hazard ratio (HR) at Cox regression analysis. Summary risk estimates for abnormal perfusion at MPI or ≥ 50% coronary stenosis at CCTA were derived in random effect regression analysis, and causes of heterogeneity were determined in meta-regression analysis. We identified 21 eligible articles (10 MPI and 11 CCTA) including 25,258 participants (13,484 in MPI and 11,774 in CCTA studies) with suspected or known coronary artery disease. Among the included publications, 8 MPI and 8 CCTA studies reported the HR for the occurrence of hard events (death and nonfatal myocardial infarction). The pooled HR was comparable for MPI and CCTA studies. The HR for the occurrence of a combined endpoint including revascularization as event was reported in 4 MPI and 6 CCTA studies. The pooled HR was higher for CCTA compared to MPI (P < .05) also when only MPI and CCTA studies with limited representation of prior CAD were considered.Conclusions
The long-term prognostic value of MPI and CCTA for the occurrence of hard events is similar. However, the association between event-free survival and CCTA is higher than MPI when coronary revascularization is included in the endpoint.13.
Objectives
To evaluate image quality, coronary evaluability and radiation exposure of coronary CT angiography (CCTA) performed with whole-heart coverage cardiac-CT in patients with atrial fibrillation (AF).Materials and methods
We prospectively enrolled 164 patients with AF who underwent a clinically indicated CCTA with a 16-cm z-axis coverage scanner. In all patients CCTA was performed using prospective ECG-triggering with targeted RR interval. We evaluated image quality, coronary evaluability and effective dose (ED). Patients were divided in two subgroups based on heart rate (HR) during imaging. Group 1: 64 patients with low HR (<75 bpm), group 2: 100 patients with high HR (≥75 bpm). Written informed consent was obtained from all patients and the institutional ethics committee approved the study protocol.Results
In a segment-based analysis, coronary evaluability was 98.4 % (2,577/2,620 segments) in the whole population, without significant differences between groups (1,013/1,024 (98.9 %) and 1,565/1,596 (98.1 %), for groups 1 and 2, respectively, p=0.15). Mean ED was similar in both groups (3.8±1.9 mSv and 3.9±2.1 mSv in groups 1 and 2, respectively, p=0.75)Conclusions
The whole-heart-coverage scanner could evaluate coronary arteries with high image quality and without increase in radiation exposure in AF patients, even in the high HR group.Key points
? Last-generation CT scanner improves coronary artery assessment in AF patients. ? The new CT scanner enables low radiation exposure in AF patients. ? Diagnostic ICA maybe avoided in AF patients with suspected CAD. ? Whole-heart coverage CT scanner enables low radiation exposure in AF patients.14.
Samir Mohamed Hassan Sorour Azza Abdel Moniem Farrag Mohammed Ali Salem Sameh Wadie Bakhoum Hala Mohamed Raslan Emmanuel Fares Evette Morcos 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(4):971-975
Background
Cardiovascular disease is the most common, complication and principal cause of death in type 2 diabetes mellitus, (T2DM). Testing atherosclerotic burden using markers such as coronary, artery calcium score (CACS), and newer emerging techniques such as, pericardial fat volume (PFV) is needed.Methods
This prospective study was conducted on 1032 patients. Using, multidetector computed tomography (MDCT), we assessed CACS and PFV for, 402 patients with T2DM included in the study. Diabetic patients with, measured PFV (204 patients) were divided into 2 groups; patients with PFV ≥100?cm3 and patients with PFV <100?cm3. The severity of coronary, artery disease (CAD) was quantified using the Gensini Score. Correlation, between CACS and PFV and severity of CAD was studied.Results
CACS, PFV and Gensini score were higher in diabetic patients. Linear correlation of CACS with Gensini score was significant whereas, linear correlation of PFV with Gensini score was not significant. Logistic regression analysis was applied; only the male gender and CACS, were the significant predictors for CAD.Conclusion
Quantification of CACS by MDCT is an effective method to, predict atherosclerotic CAD in type 2 DM. Quantification of PFV remains, uncertain for prediction of presence or severity of CAD. 相似文献15.
Youssriah Yahia Sabri Marwa Moawed Takeya Ahmed Taymour Sally Foad Tadros 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(3):624-630
Objective
This work aimed for detection of different congenital and acquired abnormalities affecting the pulmonary veins using multislice computed tomography (MSCT).Patients and methods
This study was carried on 74 patients. Cases were referred to Radiology department of Kasr Al-Ainy with different chest complaints for MSCT and only cases showing pulmonary venous abnormalities were included in this study. All patients underwent MSCT of the chest using different MSCT protocols according to the initial presentation of the patient.Results
This study included 74 patients with pulmonary veins abnormalities; congenital anomalies of the pulmonary veins were observed in 36.4% of cases and acquired abnormalities in 62.2% of cases, one case had both congenital and acquired pulmonary vein abnormalities (1.4%). The most common congenital anomaly was pulmonary vein varices while the most common acquired abnormality was pulmonary vein stenosis or obstruction.Conclusion
The presence of different pulmonary venous abnormalities can be easily delineated using MSCT, with its MPR capability, as it provides excellent resolution and a large field of view. 相似文献16.
Reza Jalli Sepideh Sefidbakht Banafsheh Zeinali-Rafsanjani Parisa Pishdad Fatemeh-sadat Hasheminasab Mahdi Saeedi-Moghadam 《The Egyptian Journal of Radiology and Nuclear Medicine》2017,48(4):861-863
Background
Sulfur mustard (SM) gas as a vesicant chemical warfare was used in the Iran-Iraq war (1981–1989) against the Iranian warriors.Objective
This alkylating agent with the potential of producing chemical injury in the skin, eyes and lung, may damage both upper and lower respiratory tract, which in turn can cause different types of sequels such as asthma, bronchiectasis, chronic bronchitis and lung fibrosis.Methods
This study was performed on 274 patients with documented history of SM gas exposure. All of the participants complained of respiratory problems. Patients with positive history of cigarette smoking, respiratory problems before the exposure to SM gas, cardiovascular problems, surgery of the lung, and exposure to occupational toxic chemicals were excluded from the study. Results of all chest HRCTs were evaluated by a radiologist.Results
HRCT findings showed that bronchiectasis involved 53 patients (19.34%) of all cases. Varicose bronchiectasis and cystic bronchiectasis was observed in 10 (18.9%) and 6 cases (11.3%) respectively. Among patients with bronchiectasis, the involvement rate of different lobes was as follows: Right upper lobe (RUL) 7.5%, right middle lobe (RML) 11.3%, left upper lobe (LUL) 15.1%, left lower lobe (LLL) 26.4% and right lower lobe (RLL) 39.6%.Discussion and conclusion
Findings of chest HRCT demonstrated tubular bronchiectasis was the most frequent type of this disease that involve the chemically injured patients and RLL had been the most frequently involved lobe of the lung with bronchiectasis. 相似文献17.
Lamiaa A. Abd ElGawad Shahenaz H. Elshorbagy Amr M. Elbadry Manal E. Badawy 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(2):590-596
Aim of work
To assess the role of color Doppler ultrasonography and multidetector computed tomography angiography (MDCTA) in diagnosis of uterine arteriovenous malformations (AVMs).Methodology
Twenty patients were referred to the radiodiagnosis and imaging department, faculty of medicine, Tanta University from obstetric and gynecology department. All patients were suspected clinically to have uterine arteriovenous malformations. All were subjected to history taking regarding clinical state, laboratory investigation and color Doppler ultrasonography and multidetector computed tomography angiography of the pelvis.Results
Color Doppler ultrasound sensitivity was 100% in detecting a uterine hypervascular lesion and highly suggesting the diagnosis of uterine AVM and the sensitivity of MDCT angiography was 100% in diagnosing and evaluating uterine AVM.Conclusion
Doppler US can strongly suggest the presence of AVM but patient should undergo CT angiography for definitive diagnosis and possible embolization, as CTA helps in providing valuable cross sectional anatomical details about the lesion, its extent and its surroundings. 相似文献18.
Mohammad Abd Alkhalik Basha Mohamad Zakarya AlAzzazy 《The Egyptian Journal of Radiology and Nuclear Medicine》2018,49(1):111-118
Objective
The objective of this study was to outline the role of multidetector computed tomography angiography (MDCTA) in the evaluation of patients with thoracic traumatic aortic injuries (TTAIs) pre- and post-thoracic endovascular aortic repair (TEVAR)Subjects and methods
Forty-two patients (30 men and 12 women; age range, 24–67?years; mean age, 42.4?±?11.5?years) with blunt chest trauma who underwent TEVAR for TTAIs were retrospectively reviewed in this study during the 66-month review period. All patients were subjected to MDCTA followed by conventional aortography as part of planning for TEVAR. Postoperative MDCTA follow-up was done for all patients within one month of TEVAR. MDCTA findings before and after TEVAR were reported.Results
The most common TTAI site was the aortic isthmus (85.7%). The MDCTA findings in 42 patients included pseudoaneurysm (38), intimal tears (30), transection (16), intraluminal haematoma (2), dissection (2), periaortic haematoma (42), and minor aortic contour abnormality without pseudoaneurysm (2). The most common associated injury was haemothorax in all patients. Postoperative MDCTA follow-up revealed only two patients with type I endoleaks.Conclusion
This study confirmed that MDCTA plays an essential role in the assessment of patients with TTAIs before and after TEVAR. 相似文献19.
Inge J. van den Hoogen Michiel A. de Graaf Cornelis J. Roos Aukelien C. Leen Aan V. Kharagjitsingh Ron Wolterbeek Lucia J. Kroft J. Wouter Jukema Jeroen J. Bax Arthur J. Scholte 《Journal of nuclear cardiology》2016,23(1):24-36
Aims
Diabetic patients with coronary artery disease (CAD) are often free of chest pain syndrome. A useful modality for non-invasive assessment of CAD is coronary computed tomography angiography (CTA). However, the prognostic value of CAD on coronary CTA in diabetic patients without chest pain syndrome is relatively unknown. Therefore, the aim was to investigate the long-term prognostic value of coronary CTA in a large population diabetic patients without chest pain syndrome.Methods
Between 2005 and 2013, 525 diabetic patients without chest pain syndrome were prospectively included to undergo coronary artery calcium (CAC)-scoring followed by coronary CTA. During follow-up, the composite endpoint of all-cause mortality, non-fatal myocardial infarction (MI), and late revascularization (>90 days) was registered.Results
In total, CAC-scoring was performed in 410 patients and coronary CTA in 444 patients (431 interpretable). After median follow-up of 5.0 (IQR 2.7-6.5) years, the composite endpoint occurred in 65 (14%) patients. Coronary CTA demonstrated a high prevalence of CAD (85%), mostly non-obstructive CAD (51%). Furthermore, patients with a normal CTA had an excellent prognosis (event-rate 3%). An incremental increase in event-rate was observed with increasing CAC-risk category or coronary stenosis severity. Finally, obstructive (50-70%) or severe CAD (>70%) was independently predictive of events (HR 11.10 [2.52;48.79] (P = .001), HR 15.16 [3.01;76.36] (P = .001)). Obstructive (50-70%) or severe CAD (>70%) provided increased value over baseline risk factors.Conclusion
Coronary CTA provided prognostic value in diabetic patients without chest pain syndrome. Most importantly, the prognosis of patients with a normal CTA was excellent.20.
Kyohei Nagata Ryoichi Tanaka Hidenobu Takagi Tetuya Fusazaki Yoshihiro Morino Kunihiro Yoshioka 《Japanese journal of radiology》2018,36(1):51-58