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1.
Malagò R Pezzato A Barbiani C Sala G Zamboni GA Tavella D Mucelli RP 《European journal of radiology》2012,81(11):3262-3269
Purpose
Coronary venous anatomy is of primary importance when implanting a cardiac resynchronization therapy device, besides, the coronary sinus can be differently enlarged depending on chronic heart failure. The aim of this study is to evaluate the usefulness of Coronary CTA in describing the coronary venous tree and in particular the coronary sinus and detecting main venous system variants.Materials and methods
301 consecutive patients (196 ♂, mean age 63.74 years) studied for coronary artery disease with 64 slice Coronary CTA were retrospectively examined. The acquisition protocol was the standard acquisition one used for coronary artery evaluation but the cardiac venous system were visualized. The cardiac venous system was depicted using 3D, MPR, cMPR and MIP post-processing reconstructions on an off-line workstation. For each patient image quality, presence and caliber of the coronary sinus (CS), great cardiac vein (GCV), middle vein (MV), anterior interventricular vein (AIV), lateral cardiac vein (LCV), posterior cardiac vein (PCV), small cardiac vein (SCV) and presence of variant of the normal anatomy were examined and recorded.Results
CS, GCV, MV and AIV were visualized in 100% of the cases. The LCV was visualized in 255/301 (84%) patients, the PCV in 248/301 (83%) patients and the SCV in 69/301 (23%) patients. Mean diameter of the CS was 8.7 mm in 276/301 (91.7%) patients without chronic heart failure and 9.93 mm in 25/301 (8.3%) patients with chronic heart failure.Conclusions
Coronary CTA allows non invasive mapping of the cardiac venous system and may represent a useful presurgical tool for biventricular pacemaker devices implantation. 相似文献2.
《Journal of Cardiovascular Computed Tomography》2020,14(1):80-86
Coronary venous anatomy can be divided into the greater cardiac venous system and the lesser cardiac venous system. With protocol optimization, including appropriate contrast bolus timing, coronary veins can be depicted with excellent detail on CT. Knowledge of variant coronary venous anatomy can sometimes play a role in pre-procedural planning. Analysis of the coronary venous anatomy on CT can detect coronary venous anomalies that cause right to left shunts with risk of stroke, left to right shunts, and arrhythmias. 相似文献
3.
Becker CR Majeed A Crispin A Knez A Schoepf UJ Boekstegers P Steinbeck G Reiser MF 《European radiology》2005,15(1):96-101
Coronary calcium mass percentiles can be derived from electron beam CT as well as from multidetector-row CT of all manufacturers. Coronary calcium mass may serve as a more individualized substitute for age for cardiac risk stratification. The aim was to investigate the potential impact of CT coronary calcium mass quantification on cardiac risk stratification using an adjusted Framingham score. Standardized coronary calcium mass was determined by multidetector-row CT in a total of 1,473 patients (1,038 male, 435 female). The impact on risk stratification of replacing the traditional Framingham age point score by a point score based on calcium mass relative to age was tested. Any coronary calcium found in males in the age group of 20–34 years and females in the age group of 20–59 years results in an increase of the Framingham score by 9 and 4–7 points, respectively. Only in males 65 years of age and older, none or minimal amounts of coronary calcium decrease the Framingham score by three points. The coronary calcium mass and age-related scoring system may have impact on the reassignment of patients with an intermediate Framingham risk to a lower or higher risk group. 相似文献
4.
Knackstedt C Mühlenbruch G Mischke K Bruners P Schimpf T Frechen D Schummers G Mahnken AH Günther RW Kelm M Schauerte P 《Cardiovascular and interventional radiology》2008,31(6):1150-1158
Information on the anatomy of the cardiac venous system (CVS) is increasingly important for cardiac resynchronization therapy
or percutaneous transvenous mitral valve annuloplasty. Three-dimensional (3D) imaging can further improve the understanding
of the relationship of cardiac structures. This study was performed to validate the accuracy of rotational coronary sinus
angiography (CSA) displaying the 3D anatomy of the CVS compared to ECG-gated, contrast-enhanced, cardiac dual-source computed
tomography (DSCT). Five domestic pigs (60 kg) underwent DSCT using a standardized examination protocol. Using a standard C-arm
for fluoroscopy, a rotational CSA was obtained and 3D-image reconstructions performed. Side branches were identified using
both methods and enumerated. Vessel visibility was estimated for each side branch and great cardiac vein/anterior interventricular
vein. Also, vessel diameters were measured at distinct landmarks, i.e., side branching. The amount of contrast medium was
determined and the effective radiation exposure of both methods was calculated. There was no significant difference regarding
the vessel diameter of the great cardiac vein/anterior interventricular vein or its side branches. Also, estimation of vessel
visibility was not different between the two imaging modalities. Estimated radiation exposure and amount of contrast medium
were lower for rotational CSA. In conclusion, a 3D reconstruction of rotational CSA images is possible. All parts of the CVS
are well depicted, allowing a 3D overview of the CVS anatomy. On-site 3D visualization might improve decision making during
cardiac interventions. In contrast to DSCT, rotational CSA does not demonstrate the anatomy of the mitral annulus or the course
of the left circumflex artery.
Conflict of Interest Statement: C. Knackstedt has received honoraria from Siemens. 相似文献
5.
Jin-Young Kim Yoo Jin Hong Kyunghwa Han Suji Lee Young Jin Kim Byoung Wook Choi Hye-Jeong Lee 《Korean journal of radiology》2022,23(2):172
ObjectiveWe aimed to evaluate the ostium of right coronary artery of anomalous origin from the left coronary sinus (AORL) with an interarterial course throughout the cardiac cycle on CT and analyze the clinical significance of the ostial findings.Materials and MethodsFrom January 2011 to December 2015, 68 patients (41 male, 57.3 ± 12.1 years) with AORL with an interarterial course and retrospective cardiac CT data were included. AORL was classified as high or low ostial location based on the pulmonary annulus in the diastolic and systolic phases on cardiac CT. In addition, the height, width, height/width ratio, area, and angle of the ostium were measured in both cardiac phases. After cardiac CT, patients were followed until December 31, 2020 for major adverse cardiac events (MACE). Clinical and CT characteristics associated with MACE were explored using Cox regression analysis.ResultsDuring a median follow-up period of 2071 days (interquartile range, 1180.5–2747.3 days), 13 patients experienced MACE (19.1%, 13/68). Seven (10.3%, 7/68) had the ostial location change from high in the diastolic phase to low in the systolic phase. In the univariable analysis, younger age (hazard ratio [HR] = 0.918, p < 0.001), high ostial location (HR = 4.008, p = 0.036), larger height/width ratio (HR = 5.621, p = 0.049), and smaller ostial angle (HR = 0.846, p = 0.048) in the systolic phase were significant predictors of MACE. In multivariable cox regression analysis, younger age (adjusted HR = 0.917, p = 0.002) and high ostial location in the systolic phase (adjusted HR = 4.345, p = 0.026) were independent predictors of MACE.ConclusionThe ostial location of AORL with an interarterial course can change during the cardiac cycle, and high ostial location in the systolic phase was an independent predictor of MACE. 相似文献
6.
Recent developments in cardiac pacing and trans-coronary vein ablations have demonstrated the increasing value of imaging of the cardiac venous system (CVS), especially computed tomographic (CT) mapping of the coronary veins. In contrast to that for coronary arteries, the literature for coronary veins is scarce. Moreover, a complete, highly efficient, and clinically useful classification of the CVS is not as straightforward as for the coronary arteries. The CVS comprises polymorphous types of venous conduits with notable anatomic variations. Recent anatomic classification divides the cardiac veins into two main groups: tributaries of the greater CVS and tributaries of the lesser CVS, consisting of the thebesian vessels. The greater CVS is subdivided into two groups: coronary sinus and non-coronary sinus tributaries. Imaging information about the CVS in this review is useful for a better understanding of the spatial orientation of the CVS and furthers proper use of the correct nomenclature for this important system. The authors describe the clinical implications of the different imaging techniques for assessment of the coronary veins, where cardiac CT venous mapping has major advantages. The role of CT in anatomic classification, assessment of anatomic variants, and diagnosis of pathologic changes of the CVS is discussed. The authors also underscore the particular role of CT venous mapping for cardiac interventions, especially for left ventricular pacing in cardiac resynchronization therapy and in percutaneous mitral annuloplasty. 相似文献
7.
Hyun Woo Goo 《Korean journal of radiology》2021,22(12):2062
Coronary artery fistula, defined as an abnormal communication between the coronary arteries and a cardiac chamber (most commonly) or a thoracic great vessel, may result in hemodynamically significant problems due to vascular shunting in children. Echocardiography, cardiac catheterization, cardiac MRI, and cardiac CT may be used to evaluate coronary artery fistula in children. Recently, CT has played a pivotal role for the accurate diagnosis of coronary artery fistula in children. Surgical or interventional treatment is performed for hemodynamically significant coronary artery fistulas. In this pictorial review, the detailed imaging findings of coronary artery fistula in children are described. 相似文献
8.
Mitsuru Momose Kenichi Nakajima Tsunehiko Nishimura 《European journal of nuclear medicine and molecular imaging》2009,36(8):1329-1337
Purpose The J-ACCESS [Japanese investigation of prognosis based on gated single photon emission computed tomography (SPECT)] study
found that quantitative gated myocardial SPECT (QGS) is valuable for predicting the prognosis of Japanese patients with known
or suspected ischaemic heart disease. The present study evaluates the incremental prognostic value of myocardial perfusion
imaging (MPI) with QGS among patients referred for coronary angiography (CAG).
Methods Among 4,031 Japanese patients registered at 117 hospitals for the J-ACCESS study, we selected 1,011 who underwent CAG within
3 months before or after MPI with QGS. Summed stress, rest and difference scores (SSS, SRS and SDS) were generated from myocardial
perfusion images using a 20-segment scoring system. Myocardial ischaemia was judged visually. End-diastolic volume (EDV),
end-systolic volume (ESV) and ejection fraction (EF) were determined by QGS. Numbers of diseased (> 75% stenosis) coronary
vessels (CDV) were assessed by CAG. All patients were followed up for 3 years to determine cardiac events (CE) including cardiac
death, non-fatal myocardial infarction and severe heart failure. Univariate and multivariate analyses of prognostic ability
included age, cardiac risk factors (hypertension, hyperlipidaemia, diabetes mellitus and prior myocardial infarction), angiographic
findings and the QGS parameters as independent variables.
Results Cardiac events occurred more frequently with increasing numbers of coronary vessel lesions (p = 0.0016). Cox univariate analysis revealed that diabetes, CDV, SSS, SDS, EDV, ESV and EF were significant predictors (Wald
χ2 = 5.99, 12.9, 8.39, 9.11, 35.5, 42.1 and 31.1, respectively), whereas multivariate analysis selected only ESV and SDS as
significant predictors (Wald χ2 = 36.4, 8.4; p = 0.0038, p < 0.001).
Conclusion MPI with QGS, especially with gated functional data, has incremental prognostic value in addition to angiographic findings.
MPI with QGS findings predominantly contribute to the prediction of prognosis rather than numbers of diseased vessels assessed
by CAG. Thus, MPI with QGS is the most useful tool with which to guide decisions regarding therapy even among patients referred
for CAG. 相似文献
9.
Electron beam tomography (EBT) has been used for cardiac diagnosis and the quantitative assessment of coronary calcium since
the late 1980s. The introduction of mechanical multi-slice spiral CT (MSCT) scanners with shorter rotation times opened new
possibilities of cardiac imaging with conventional CT scanners. The purpose of this work was to qualitatively and quantitatively
evaluate the performance for EBT and MSCT for the task of coronary artery calcium imaging as a function of acquisition protocol,
heart rate, spiral reconstruction algorithm (where applicable) and calcium scoring method. A cardiac CT semi-anthropomorphic
phantom was designed and manufactured for the investigation of all relevant image quality parameters in cardiac CT. This phantom
includes various test objects, some of which can be moved within the anthropomorphic phantom in a manner that mimics realistic
heart motion. These tools were used to qualitatively and quantitatively demonstrate the accuracy of coronary calcium imaging
using typical protocols for an electron beam (Evolution C-150XP, Imatron, South San Francisco, Calif.) and a 0.5-s four-slice
spiral CT scanner (Sensation 4, Siemens, Erlangen, Germany). A special focus was put on the method of quantifying coronary
calcium, and three scoring systems were evaluated (Agatston, volume, and mass scoring). Good reproducibility in coronary calcium
scoring is always the result of a combination of high temporal and spatial resolution; consequently, thin-slice protocols
in combination with retrospective gating on MSCT scanners yielded the best results. The Agatston score was found to be the
least reproducible scoring method. The hydroxyapatite mass, being better reproducible and comparable on different scanners
and being a physical quantitative measure, appears to be the method of choice for future clinical studies. The hydroxyapatite
mass is highly correlated to the Agatston score. The introduced phantoms can be used to quantitatively assess the performance
characteristics of, for example, different scanners, reconstruction algorithms, and quantification methods in cardiac CT.
This is especially important for quantitative tasks, such as the determination of the amount of calcium in the coronary arteries,
to achieve high and constant quality in this field.
Electronic Publication 相似文献
10.
Mouaz Al-Mallah 《Journal of Cardiovascular Computed Tomography》2008,2(1):61-63
A 34-year-old man with a prior history of Hodgkin’s disease and coronary artery bypass surgery for radiation-induced left main disease presented with persistent chest pain. Cardiac catheterization showed near simultaneous filling of the venous system during arterial injection and could not precisely delineate the insertion point of the vein graft anastamosis to the diagonal branch, and the patient was referred for coronary computed tomography angiography (CTA). CTA demonstrated that the anastamosis of the graft was with a cardiac vein. This case illustrates the valuable complementary role of both angiographic methodologies in confirming a complex anatomic diagnosis. 相似文献
11.
Ruder TD Bauer-Kreutz R Ampanozi G Rosskopf AB Pilgrim TM Weber OM Thali MJ Hatch GM 《European journal of radiology》2012,81(9):2208-2214
Objectives
Minimally invasive or virtual autopsies are being advocated as alternative to traditional autopsy, but have limited abilities to detect coronary artery disease. It was the objective of this study to assess if the occurrence of chemical shift artifacts (CSA) along the coronary arteries on non-contrast, post-mortem cardiac MR may be used to investigate coronary artery disease.Methods
We retrospectively compared autopsy and CT findings of 30 cases with significant (≥75%), insignificant (<75%), or absent coronary artery stenosis to post-mortem cardiac MR findings. The chi-square test was used to investigate if the occurrence of CSA depends on the presence or absence of stenosis. Sensitivity, specificity and predictive values were calculated for each finding.Results
CSA indicates the absence of (significant) stenosis (p < 0.001). The occurrence of paired dark bands in lieu of CSA on post-mortem cardiac MR suggests (significant) coronary arteries stenosis (p < 0.001). Both findings have a high specificity but low sensitivity.Conclusions
CSA is a marker of vessel patency. The presence of paired dark bands indicates stenosis. These criteria improve the ability of minimally invasive or virtual autopsy to detect coronary artery disease related deaths. 相似文献12.
Cardiac imaging using 256-detector row four-dimensional CT: preliminary clinical report 总被引:2,自引:0,他引:2
Kido T Kurata A Higashino H Sugawara Y Okayama H Higaki J Anno H Katada K Mori S Tanada S Endo M Mochizuki T 《Radiation Medicine》2007,25(1):38-44
Purpose Along with the increase of detector rows on the z-axis and a faster gantry rotation speed, the spatial and temporal resolutions
of the multislice computed tomography (CT) have been improved for noninvasive coronary artery imaging. We investigated the
feasibility of the second specification prototype 256-detector row four-dimensional CT for assessing coronary artery and cardiac
function.
Materials and methods The subjects were five patients with coronary artery disease. Contrast medium (40–60 ml) was intravenously administered at
the rate of 3–4 ml/s. The patient's whole heart was scanned for 1.5 s to cover at least one cardiac cycle during breathholding
without electrocardiographic gating. Parameters used were 0.5 mm slice thickness, 0.5 s/rotation, 120 Kv, and 350 mA, with
a half-scan reconstruction algorithm (temporal resolution 250 ms). Twenty-six transaxial datasets were reconstructed at intervals
of 50 ms.
Results The assessability of the coronary arteries in AHA segments 1, 2, 3, 5, 6, 7, 9, and 11 was visually evaluated, resulting in
29 of 32 (90.9%) segments being assessable. Functional assessment was also performed using animated movies without banding
artifacts in all cases.
Conclusions The 256-detector row four-dimensional CT can assess the coronary artery and cardiac function using data during 1.5 s without
banding artifacts. 相似文献
13.
Felipe S. Torres Andrew M. Crean Elsie T. Nguyen Ravi Menezes Deirdre Doyle Anoop P. Ayyappan Sobhi Abadi Narinder Paul 《Journal l'Association canadienne des radiologistes》2010
Purpose
To compare the incidence of respiratory artifact in computed tomography (CT) coronary angiography performed with 64-row and 320-row multidetector scanners and to assess its effect on coronary evaluability.Methods
A retrospective review of consecutive coronary angiograms performed on a 64-row multidetector CT from March to April 2007 (group 1: 115 patients, 63 men; mean age [standard deviation] 59.6 ± 12.8 years) and on a 320-row multidetector CT from March to April 2008 (group 2: 169 patients, 89 men; mean [SD] age 57.9 ± 11.6 years). Two cardiac radiologists assessed the occurrence of respiratory artifact and coronary evaluability in studies with respiratory artifacts. Unevaluable coronary segments because of motion at the same anatomical level of the respiratory artifact were considered unevaluable because of this artifact. The association between the occurrence of respiratory artifact and patient biometrics, medication, and scan parameters was examined.Results
Respiratory artifacts were detected in 9 of the 115 patients from group 1 (7.8%) and in none of the 169 patients from group 2 (P < .001). Group 1 had longer scan times (median, 9.3 seconds; range, 7.5−14.4 seconds) compared with group 2 (median, 1.5 seconds; range, 1.1−3.5 seconds; P < .001). In group 1, 4 patients (3.5%) showed unevaluable coronary segments because of respiratory artifacts, and the CT coronary angiography was repeated in 1 patient (0.9%).Conclusions
Respiratory artifacts are important in CT coronary angiography performed with 64-row multidetector scanners and impair the diagnostic utility of the examination in up to 3.5% of the studies. These artifacts can be virtually eliminated with a faster scan time provided by 320-row multidetector CT. 相似文献14.
15.
A prospective, electrocardiographically gated technique was recently adapted for use with coronary and cardiac multidetector row CT studies. The most widely available form of prospective gating uses “step-and-shoot” axial data acquisition, an incrementally moving table, adaptive electrocardiographic triggering, an improved image reconstruction algorithm, and multiphase reconstruction capability. Studies have shown a 77%-87% effective radiation dose reduction compared with retrospective gating and equal to significantly improved image quality. Comparison with conventional angiography has proven it to be as accurate as retrospective gating for coronary stenosis detection. The technique is not applicable to all patients because there are some restrictions for clinical use, including a limited number of reconstructed phases and a maximum scan heart rate of 68-75 beats/min. However, with careful patient selection and effective heart rate control, prospective gating can be used in a high percentage of cardiac CT examinations. This article reviews the scanning and patient selection protocols for prospective gating and discusses how it may be used in clinical practice. 相似文献
16.
Andr J. Duerinckx Dennis Atkinson Robert Hurwitz 《Journal of magnetic resonance imaging : JMRI》1998,8(4):896-902
The ability to noninvasively assess the patency of coronary stents would represent a significant advance. We evaluated the safety and ability of two-dimensional coronary MR angiography In imaging stents and suggesting patency. Coronary MR angiography of 26 coronary stents (Palmaz-Schatz) was performed in 16 patients 39 to 73 years of age. Studies were performed between 2 and 4 months after stent placement. All patients were symptom free at the time of imaging. Coronary MR angiography was performed with a commercial 1.5-T MR imager using an electrocardio-graphically gated pulse sequence with breath-holding. Images were obtained in mid-diastole with and without fat suppression. Image artifacts caused by the metal in the stents were clearly visualized in all 26 stents (100% sensitivity for stent detection). Arterial flow signal was seen in the coronary artery or graft distal to the stent in 25 of 26 cases (96%). All patients, except for the one in which distal flow could not be seen, remained symptom free for >2 years. The distribution of stent locations was as follows: 10 in the right coronary artery (RCA), 10 in the left anterior descending coronary artery (LAD), 2 in the left circumflex coronary artery, and 4 in saphenous vein grafts (SVGs) to RCA. One patient had 2 RCA and 2 LAD stents, one had 3 RCA and 1 LAD stents, one had 3 SVG stents, and two had double RCA stents. Coronary MR angiography is safe for noninvasive imaging of coronary stents, and in the proper clinical setting, it can be used to help suggest patency. 相似文献
17.
Coronary CT angiography has been increasingly used in the diagnosis of coronary artery disease due to rapid technological developments, which are reflected in the improved spatial and temporal resolution of the images. High diagnostic accuracy has been achieved with 64- and more slice CT scanners and in selected patients, coronary CT angiography is regarded as a reliable alternative to invasive coronary angiography. Although the tremendous contributions of coronary CT angiography to cardiac imaging are acknowledged, appropriate use of cardiac CT as the first line technique by physicians has not been well established. Optimal selection of cardiac CT is essential to ensure acquisition of valuable diagnostic information and avoid unnecessary invasive procedures. This is of paramount importance since cardiac CT not only involves patient risk assessment, prediction of major cardiac events, but also impacts physician decision-making on patient management. Applications of CT in cardiac imaging include coronary artery calcium scoring for predicting the patient risk of developing major cardiac events, followed by coronary CT angiography which is commonly used to determine the diagnostic and prognostic accuracy in the coronary artery disease. This review presents an overview of the applications of CT in cardiac imaging in terms of coronary calcium scoring and coronary CT angiography. Judicious use of both cardiac CT tools will be discussed with regard to their value in different patient risk groups with the aim of identifying the appropriate criteria for choosing a cardiac CT modality. An effective diagnostic pathway is finally recommended to physicians for appropriate selection of cardiac CT in clinical practice. 相似文献
18.
Mark B. M. Hofman Samuel A. Wickline Christine H. Lorenz 《Journal of magnetic resonance imaging : JMRI》1998,8(3):568-576
Motion of the coronary arteries during the heart cycle can result in image blurring and inaccurate flow quantification by MR. This condition applies particularly for longer acquisition windows that are typical of breath-hold coronary flow measurements. To determine the sensitivity of the technique to in-plane motion of different coronary arteries, the temporal variation in coronary position was measured in a plane perpendicular to the proximal portion of the vessel. The results indicated the presence of substantial displacement of the coronary arteries within the cardiac cycle, with a magnitude of motion approximately twice as large for the right as for the left coronary arteries. An estimation of the resulting vessel blurring was calculated, showing that the duration of the acquisition window for high spatial resolution coronary flow acquisitions should be less than 25 to 120 msec, depending on the specific coronary artery studied. In addition, these data specify optimal acquisition window placement for high resolution coronary angiography. 相似文献
19.
Hyun Woo Goo 《Korean journal of radiology》2021,22(9):1441
Anomalous origin of the coronary artery from the pulmonary artery is a rare and potentially fatal congenital heart defect. Up to 90% of infants with an anomaly involving the left coronary artery die within the first year of life if left untreated. Patients who survive beyond infancy are at risk of sudden cardiac death. Cardiac CT and MRI are increasingly being used for the accurate diagnosis of this anomaly for prompt surgical restoration of the dual coronary artery system. Moreover, life-long imaging surveillance after surgery is necessary for these patients. In this pictorial review, multimodal cardiac imaging findings of this rare and potentially fatal coronary artery anomaly are comprehensively discussed, and representative images are provided to facilitate the understanding of this anomaly. 相似文献
20.
Accuracy of 16-detector multislice spiral computed tomography in the initial evaluation of dilated cardiomyopathy 总被引:1,自引:0,他引:1
Cornily JC Gilard M Le Gal G Pennec PY Vinsonneau U Blanc JJ Mansourati J Boschat J 《European journal of radiology》2007,61(1):84-90
BACKGROUND: Multislice Computed Tomography (MSCT) recently proved its accuracy in the detection of coronary artery disease (CAD). It can also give information about left ventricular function and venous network anatomy. We here sought to validate a MSCT-based strategy in the initial evaluation of patients with dilated cardiomyopathy (DCM). METHODS: 36 patients with DCM underwent cardiac MSCT before conventional coronary angiography with ventriculography. We analysed arterial calcium score (Agatston score equivalent: ASE), coronary stenosis, left ventricular parameters and venous network. RESULTS: The sensitivity of a MSCT-based strategy in detecting significant CAD was 100% and the specificity 80%. The positive and negative predictive values were respectively 67% and 100%. For ASE <1.000 (75% of patients), MSCT detected all non-CAD patients without one (motion artifacts), enabling conventional angiography to be avoided in 21/27 patients (77.7%). For ASE > or =1000, MSCT enabled conventional angiography to be avoided in only 2/9 patients (22.2%). The ventricle was assessable in 83.4% (30 patients) on MSCT. Correlation coefficient Rs with ventriculography were 0.78 (p<0.0001), 0.77 (p<0.0001) and 0.82 (p<0.0001) respectively for end-diastolic volume, end-systolic volume and EF. The venous network was assessable in all patients both on MSCT and angiography. CONCLUSION: In patients undergoing an initial evaluation of DCM, MSCT appears to be an effective alternative to conventional angiography. The following attitude may be proposed: when ASE >1.000, conventional coronary angiography is mandatory due to MSCT's poor interest in such cases; when ASE <1.000, a contrast-enhanced MSCT may, when normal, replace coronary angiography. 相似文献