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Kamia Thakur MD Tamim M. Nazif MD Omar K. Khalique MD FACC FASE FSCCT Jean‐Michel Paradis MD Kishore J. Harjai MD 《Journal of interventional cardiology》2018,31(5):543-552
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Hamid Shokoohi MD MPH RDMS RDCS Sigrid Nasser MD Matthew Pyle MD James P. Earls MD FSCCT Andrew Liteplo MD Keith Boniface MD RDMS 《Journal of clinical ultrasound : JCU》2020,48(6):337-342
In emergency department (ED) cases with clinically suspected diverticulitis, diagnostic imaging is often needed for diagnostic confirmation, to exclude complications, and to direct patient management. Patients typically undergo a CT scan in the ED; however, in a subset of cases with suspected diverticulitis, point-of-care ultrasound (POCUS) may provide sufficient data to confirm the diagnosis and ascertain a safe plan for outpatient management.We review the main sonographic features of diverticulitis and discuss the diagnostic accuracy and potential benefits of a POCUS First model. 相似文献
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Ronak Rajani MD MRCP FSCCT Roberta L. Brum MRCP Edward Barden FRCR MRCP Sarah Drake MRCP Rebecca L. Preston FRCR MRCP Gerald Carr‐White PHD MRCP John B. Chambers MD FACC FESC 《Catheterization and cardiovascular interventions》2013,82(7):E952-E958
Transcatheter aortic valve implantation (TAVI) has now become an acceptable alternative to surgical aortic valve replacement for patients with severe aortic stenosis at high risk. The early enthusiasm for this technology has not diminished but rather has developed at an unprecedented rate over the last decade. Alongside the developments in implantation technique, transcatheter design, and postprocedural care, cardiac imaging modalities have also had to concurrently evolve to meet the perpetual demand for lower peri‐ and postprocedural complication rates. Although transthoracic and transesophageal echocardiography remain vital in patient's selection and periprocedural guidance, there is now emerging evidence that indicates that multidetector‐computed tomography (MDCT) may also have an equally important role to play. The aim of the current review is to examine the modern role of MDCT in assessing patients with aortic stenosis being considered for TAVI. © 2012 Wiley Periodicals, Inc. 相似文献
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Mohammed A. Qutub MD FRCPC Taylor Dowsley MD PhD Iftikhar Ali MD R. Glenn Wells PhD Li Chen MSc Terrence D. Ruddy MD FRCPC FACC FASNC Benjamin J. W. Chow MD FRCPC FACC FASNC FSCCT 《Journal of nuclear cardiology》2013,20(4):545-552
Background
Though myocardial perfusion imaging (MPI) with single-photon emission computed tomography (SPECT) is an established diagnostic method, equivocal studies are commonly encountered. New software has been introduced that incorporates resolution recovery (RR) and noise regulation into the reconstruction algorithm and has been used to facilitate “half-dose” and “half-time” studies. Its utility with “full-time, full-dose” acquisition has not been well studied.Objective
We sought to understand the potential benefit of incorporating RR software in equivocal SPECT studies.Methods
Patients with full-time, full-dose SPECT MPI were reviewed and those with equivocal results, who subsequently underwent cardiac Rb-82 positron emission tomography (PET) scan were identified. Image reconstruction was performed with iterative reconstruction (IR), attenuation correction (IR + AC), and RR software (IR + AC + RR). Images were anonymized and read blindly by consensus of two experienced readers. All images were qualitatively assessed and semi-quantitatively graded using summed stress and summed rest scores.Results
45 patients were included (28 males, age = 59.6 ± 9.9 years) and the diagnostic accuracy of each of the reconstruction algorithms (IR, IR + AC, IR + AC + RR) was compared to Rb-82 PET. Agreement of clinical diagnosis of each SPECT reconstruction with Rb-PET showed incremental improvement. The agreement with PET for IR + AC + RR (κ = 0.66, CI 0.454-0.875) is significantly better than for IR (κ = 0.22, CI 0.0-0.450, P = .005) and for IR + AC (κ = 0.32, CI 0.077-0.563, P = .03). Also, IR + AC + RR improved the clinical diagnosis in 14 cases and with overall improvement of reclassification proportion of 23.5% compared to IR (P = .01). Using PET as a reference standard, ROC curves were created for IR + AC + RR, IR + AC, and IR which showed incremental value of the area under the curve of IR + AC + RR (AUC: 0.87; CI 0.76-0.98) over IR + AC (AUC: 0.75; CI 0.61-0.89, P = .078), and over IR (AUC 0.68; CI 0.52-0.84, P = .025).Conclusion
The addition of RR may help in the diagnosis of patients with equivocal SPECT MPI without the need for additional testing. Further prospective studies are needed to define the role of this new software. 相似文献5.
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Harvey S. Hecht MD FACC FSCCT Christopher Gade MD FACC 《Catheterization and cardiovascular interventions》2011,77(6):843-859
Objectives : To demonstrate the variety of stent abnormalities that may be evaluated by coronary computed tomographic angiography (CTA). Background : The application of CTA to the evaluation of coronary stents has focused almost entirely on the detection of in‐stent restenosis. Methods : All CTA performed for stent evaluation at a single institution were reviewed. Results : In addition to in‐stent restenosis, stent fracture, and overlap failure, a multiplicity of stent‐related problems not previously addressed by CTA was categorized and illustrated: late stent thrombosis, jailed branches, edge stenosis, bifurcation stents, inadequate stent expansion, stent aneurysms, peri‐stent plaque, and stenting into bridged myocardium. Conclusions : CTA may be used to evaluate the full range of stent‐related problems. This work provides the framework for future studies validating these applications. © 2011 Wiley‐Liss, Inc. 相似文献
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Ahmed Aljizeeri MBBS Myra S. Cocker PhD Benjamin J. W. Chow MD FRCPC FACC FASNC FSCCT 《Journal of nuclear cardiology》2013,20(3):465-472
Non-invasive cardiac imaging is pivotal in the diagnosis and prognosis of patients with stable CAD. Nuclear SPECT, PET, stress echocardiography and more recently cardiac magnetic resonance imaging have been utilized with excellent diagnostic accuracy. However, along with their inherent individual limitations, most modalities detect ischemia but lack the ability to define coronary anatomy or evaluate for subclinical atherosclerosis. A modality that not only accurately diagnoses obstructive CAD and also facilitates early identification of non-obstructive CAD may be of interest because it may allow for earlier aggressive risk factor modification and primary prevention. Cardiac computerized tomographic angiography (CCTA) has the potential to accurately detect or exclude luminal stenosis, as well as identify and quantify subclinical atherosclerosis in the absence if luminal narrowing. However CCTA, being a relatively a new modality, has less supporting evidence when compared to more mature modalities such as SPECT. Therefore, the question that begs to be addressed is whether CCTA can be utilized as a first line test in establishing the diagnosis and prognosis of CAD. 相似文献
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Kavitha M. Chinnaiyan MD FACC FSCCT Gilbert L. Raff MD FACC FSCCT Karthik Ananthasubramaniam MD FRCP FACC FASE FASNC 《Journal of nuclear cardiology》2012,19(4):649-657
Coronary CT angiography (CCTA) has matured to be a fast noninvasive imaging test in the evaluation of coronary artery disease (CAD). It has demonstrated excellent accuracy for defining the presence and the severity of luminal coronary artery stenoses and is probably the best noninvasive test to reliably exclude atherosclerotic coronary disease. Furthermore, accumulating CCTA data indicate that it can identify individuals at risk for all-cause mortality. It is also well known that despite the wealth of data regarding diagnostic and prognostic values of stress testing in CAD, up to 10% of stress imaging studies are considered inconclusive, leading to subsequent invasive coronary angiography for definitive diagnosis often with negative results. Moreover, recent data indicate that up to 30 % of patients undergoing angiography have no significant CAD despite a majority of them having had a prior stress test. Whether CCTA can serve as a cost-effective methodology to invasive angiography has been a source of active research. In this context, we will discuss the implications of the recently published data from the Advanced Cardiovascular Imaging Consortium registry looking at the use of CCTA after stress testing in Michigan. 相似文献