0000000000408938
AUTHOR
Pim J. De Feyter
Non-invasive visualisation of coronary atherosclerosis: state-of-art.
Coronary artery disease remains the leading cause of death in the Western world. Non-invasive coronary artery imaging challenges any diagnostic modality because the coronary arteries are small and tortuous, whereas cardiac contraction and respiration cause motion artifacts. Therefore, non-invasive coronary imaging requires high spatial and temporal resolution. This review discusses the feasible applications in coronary imaging of magnetic resonance imaging and multi-slice computed tomography (MSCT), which are currently the only non-invasive diagnostic modalities for direct coronary atherosclerosis imaging. Particular attention and focus is devoted to the potential indications and clinical i…
Parameters for coronary plaque vulnerability assessed with multidetector computed tomography and intracoronary ultrasound correlation
In the absence of a fixed relationship between plaque vulnerability and flow-limiting stenosis, alternative morphological expressions exist that could predict the liability of coronary lesions to rapidly progress or rupture, causing acute coronary syndromes. Modern multidetector computed tomography technology is capable of noninvasively detecting lesion location, attenuation, remodeling and calcification pattern, which may be considered as surrogate morphological markers of vulnerability and could contribute to increase the prognostic value of individual coronary plaque burden. J Cardiovasc Med 10:821 -826 (C) 2009 Italian Federation of Cardiology.
Impact of coronary calcium score on diagnostic accuracy for the detection of significant coronary stenosis with multislice computed tomography angiography.
One hundred twenty patients in sinus rhythm with suspected coronary artery disease who underwent multislice computed tomography of the heart and conventional coronary angiography were retrospectively selected. The population was divided into 2 groups depending on their calcium score (CS) (e.g., low CS and high CS). The diagnostic accuracy of multislice computed tomographic scans for detecting significant lesions (>50% lumen reduction) in both groups was compared with quantitative coronary angiography. The sensitivity and specificity of multislice computed tomography were 90% and 92%, and 97% and 91% for low and high CS groups, respectively.
Higher intracoronary attenuation improves diagnostic accuracy in MDCT coronary angiography
OBJECTIVE: The purpose of this study was to investigate whether the amount of intracoronary attenuation influences the diagnostic accuracy of MDCT coronary angiography in the detection of clinically significant stenosis. MATERIALS AND METHODS: One hundred twenty patients in sinus rhythm with suspected coronary artery disease who underwent MDCT of the heart and conventional coronary angiography were retrospectively selected. The population was divided into two groups depending on median (326 H) coronary vascular enhancement (i.e., low attenuation and high attenuation). The diagnostic accuracy of MDCT for the detection of clinically significant coronary artery lesions (> or = 50% lumen reduct…
High Iodine Concentration Contrast Material for Noninvasive Multislice Computed Tomography Coronary Angiography
OBJECTIVE: The objective of this study was to compare intracoronary attenuation on 16-row multislice computed tomography (16-MSCT) coronary angiography using 2 contrast materials (CM) with high iodine concentration. MATERIAL AND METHODS: Forty consecutive patients (29 male, 11 female; mean age, 61 ± 11 years) with suspected coronary artery disease were randomized to 2 groups to receive 100 mL of either iopromide 370 (group 1: Ultravist 370, 370 mg iodine/mL; Schering AG, Berlin, Germany) or iomeprol 400 (group 2: Iomeron 400, 400 mg iodine/mL; Bracco Imaging SpA, Milan, Italy). Both CM were administered at a rate of 4 mL/s. All patients underwent 16-MSCT coronary angiography (Sensation 16; …
Physiopathology of the aging heart.
Coronary heart disease remains the leading cause of morbidity and mortality in older adults, despite improved survival and declining mortality. Prevalence in and impact of heart disease on elderly people, increasing risk factors, and the underlying physiologic changes of aging are briefly reviewed. High prevalence of clinical and subclinical heart disease provides a basis for considering opportunities for prevention and follow-up. This article focuses on recently developed noninvasive techniques, such as cardiac multislice CT and cardiac MR imaging.
Improving diagnostic accuracy of MDCT coronary angiography in patients with mild heart rhythm irregularities using ECG editing
OBJECTIVE. The objective of our study was to compare diagnostic accuracy of MDCT coronary angiography in a population of patients with mild heart rhythm irregularities before and after editing the ECG. SUBJECTS AND METHODS. Thirty-eight patients who underwent MDCT coronary angiography and conventional coronary angiography were enrolled in the study. The inclusion criterion was the presence of mild heart rhythm irregularities (i.e., premature beats; atrial fibrillation; mistriggering; or low heart rate, defined as 40 beats per minute or less) during the scan. All patients underwent MDCT with the following parameters: 16 detectors; collimation, 0.75 mm; gantry rotation time, 375 msec; 120 kV;…