Coronary plaque imaging with multislice computed tomography: technique and clinical applications.

The composition of an atherosclerotic lesion, rather than solely the degree of stenosis, is considered to be an important determinant of acute coronary events. Whereas until recently only invasive techniques have been able to provide clues about plaque composition with consistent reproducibility, several recent studies have revealed the potential of multislice computed tomography (MSCT) for noninvasive plaque imaging. Coronary MSCT has the potential to detect coronary plaques and to characterize their composition based on the X-ray attenuating features of each structure. MSCT may also reveal the total plaque burden (calcified and noncalcified components) for individual patients with coronar…

Stercorary aseptic peritonitis due to diastatic caecal perforation: Computed tomography findings

Caecal perforation is a complication secondary to colon obstruction. It may present with insidious clinical features and may be associated with chronic constipation. The event may become severe due to the peritonitic development. We present a case of caecal perforation associated with sub-occlusive carcinoma of the left colon and hypotonic colitis caused by chronic lavative abuse, demonstrated with Computed Tomography.

Computed tomography coronary angiography in asymptomatic patients

This study assessed the accuracy of computed tomography coronary angiography (CT-CA) for detecting significant coronary artery disease (CAD; a parts per thousand yen50% lumen reduction) in intermediate/high-risk asymptomatic patients. A total of 183 consecutive asymptomatic individuals (92 men; mean age 54 +/- 11 years) with more than one major risk factor (obesity, hypertension, diabetes, hypercholesterolaemia, family history, smoking) and an inconclusive or nonfeasible noninvasive stress test result (stress electrocardiography, stress echocardiography, nuclear stress scintigraphy) underwent CT-CA in an outpatient setting. All patients underwent conventional coronary angiography (CAG) with…

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Abstract Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18–49, 50–69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in su…

Prevalence of anatomical variants and coronary anomalies in 543 consecutive patients studied with 64-slice CT coronary angiography

The aim of our study was to assess the prevalence of variants and anomalies of the coronary artery tree in patients who underwent 64-slice computed tomography coronary angiography (CT-CA) for suspected or known coronary artery disease. A total of 543 patients (389 male, mean age 60.5 +/- 10.9) were reviewed for coronary artery variants and anomalies including post-processing tools. The majority of segments were identified according to the American Heart Association scheme. The coronary dominance pattern results were: right, 86.6%; left, 9.2%; balanced, 4.2%. The left main coronary artery had a mean length of 112 +/- 55 mm. The intermediate branch was present in the 21.9%. A variable number …

Spectrum of collateral findings in multislice CT coronary angiography.

Purpose. The aim of the study was to investigate the prevalence of the noncardiac collateral findings during multislice computed tomography coronary angiography (MSCT-CA). Materials and methods. Six hundred and seventy patients undergoing MSCT-CA with 16-slice and 64-slice CT scanners for suspected atherosclerotic disease of the coronary arteries were retrospectively reviewed. All data sets obtained with a large field of view (FOV) were analysed by two radiologists using standard mediastinal and lung window settings. Collateral findings were divided according to clinical importance into nonsignificant, remarkable and compulsory to be investigated. Results. Eighty-five percent of patients re…

Prognostic value of Morise clinical score, calcium score and computed tomography coronary angiography in patients with suspected or known coronary artery disease

Our aim was to determine the prognostic value of computed tomography coronary angiography (CTCA), coronary artery calcium scoring (CACS) and Morise clinical score in patients with known or suspected coronary artery disease (CAD). A total of 722 patients (480 men; 62.7 +/- 10.9 years) who were referred for further cardiac evaluation underwent CACS and contrast-enhanced CTCA to evaluate the presence and severity of CAD. Of these, 511 (71%) patients were without previous history of CAD. Patients were stratified according to the Morise clinical score (low, intermediate, high), to CACS (0-10, 11-100, 101-400, 401-1,000, > 1,000) and to CTCA (absence of CAD, nonsignificant CAD, obstructive CAD…

A new automated method for quantitative computer tomography coronary angiography (QMSCTA): an in-vivo validation study with intracoronary ultrasound as reference

Lesions of Proximal Coronary Arteries

Coronary artery disease (CAD) remains the leading cause of death in the Western world. Conventional coronary angiography (CCA) is the gold standard method for evaluation of the vascular lumen and provides excellent results in demonstrating stenotic lesions of CAD. However, it is an invasive procedure with a small risk of fatal events. Furthermore, CCA is a lumen-oriented technique that does not permit a direct visualization and evaluation of the coronary artery wall. The characterization of coronary plaques without a significant lumen narrowing is also not feasible with CCA. This information is relevant since the comparison of angiographic studies of coronary arteries performed before and a…

Valorization of waste solvents through supercritical water gasification

The supercritical water gasification of various organic species belonging to the groups of organic acids, aldehydes, ketones, alcohols and phenols, has been studied as a possible waste disposal method for polluted water stream produced in industries and laboratories. Gasification has been investigated using a 200 cm3 down flow reactor working continuously at 24 MPa and 660 °C. Supercritical water gasification (SCWG) is effective for the syngas production at very high conversion rate for all the species investigates, but phenol. Phenol, when mixed with other species, has an inhibitory effect of the radical chain gasification mechanism that dramatically reduced the gasification performance. …