64-slice Computed Tomography Angiography Research Articles

A Comparative Study of 64-Slice Coronary CT Angiography (CCTA) and Myocardial Perfusion Imaging (MPI) in the Identification of Coronary Artery Stenosis.

The aim of this study was to compare the diagnostic accuracy of 64-Slice Coronary Computer Tomography Angiography (CCTA) and Myocardial Perfusion Imaging (MPI) in the identification of significant coronary artery stenosis (>50% luminal narrowing). A total of 120 patients suspected of having coronary artery disease were divided into two groups, with 60 patients in each group. Group 1 underwent CCTA and group 2 underwent MPI. Diagnostic accuracy parameters, image quality, radiation exposure, and procedure time were compared. CCTA demonstrated higher sensitivity (90% vs. 80%, p = 0.049) and similar specificity (75% vs. 70%, p = 0.453) compared to MPI. Image quality was slightly superior in the CCTA group. Radiation exposure was significantly lower in the CCTA group compared to the MPI group (3.5 ± 1.2 mSv vs. 9.4 ± 1.7 mSv, p < 0.001). The procedure time for CCTA was also significantly less than that for MPI (10.3 ± 2.1 minutes vs. 45.2 ± 5.3 minutes, p < 0.001). CCTA showed superior sensitivity, image quality, and efficiency compared to MPI while exposing patients to a lower radiation dose. Further multicenter studies with larger patient populations are needed to validate these findings.

Imaging Effect and Accuracy Analysis of 64-Slice Spiral CT in the Diagnosis of Coronary Artery Stenosis

Objective: To analyze the imaging effect and accuracy of 64-slice spiral CT in the diagnosis of coronary arterystenosis. Methods: 30 patients with suspected coronary heart disease admitted to our hospital from March 2022 to March 2023 were selected. All patients underwent both 64-slice spiral CT and digital subtraction angiography (DSA). DSA is considered the gold standard for diagnosis, so it was used to analyze the diagnostic performance of 64-slice spiral CT. Results: (1) The diagnostic results of digital subtraction angiography and 64-slice spiral CT was analyzed and compared with each other. The 64-slice spiral CT had an accuracy of 96.67% (29/30), a sensitivity 96.55% (28/29), and a specificity of 100.00% (1/1) in diagnosing coronary artery stenosis. (2) There was no significant difference between 64-slice spiral CT and digital subtraction angiography in the positive detection rate of anterior descending artery lesion, the positive detection rate of left main lesion, the positive detection rate of left circumflex artery lesion and the positive detection rate of right coronary artery lesion (P &gt; 0.05). (3) There was no significant difference between 64-slice spiral CT examination and DSA examination in identifying mild stenosis, moderate stenosis, and severe stenosis of coronary arteries (P &gt; 0.05). Conclusion: 64-slice spiral CT examination can accurately determine the degree of occlusion of coronary arteries, which allows for the accurate diagnosis of coronary artery stenosis.

Comparative Study between Role of Multi Slice Computed Tomography Angiography and Doppler Ultrasonography in Evaluation of Patients with Lower Limb Arterial Diseases

Comparative Study between Role of Multi Slice Computed Tomography Angiography and Doppler Ultrasonography in Evaluation of Patients with Lower Limb Arterial Diseases

Exploration of the Value of 64-Slice Spiral CT Angiography in the Diagnosis and Differentiation of Intracranial Aneurysms

Exploration of the Value of 64-Slice Spiral CT Angiography in the Diagnosis and Differentiation of Intracranial Aneurysms

The Association Between the Use of Low-Slice Computed Tomography Machines and Downstream Care: Comparative Study of 16-Slice and 64-Slice Computed Tomography Angiography.

BackgroundAlthough computed tomography (CT) studies on machines with more slices have reported higher positive and negative predictive values, the impact of using low-slice (16-slice) CT machines on downstream testing has not been well studied. In community outpatient settings, low-slice CT machines remain in use, although many hospitals have adopted higher-slice machines.ObjectiveThis study examines the association between the use of low-slice CT machines and downstream invasive testing in the context of the CT angiography of the neck.MethodsIncluded health insurance claims pertained to adults with commercial or Medicare Advantage health plans who underwent the CT angiography of the neck. Site certification data were used to assign counts of slices to claims. Claims that were made in the 60 days after CT were examined for cervicocerebral angiography. The association between the number of slices and cervicocerebral angiography was evaluated by using a chi-square test and multivariate logistic regression.ResultsClaims for 16-slice CT had a 5.1% (33/641) downstream cervicocerebral angiography rate, while claims for 64-slice CT had a 3.1% (35/1125) rate, and a significant difference (P=.03) was observed. An analysis that was adjusted for patient demographics also found a significant relationship (odds ratio 1.64, 95% CI 1.00-2.69; P=.047).ConclusionsThe use of low-slice CT machines in the community may impact the quality of care and result in more downstream testing.

Data on changes in renal calyceal pattern among renal donors using CT angiography.

It is known that the recovery period after laparoscopic surgery is quicker than open surgery. Therefore, it is important to know the variations of the renal calyceal pattern prior to the laparoscopic surgery during renal surgeries. We analyzed the calyceal system in kidney donors using 64-Slice Computed Tomography Angiography. A total 99 healthy kidney donors were included to study the pattern of pelvicalyceal pattern and to classify further into bi-calyceal, tri-calyceal and multi-calyceal. This study found that bi-calyceal pattern is the most common pattern and further this pattern was more in right side in males and left side in females. The numbers of minor calyces were significantly more in right multi-calyceal pattern than left multi-calyceal, tri-calyceal and bi-calyceal patterns. The association of occurrence in these patterns was significant in males with strong association and insignificant in females. A detailed description of intrarenal arterial patternand its relationship with calyceal pattern could give great significance in renal transplantation and also for other urological procedures.

Color Doppler ultrasonography findings of vertebral arteries: A correlation with 64-slice CTA

Background/Aim: Although normal Color Doppler US (CDU) findings of the carotid system were described by many studies, normal findings of the vertebral system have not been studied extensively. This study aimed to evaluate vertebral artery CDU hemodynamic and morphologic findings in patients with normal vertebral arteries (VAs) on 64-slice Computed Tomography Angiography (CTA) and investigate the correlation between RDUS and CTA in evaluating the VA anatomy. Methods: In this retrospective cohort analysis, the patients referred to our radiology department for CTA who had normal VA anatomy underwent a CDU for visualization of the orifice and segments (V1-V2) of the VA. Peak systolic velocity (PSV), and end-diastolic velocity (EDV) were measured in V1 while PSV, EDV were measured and resistive index and FV were calculated in V2. The presence of hypoplasia and dominance were noted. Results: A total of 77 patients who had normal vertebral arteries on CTA were included in this study. CDU findings were highly consistent with multislice CTA findings regarding the measurement of VA diameter (ICC=0.856, ICC=0.830), hypoplasia (kappa=0.488), and dominance (kappa=0.752). No consistency was found between the two modalities in the visualization of the orifice and V1 segment of the VAs on both sides. CTA was able to show the orifice and the V1 segment in all cases, while the success rate was lower in CDU, especially in terms of visualizing the orifice of VA. VA FV was not significantly different between the patients with and without vertebrobasilar insufficiency (P=0.300). Conclusion: CDU findings were consistent with 64-slice CTA findings in VA diameter measurement and the diagnosis of hypoplasia and dominance. However, CTA is more successful than RDUS in evaluating the vertebral artery orifice and V1 segment, the most common sites of atherosclerotic involvement. There was no significant difference between the patients with and without VBI symptoms in evaluating FV.

Diagnostic Accuracy of 64-Slice Computed Tomography Angiography in Patients with Chest Pain vs. SPECT in the Assessment of Significant Coronary Artery Disease: A Systematic Review and Meta-analysis

Context: This systematic review and meta-analysis intended to investigate the diagnostic accuracy of computed tomography angiography (CTA) in comparison with single-photon emission computed tomography (SPECT) for the diagnosis of coronary artery disease (CAD) in chest pain patients with no history of cardiovascular diseases (CVDs).&#x0D; Methods: Invasive angiography was considered as the reference test with a stenosis threshold of ≥ 50%. Cochrane, Scopus, Science Direct, PubMed, and Embase databases were comprehensively searched from the time of inception of these databases to May 15, 2018. A manual search in Google Scholar, a reference review of the obtained studies, and a review of gray literature (including those presented in conferences and congresses) regarding diagnostic performances of CTA and SPECT techniques were performed independently by two researchers. A meta-analysis was performed to determine pooling estimates of sensitivity, specificity, diagnostic odds ratio, and positive as well as negative likelihood ratios in CTA and SPECT tests. According to the 2 × 2 contingency table of each study, at 0.95 confidence interval, the diagnostic accuracy of CTA and SPECT was meta-analyzed by pooling estimates of sensitivity, specificity, diagnostic odds ratio (DOR), and positive and negative likelihood ratios based on DerSimonian-Laird’s random-effects model. Heterogeneity was assessed by calculating I2. Analyses were performed using MetaDiSc version 1.4 and Stata version 11. The qualities of the selected studies were assessed independently by two researchers according to the quality assessment of diagnostic accuracy studies (QUADAS) questionnaire. Sensitivity analyses were performed by the Jackknife method. Publication bias was evaluated by Deeks’ funnel plot.&#x0D; Results: Fourteen studies related to CTA (1206 individuals) and 15 related to SPECT (1638 individuals) were eligible for meta-analysis. The pooled sensitivity and the specificity of CTA for CAD diagnosis were 91% (95% CI, 88% - 94%) and 87% (95% CI, 84% - 98%), respectively. The pooled positive and negative likelihood ratios, the diagnostic odds ratio, and the area under the ROC curve for CTA were 7.93 (95% CI, 5.11 - 12.29), 0.1 (95% CI, 0.06 - 0.17), 95.71 (95% CI, 59.81 - 153.15), and 0.96, respectively. The pooled sensitivity and the specificity of SPECT for CAD diagnosis were 81% (95% CI, 79% - 83%) and 74% (95% CI, 71% - 78%), respectively. The pooled positive and negative likelihood ratios, the diagnostic odds ratio, and the area under the ROC curve for SPECT were 3.03 (95% CI, 2.34 - 3.91), 0.25 (95% CI, 0.21 - 0.30), 13.56 (95% CI, 10.60 - 12.34), and 0.86, respectively. According to the sensitivity analyses, the removal of any single study at a time did not change the effect size of the remaining studies. We observed symmetry in the Deeks’ funnel plot, indicating that there was ignorable publication bias for CTA and SPECT studies.&#x0D; Conclusions: This study demonstrated that the diagnostic accuracies of CTA and SPECT tests lie in the ‘excellent’ and the ‘very good’ ranges, respectively. CTA is stronger evidence, than SPECT, to rule out CVDs in patients with low and intermediate risks of CAD with no history of cardiovascular diseases.

Analysis Of Morphology Of Renal Calyceal Pattern In Renal Donors Using Ct Angiography

Transplants are one of the biggest achievements of modern medicine and can save or greatly enhance the lives of other people. The recovery period after laparoscopic surgery is quicker than open surgery. It is important to know the variations of the renal calyceal pattern prior to the laparoscopic surgery during renal surgeries. The aim is to analyze the calyceal system in kidney donors using 64-Slice Computed Tomography Angiography. The study was conducted in a specialized scan centre located in Chennai after getting appropriate permission and ethical clearance. The study group was drawn from kidney donors who approached the scan centre and had no diseases related to kidney. In this study, a total of 99 healthy kidney donors were included to study the pattern of pelvicalyceal pattern and to classify further into bi-calyceal, tri-calyceal and multi-calyceal. This study found that bi-calyceal pattern is the most common pattern (%) and further this pattern was more in the right side in males and left side in females. The numbers of minor calyces were significantly more in the right multi-calyceal pattern than left multi-calyceal, tri-calyceal and bi-calyceal patterns. The association of occurrence in these pattern was significant in males with a strong association and insignificant in females. A detailed description of intrarenal arterial pattern and its relationship with calyceal pattern will be great significance in renal transplantation and also for other urological procedures.

"Crown of Death"; Corona Mortis, a Common Vascular Variant in Pelvis: Identification at Routine 64-Slice CT-Angiography.

Objective:To establish the incidence of arterial corona mortis variant in angiographic studies being performed using a 64 slice CT scan machine in a series of patients.Methods:This was a prospective cross-sectional study including 100 consecutive patients undergoing routine clinically indicated, standard protocol, CT-angiography for the abdominal aorta and/or lower limbs using a 64 slice CT scanner. Patients having severe arterial insufficiency (Grade 4 stenosis on CT angiography), pelvic infections and tumours, patients with past pelvic trauma and those who had previous pelvic surgery were excluded from the study. In total 200 hemi-pelvises were evaluated for the presence or absence of corona morti.Results:Overall, we included 100 patients in this series including 67 men and 33 women with mean age of 40.1±2.3 (ranging from 22-74) years. The arterial variant was identified on thin, 0.625-mm-thick images in 24 out of 100 patients studied (unilateral in 20 patients and bilateral in 4 patients; 28 out of 200 hemipelvises evaluated, having an incidence of 14%). We found that the distance of corona mortis artery from the symphysis was significantly greater for women compared to men, both on right (p=0.034) and left sides (p=0.046). Conclusion:Corona mortis may be prospectively identified at contrast-enhanced multidetector CT especially in pelvic trauma patients and help guide subsequent endovascular embolization or surgical interventions.

Analysis of Morphometry of Calyceal Pattern in Kidney Donors Using CT Angiogram Images

The advent of more conservative methods of treatment for renal pathologies has necessitated a precise knowledge of renal pelvicalyceal system. Knowledge on the patterns of pelvicalyceal system and its relation to the renal segmental arteries is of importance in procedures in kidney. The aim is to analyze the morphometry of calyceal system in kidney donors using 64- Slice Computed Tomography Angiography. The study was conducted in specialized scan center located in Chennai after getting appropriate permission from medical director of the center. The study group was drawn from kidney donors who approached the scan center who had no diseases related to kidney. In this study, a total of 99 kidney donors were included. This was a prospective cross-sectional study conducted from June 2014 to September 2017. The statistical analysis and plotting of graphs were carried out using Sigma stat 13.0 (Systat Software, USA). Various patterns of the pelvicalyceal system along with morphometric dimensions of the infundibulum, which leads from the major calyces to the renal pelvis were studied. The result was then correlated with clinically significant parameters.

ROLE OF 128-SLICE, DUAL-SOURCE CT CORONARY ANGIOGRAPHY AS A NOVEL IMAGING TECHNIQUE IN ASSESSMENT OF IN-STENT RESTENOSIS

Background: Over the past 35 years, catheter-based intervention has become the dominant form of coronary revascularization. Percutaneous coronary interventions are increasingly performed. The most important advance in the field of percutaneous coronary interventions was the introduction of coronary stent implantation in the 1990s, which led to reductions in incidence of restenosis. The use of multi–slice CT is gaining increasing acceptance for noninvasive cardiac imaging. Recent years with the new emerging machines have demonstrated successful application of multi–slice CT angiography for the noninvasive assessment of coronary artery disease and the evaluation of coronary artery stents.Aim of the Work: To evaluate the role of 128-slice, dual-source CT coronary angiography as a novel technique in assessment of coronary artery in-stent restenosis. Patients and Methods: This study included forty patients withprior coronary artery stent implantation. The mean age of the included patients was 58 with an age range between 40 and 73 years. A total of 42 coronary artery stents deployed within 40 patients were included in this study; and assessed by MSCT angiography and they underwent invasive coronary angiography as a gold standard for evaluation of the coronary artery stents. Results: In an overall view, MSCT angiography compared to the invasive coronary angiography as a gold standard technique gave us a sensitivity of 100%, a specificity of about 83.8 %, an accuracy of about 87.1%, positive predective value (PPV) is 61.5% and negative predective value (NPV) is 100% in the assessment of the patency ofthe coronary artery stents, taking into consideration proper standard CT angiography techniques in all cases.Conclusion: Our study helps to identify factors that influence the assessability of coronary artery stents by 128-slice dual source CT scanner, namely, stent type and diameter. It shows that under certain conditions, the detection of in-stent restenosis might be possible with an accuracy that could permit clinical applications, but the nonassessable stents do not allow the use of MSCT coronary angiography in unselected patients with implanted stents in coronary arteries. So that MSCT angiography as a noninvasive technique can be used for assessment of in-stent restenosis but patients must becarefully selected.

Study of pattern of origin of central branches of middle cerebral artery by using 64-slice computed tomography angiography

Background and Aims: Middle cerebral artery (MCA), a branch of the internal carotid artery, is the most commonly affected vessel in cerebrovascular diseases. Various studies have reported for variations in the origin pattern of MCA. The detection of these variations is of clinical relevance for the clinicians for planning their line of treatment. The present study was performed to identify the variations using 64-slice computed tomography (CT) angiography. Materials and Methods: The present study was performed in 45 participants (32 males and 13 females). MCA was identified and observed for a different pattern of origin of the central (perforating) branches using 64-slice CT angiography. Results: The observations revealed that the M1 segment of MCA showed single, dual, or multiple origins of central branches. Single central branch of MCA originated in 8.88% of cases, double branches were observed in 11.11% of cases, whereas the multiple branches were found in 66.67% of cases and mix pattern was observed in 13.3% of cases. These central branches coursed through the anterior perforating substance to reach the basal area of the subcortical zone. Conclusions: The present study revealed the variations in origin of the central branches of MCA using 64-slice CT angiography and the knowledge of radiological identification of these variations can be of use for radiologists and neurosurgeons dealing with cerebrovascular diseases.

Left ventricular and atrial strain imaging with cardiac computed tomography: Validation against echocardiography

BackgroundData on left ventricular (LV) deformation imaging using CT angiography (CTA) are scarce and the feasibility of atrial deformation analysis by CT has not been addressed. We aimed to compare 2D echocardiographic and CT derived LV and left atrial (LA) global longitudinal strain (GLS) obtained by using a novel feature tracking algorithm in patients following transcatheter aortic valve implantation. MethodsTwenty-eight patients were included who underwent retrospectively-gated 256-slice CTA and speckle-tracking echocardiography (STE) on the same day. CT datasets in 10% increments were reconstructed throughout the cardiac cycle. LV GLS and LA global peak reservoir strain (LA GS) was measured. ResultsMedian absolute values for LV GLS were 19.9 [14.8–22.4] vs. 19.9 [16.8–24.7], as measured by CT vs STE, respectively (p = 0.017). We found good inter-modality correlation for LV GLS (ρ = 0.78, p < 0.05) with a mean bias of −1.6. Regarding atrial measurements, the median LA GS was 19.0 [13.5–27.3] for CT vs. 28.0 [17.5–32.6] for STE (p < 0.001) with a mean bias of −5.6 between CT and STE and a correlation coefficient of ρ = 0.87, p < 0.001. CT measurements were highly reproducible: intra-observer intra-class correlation coefficient was 0.96 for LV GLS and 0.95 for LA GS. ConclusionWe detected good correlation between CTA and echocardiography-based LV and LA longitudinal strain parameters. CTA provides accurate strain measurements with high reproducibility. Feature tracking-based deformation analysis could provide a clinically important addition to CT examinations by complementing anatomical information with functional data.

Standardization of Semiautomatic Tortuosity Measurements in the Carotid Artery

Introduction - Increased arterial tortuosity has been suggested as a predisposing factor for carotid artery dissection, which is an important etiological risk factor for development of extracranial carotid artery aneurysms (ECAA). Conversely, little is known about tortuosity of the carotid artery in patients with ECAA. Prior to comparison with non-ECAA controls, the optimal measurement technique should be defined. This study aimed to determine the difference between software packages in terms of reproducibility and absolute outcome of arterial tortuosity measurements in patients with ECAA. Methods - Four commercial software packages were compared: 3mensio Vascular (Pie Medical Imaging BV, Maastricht, NL), TeraRecon (Aquarius, Foster City, CA, USA), Vital Images (Toshiba Medical, Minnetonka, MN, USA), and Aycan OsiriX PRO (Aycan Medical Systems, Rochester, NY, USA). Patients with ECAA were selected from our ECAA registry. Two observers independently scored two rounds of 12 thin slice computed tomography angiography (CTA) scans using the software packages. The tortuosity index (TI) was calculated from skull base until 1) carotid bifurcation and 2) aortic arch, and was defined as the true length of the centerline divided by the straight distance. Intraclass correlation coefficients (ICC) with 95% confidence intervals were calculated to quantify inter- and intraobserver variability within one software package, and differences in measured TI between the software packages. Results - The interobserver agreement was close to perfect for 3mensio, excellent for Vital Images and OsiriX, and substantial for TeraRecon, with ICC 0.99 (0.96-1.0), 0.90 (0.69-0.97), 0.84 (0.53-0.95), and 0.72 (0.28-0.91), respectively. The intraobserver agreement ranged from ICC 1.0 for 3mensio to ICC 0.91 for TeraRecon. Agreements between software packages on measured TI ranged from ICC 0.99 (0.98-1.0) for 3mensio vs. OsiriX, to ICC 0.95 (0.82-0.98) for 3mensio vs. TeraRecon. Median time needed to complete one round of measurements was highest for OsiriX (p=0.013). Conclusion - Carotid artery tortuosity measurements are reproducible and comparable between current commercially available software packages, with high intraobserver agreement. Although the reproducibility differed per software packages, all packages scored an acceptable interobserver agreement.

Perioperative predictors of early silent coronary graft occlusion after direct myocardial revascularisation

Background. The condition of the coronary grafts is the most important determinant of prognosis after direct myocardial revascularisation. Previous studies mainly aimed at exploring the long-term patency and causes of coronary graft occlusions; identification of patients at risk for asymptomatic graft occlusion in the early postoperative period remains an unresolved issue.Aim. The purpose of this study was to define perioperative predictors of early asymptomatic coronary graft occlusion after direct myocardial revascularisation.Methods. This retrospective study included 201 patients with coronary artery disease who underwent microscope-assisted coronary artery (CA) bypass surgery in 2013–2018. All patients underwent 64-slice computed tomography angiography 7 days after surgery. The patients were categorised into two groups: those with confirmed patency of all coronary grafts (n = 153; group I) and those with occlusion of at least one graft (n = 48; group II). The perioperative predictors of early asymptomatic coronary graft occlusion were analysed using logistic regression.Results. The total graft patency was 91.7% among a total of 650 coronary grafts that were examined. The frequencies of mammary and venous graft occlusions were comparable (8.4% and 8.2%, respectively). No differences were noted in the conduit types or the revascularised areas of the myocardium between the two groups. Multivariate regression analysis revealed that diffuse CA lesions (odds ratio [OR], 2.74; 95% confidence interval [CI], 1.36–5.52; p = 0.005), lesion diameter of CA of &lt;1.5 mm (OR, 2.86; 95% CI, 1.34–6.71; p = 0.007) and hyperglycaemia (glucose &gt;7.8 mmol/l) during the first postoperative day (OR, 4.22; 95% CI, 1.70–10.5; p = 0.002) were independent predictors of early coronary graft occlusion. History of percutaneous coronary intervention (OR, 0.32; 95% CI, 0.11–0.97; p = 0.045) and increased baseline glomerular filtration rate (OR, 0.96; 95% CI, 0.93–0.98; p = 0.002) were associated with a reduced risk of early graft occlusion.Conclusion. The frequency of early asymptomatic occlusion after microscope-assisted coronary artery bypass surgery was comparable between the venous and mammary grafts and did not depend on the anatomical zone of myocardial revascularisation. Diffuse CA lesions, target CA diameter of &lt;1.5 mm and hyperglycaemia (&gt;7.8 mmol/L) during the first postoperative day were associated with an increased risk of early silent graft occlusion, whereas increased baseline glomerular filtration rate and history of percutaneous coronary intervention were protective for the early patency of coronary bypass grafts. Received 24 June 2019. Revised 23 August 2019. Accepted 29 August 2019. Funding: The study did not have sponsorship. Conflict of interest: Authors declare no conflict of interest.

Agreement Between 64-Slice Multidetector CT Angiography and Transthoracic Echocardiography in Detection of Extracardiac Findings of Congenital Heart Disease.

To determine the degree of agreement between multi-detector computed tomography angiography and transthoracic echocardiography in diagnostic evaluation of congenital heart disease with extracardiac findings. Descriptive cross-sectional study. Radiology Department, Doctors Hospital and Medical Centre, Lahore, from May to November 2016. Patients with clinical suspicion of cardiovascular malformation were included in the study. All the patients had echocardiography and thoracic computed tomography angiography done to diagnose congenital heart disease. Agreement was labelled in true positive and true negative patients. Computed tomography angiography could detect the extracardiac findings of congenital heart disease in 140 (93.3%) patients, while transthoracic echocardiography in 118 (78.7%) patients. Agreement was detected in 108 (72%) patients. Kappa statistics showed poor agreement (kappa = -0.113). Although transthoracic echocardiography is usually the first line of investigation in evaluation of congenital heart disease; it has its limitations for evaluating congenital heart disease with extracardiac findings, due to intrinsic limitation of the imaged field. Computed tomography angiography has better sensitivity in detecting extracardiac findings of congenital heart disease along with better delineation of anatomy.

Analysis of Intra Renal Arterial Pattern in Kidney Donors using 64-Slice Computed Tomography Angiography

The renal artery when it reaches close to the hilum of kidney where it cleaves into anterior and posterior divisions were receives around 75% and 25% of blood respectively. Further these branches divide into many segmental branches. These segmental arteries does not have collateral system, so when there is any occlusion of these arteries which results in the ischemia of the particular segment of kidney. Anatomists believe that knowledge of presence of lower polar artery is essential for polar nephrectomy. Prior knowledge of variations in the renal vessels is required for urological surgery for preoperative investigations as there are reports of surgical complications which include enormus haemorrhage. In this study we analyzed the different variations in the intra renal branch of inferior segmental artery.

Assessing the prevalence, quantification and morphological composition of coronary atherosclerosis in patients with type 2 diabetes and the metabolic syndrome via 64-Slice CT angiography

Background: We determined the prevalence, morphology, and severity of coronary artery plaque in high-risk patients via 64-slice cardiovascular computed tomography (CVCT). Methods: Based on chart review, 101 subjects having a 64-slice CVCTwere assigned to one of three groups: type 2 diabetes, metabolic syndrome, or comparison. Disease severity was classified as:no disease, subclinical disease (lesions <70%), or clinically significant disease (lesions >70%). Plaque morphology wasstratified as either vulnerable or stable plaque by Houndsfield units and established American Heart Association criteria.Results: Diabetic subjects had the highest prevalence of CAD (78%), compared to 65% in the metabolic syndrome subjectsand 55% in the comparison group (p<.05). Diabetic subjects were also most likely to have both significant CAD (41%), andstable plaque (52%) followed by metabolic syndrome subjects (33% and 25%) and the comparison group (15% and 20%) (p< 0.05). The metabolic syndrome group was most likely to have vulnerable lesions (36%) potentially placing them atincreased risk of acute events. 22% of subjects in the diabetes group, 35% in the metabolic syndrome group, and 45% in thecomparison cohort were disease-free. Conclusions: 64-slice CVCT allows non-invasive diagnosis and stratification ofsubjects with diabetes and the metabolic syndrome, providing relevant information regarding coronary disease prevalence,severity, and plaque composition, that are statistically different among these high risk patient cohorts. (Int J Diabetes Metab14: 120-125, 2006)

Abstract TP246: Thin Slice Ct Angiography is Useful for Detecting Aortic Arch Disease in Ischemic Stroke Patients

Purpose: Aortic arch disease is an important embolic source of ischemic stoke. To evaluate aortic arch disease, CT angiography (CTA) and transesophageal echocardiography (TEE) have been regularly examined. Recently, thin slice CTA is used for evaluating coronary artery disease. Thus, we considered that thin slice CTA was also useful for detecting aortic arch disease. The aim of this study was to assess the usefulness of thin slice CTA in the evaluation of the aortic arch disease and to compare with that of TEE. Methods: We retrospectively enrolled acute ischemic stroke patients admitted to our hospital within 7 days of onset, from October 2016 to June 2018. The findings detected by thin slice (0.5-1.0mm) CTA were evaluated by two stroke specialized neurologists. The presence and localization of plaques and ulcers were evaluated. These findings were compared to those of TEE in case of which both examinations were underwent. Results: We enrolled 60 acute ischemic stroke patients (37 men, mean age 70 years) who underwent CTA. Large artery atherosclerosis was detected in 17 patients (28%), and atrial fibrillation was found in 6 patients (10%). CTA was mostly examined for searching embolic sources. Plaques of 4mm or more and ulcers were found in 29 (48%) and 22 patients (37%). Accordingly, 14 patients (23%) were diagnosed as aortagenic stroke. Among 29 patients with both examinations, plaques were detected in 22 patients (76%) by CTA and in 16 patients (55%) by TEE. The sensitivity and negative predictive value of TEE in detecting plaques compared with CTA was 73% and 100%. Plaques missed by TEE were mostly located on the side close to esophagus. Ulcers were highly investigated by CTA than by TEE (45% v.s. 17%, p&lt;0.05). The sensitivity and negative predictive value of TEE in detecting ulcers compared with CTA was 31% and 94%. Conclusion: In this study, thin slice CTA was superior to TEE for detecting plaques located on the side close to esophagus and ulcers. Thin slice CTA may be useful for detecting embolic sources in ischemic stroke patients. &lt;!--EndFragment--&gt;