Multi-slice Spiral CT Coronary Angiography Research Articles

The Complementary Relationship Between Echocardiography and Multi-Slice Spiral CT Coronary Angiography in the Diagnosis of Coronary Artery Thrombosis in Children With Kawasaki Disease.

Aim: To compare the diagnostic values by using transthoracic echocardiography (ECHO) and multi-slice spiral CT coronary angiography (CTCA) for identifying coronary artery thrombosis in children with Kawasaki disease (KD).Methods: Total 97 KD children with coronary artery dilation complications in our hospital from June 2012 to December 2020 were included in the study. CTCA and ECHO were performed after over 1 month of illness.Results: Coronary artery thrombosis was found in 14 out of 97 patients. Among them, 10 were identified as positive by CTCA, 9 were identified as positive by ECHO, and 5 were identified as positive by both CTCA and ECHO.Conclusion: Both CTCA and ECHO can be used to diagnose coronary artery thrombosis. ECHO has advantage in identifying low-density thrombus, and CTCA is better for the clot in distal coronary artery. They can complement each other.

Clinical value of the correlations of mural coronary artery compression extent with myocardial bridge length and thickness evaluated by 128-slice CT

This study aimed to investigate the correlations between the detection rate of mural coronary artery (MCA) by 128-slice CT and the MCA compression extent in systole with myocardial bridge (MB) length and thickness. A retrospective analysis was conducted for 580 patients receiving multislicespiral CT coronary angiography (MSCTCA). In addition, the MCA incidence rate and position were detected, and the MB length and thickness in the left anterior descending branch (LAD) and MCA compression extent in systole were measured to compare the differences between MB-MCA length and thickness among the mild, moderate and severe groups. A total of 140 cases of MB-MCA (24.14%) were involved in the study. Among them, 104 cases occurred in the middle segment of the LAD (74.3%), 16 cases (11.4%) occurred in the distal segment of the LAD, 8 cases (5.7%) occurred in the left circumflex-obtuse marginal branch (LCX-OM), 7 cases (5.0%) occurred in the first diagonal branch (1st D), 3 cases (2.1%) in the intermediate branch (M) and 2 cases (1.5%) occurred in the posterior descending branch of the right coronary artery (RCA-PD). The mean length of the MB in the LAD was 21.80±5.98 mm, the mean thickness was 2.15±0.74 mm and the mean compression extent was 38.5±19.6%. Among the different groups, there were no significant difference in MB length (P>0.05) but there were significant differences in MB thickness (P<0.05). In addition, the extent of MCA compression in systole was linearly and positively correlated with MB thickness (r=0.408, P<0.05) but was not correlated with MB length (r=0.076, P>0.05). 128-slice CT coronary angiography (SCTCA) is able to accurately detect MB-MCA and evaluate the correlations of MCA compression extent in systole with MB length and thickness which provides a basis for its clinical use.

The application of the retrospective electrocardiographic gating technique combined with electrocardiographic editing in 64 multislice spiral CT coronary angiography

Objective To assess the value of the retrospective electrocardiographic gating technique with electrocardiographic editing in 64 multislice spiral CT coronary angiography(MSCTCA).Methods Sixty-seven patients with suspicion of coronary artery disease underwent coronary angiography with 64 MSCT,including arrhythmia(n=37,17 with atrial extrasystoles and 20 with ventricular extrasystoles),unequal R-R intervals resulted from the absence of trigger points on partial R waves(n=14)and inaccurate trigger points(n=16).The images were reconstructed with the retrospective electrocardiographic gating technique after electrocardiacgraphic signal editing and processed On the postprocessing workstation.Results The electrocardiographic signal editing was failed in one patient with atrial extrasystole.According to the image quality,763 segments of coronary arteries in 66 patients were defined as excellent(n=473,62.0%),good (n=213,27.9%),moderate(n=51,6.7%)or poor(n=26,3.4%)and divided into 4 groups.The images of 737 segments(96.6%)of coronary arteries were diagnostable.The Results of CT angiography in 12 patients were compared with coronary angiography(CAG),and the sensitivity of 64-slice spiral CT for the≥50% stenosis and＜50% stenosis were 84.6%(22/26)and 83.3%(10/12),respectively.The specificity was 96.3%(105/109)and the negative predictive value was 97.2%(105/108)in the diagnosis of coronary artery stenosis.Conclusion The retrospective electrocardiographic gating technique combined with electrocardiographic signal editing expands the applications of 64 MSCTCA. Key words: Coronary angiography; Tomography; X-ray computed

Value of multislice spiral CT in the diagnosis of anomalous origin of the coronary arteries

To investigate the value of multislice spiral CT (MSCT) coronary angiography in the diagnosis of anomalous origin of coronary arteries. 5000 patients diagnosed or suspected as with diseases of coronary artery underwent MSCT coronary angiography (retrospectively ECG-gating; 0.5 s rotation; one-sector or two-sector reconstruction algorithm; intravenous contrast agent) 2001-2005. Anomalous origin of coronary artery was incidentally found with multislice spiral CT in 39 patients (0.78%), including anomalously high origin of the right coronary artery (n = 20), anomalous origin of the right coronary artery from left coronary sinus (n = 11), aberrant circumflex artery arises from the right coronary sinus or right coronary (n = 3), anomalous origin of the right coronary artery from the posterior coronary sinus (n = 1), anomalous origin of the left coronary artery from the posterior coronary sinus (n = 1), single coronary artery (n = 2), separate origin of circumflex and left anterior descending arteries from left coronary sinus (n = 1). These signs were better shown by MSCT coronary angiography. MSCT coronary angiography is a useful adjunctive technique to invasive coronary angiography in the diagnosis of anomalous origin of coronary arteries.

The clinical application of multi-slice spiral CT coronary angiography in patients with coronary heart disease

目的 评价多层螺旋CT冠状动脉造影(MSCTA)在冠心病中的应用价值.方法对40例冠心病患者(35例拟诊冠心病,5例冠状动脉支架或搭桥术后患者)进行了心电门控螺旋CT(MSCT)增强扫描,所得数据传到工作站进行三维重建,并与冠状动脉造影结果相对照.结果 40例患者中对160支冠状动脉(简称冠脉)进行了MSCT三维重建, 35例拟诊者中4例MSCTA和DSA排除了冠脉疾病;31例124支冠脉中,MSCTA对于显示近中段≥50%的狭窄有一定的准确性(敏感性81.8%,特异性90.1%),不能显示轻度狭窄病变、远端或细小分支病变;可以发现并判断粥样硬化斑块的类型,显示斑块的形态及引起狭窄的程度.钙化斑块特别是钙化范围广者可引起管腔轻度狭窄(冠状动脉腔径狭窄＜50%),非钙化斑块则引起较明显的狭窄(冠状动脉腔径狭窄≥50%).4例冠状动脉支架和1 例冠状动脉搭桥术后均可清晰显示支架和血管桥的位置及远端血流情况.结论MSCTA是有效可靠的冠心病诊断方法,对病变血管管腔狭窄、粥样硬化斑块的评价有一定的应用价值.它作为一种非创伤性检查方法,可替代DSA用于易碎软斑块的早期检查。

Multi-slice spiral CT coronary angiography: influence of heart rate and reconstruction window on image quality

目的 探讨心率及重建相位窗对多层螺旋CT冠状动脉造影图像质量的影响.方法80例健康体检者行16层螺旋CT回顾性心电门控条件下冠状动脉造影.结果每位患者的4条冠状动脉分支(左冠状动脉主干、左前降支、左回旋支、右冠状动脉)分别用于图像质量分析.心率≤60次/min者,有82.1%(46/56支)的图像可用于诊断;心率61～70次/min者,有63.4%(104/164支)的图像可用于诊断;心率71～80次/min者,有41.2%(28/68支)的图像可用于诊断;心率80次/min以上者有31.2%(10/32支)的图像可用于诊断.左冠状动脉前降支在60%～70%的重建相位窗时图像质量最佳,左冠状动脉回旋支在50%～60%时最佳,右冠状动脉重建相位窗为50%～70%较满意.结论心率及重建相位窗对多层螺旋CT冠状动脉造影图像质量有重要影响作用。

Multislice spiral CT myocardial perfusion and coronary angiography in acute myocardial infarction: an experimental study

Objective To study the myocardial perfusion in acute myocardial infarction by using Multislice spiral CT (MSCT),and to explore the value of MSCT coronary angiography in showing the coronary artery blockage.Methods The left anterior descending artery (LAD) was ligated in nine healthy dogs.Then MSCT perfusion scans were done in several stages (pre-ligation,30 min,1,2,4,6,and 8 h post-ligation).The perfusion peculiarity was analyzed and compared with pathological findings.MSCT coronary angiography was done before and after LAD ligation.Results The mean normal myocardial perfusion was (69.3±13.9) ml·100 g -1· min -1.The mean time to peak (TTP) was (12.8±2.1) s.30 min after LAD was ligated,the myocardial perfusion was (25.2±3.4) ml·100 g -1· min -1 .It became significantly lower than normal,and time-density curve got flat.There was no significant difference between the density of normal myocardium (44.9 ±22.0) HU and that of LAD ligation areas on 10 min delay scan (67.1±11.4)HU (P0.05).But significant enhancement was found after LAD ligation for 4 hours (82.1±15.2) HU.MSCT coronary angiography could show the blockage of LAD in nine dogs.Conclusion MSCT myocardial perfusion combined with coronary angiography could estimate myocardial ischemia and infarction,and show the blockage of the coronary artery.

Retrospectively electrocardiographically-gated reconstructed multi-slice spiral CT coronary angiography: optimal R-R phase and clinical application

目的 探讨多层螺旋CT回顾性心电门控冠状动脉重建的最佳R-R时相,评价多层螺旋CT冠状动脉重建的临床应用价值.方法对20例拟诊冠心病患者多层螺旋CT扫描后,利用回顾性心电门控重建出37.5%、50.0%、62.5%、75.0%R-R时相的横断面图像.然后进行冠状动脉容积重建及仿真血管内窥镜重建,分析不同R-R时相各支冠状动脉的显示情况.以选择性冠状动脉造影结果为对照,评价多层螺旋CT冠状动脉重建图像诊断冠状动脉≥50%管径狭窄的临床应用价值.结果左前降支、左回旋支和右冠状动脉重建的最佳时相为50.0%和62.5%R-R时相;多层螺旋CT冠状动脉重建图像诊断冠状动脉≥50%管径狭窄的敏感度、特异度、阳性预测值、阴性预测值和诊断正确率分别为91.7%、83.3%、28.2%、99.3%和83.9%.结论选择回顾性心电门控最佳R-R时相重建冠状动脉可以最大限度减轻心脏运动伪影,提高图像质量;多层螺旋CT冠状动脉重建图像具有很高的敏感度和阴性预测值,可以作为选择性冠状动脉造影前的筛选检查.

Multislice computed tomography of the coronary arteries.

Multislice spiral CT (MSCT) of the coronary arteries is developing rapidly as a noninvasive method for assessing coronary artery anatomy and for calculating various parameters of cardiac function. This article reviews the issues involved in MSCT coronary angiography and the methods used to overcome them. The current clinical applications for MSCT coronary angiography are summarized with reference to published clinical studies. The capabilities of CT are compared with those of MRI. Both modalities have a wide range of indications in the noninvasive diagnostic assessment of the heart and partly overlap in their clinical application.