Tomography Angiography For Detection Research Articles

Comparison of multicolor scanning laser ophthalmoscopy and optical coherence tomography angiography for detection of microaneurysms\xa0in diabetic retinopathy

This study aimed to evaluate the usefulness of multicolor (MC) scanning laser ophthalmoscopy (MC-SLO) in detecting microaneurysm (MA) in eyes with diabetic retinopathy (DR). This was a retrospective cross-sectional study. Eyes with DR underwent fluorescein angiography (FA), MC-SLO, optical coherence tomography angiography (OCTA), and color fundus photography (CFP) were analyzed. The foveal region was cut in an 6 × 6 mm image and the number of MA in each image was counted by retina specialists to determine the sensitivity and positive predictive value. FA results were used as the ground standard. MAs were classified as those with early, late, or no dye leakage based on FA images. Fifty-four eyes of 35 patients with an average age of 64.5 ± 1.24 years were included. The sensitivity of MA detection was 37.3%, 15.3%, and 4.12% in MC-SLO, OCTA, and CFP, respectively (P < 0.01 in each pair).The positive predictive value was 66.4%, 46.4%, and 27.6% in MC, OCTA, and CFP, respectively (P < 0.01 in each pair). Sensitivity for MAs with early leakage was 36.4% in MC-SLO, which was significantly higher than 4.02% in OCTA. MC-SLO was more useful in detecting MA in eyes with DR than OCTA.

Comparison of swept-source versus spectral-domain optical coherence tomography angiography for detection of macular neovascularization

PurposeTo compare swept-source (SS) versus spectral-domain (SD) optical coherence tomography angiography (OCTA) for the detection of macular neovascularization (MNV).MethodsIn this prospective cohort study, 72 eyes of 54 patients with subretinal hyperreflective material (SHRM) and/or pigment epithelial detachment (PED) on OCT possibly corresponding to MNV in at least one eye were included. OCTA scans were acquired using two devices, the PLEX Elite 9000 SS-OCTA and the Spectralis SD-OCTA. Fluorescein angiography (FA) was used as reference. Two graders independently evaluated en face OCTA images using a preset slab as well as a manually modified slab, followed by a combination of en face and cross-sectional OCTA.ResultsSensitivity (specificity) for the automated slabs was 51.7% (93.0%) for SS-OCTA versus 58.6% (95.3%) for SD-OCTA. Manual modification of segmentation increased sensitivity to 79.3% for SS-OCTA but not for SD-OCTA (58.6%). The combination of en face OCTA with cross-sectional OCTA reached highest sensitivity values (SS-OCTA: 82.8%, SD-OCTA: 86.2%), and lowest number of cases with discrepancies between SS-OCTA and SD-OCTA (4.2%). Fleiss kappa as measure of concordance between FA, SS-OCTA, and SD-OCTA was 0.56 for the automated slabs, 0.60 for the manual slabs, and 0.73 (good agreement) for the combination of en face OCTA with cross-sectional OCTA. Concordance to FA was moderate for the automated slabs and good for manual slabs and combination with cross-sectional OCTA of both devices.ConclusionBoth devices reached comparable results regarding the detection of MNV on OCTA. Sensitivity for MNV detection and agreement between devices was best when evaluating a combination of en face and cross-sectional OCTA.

Reliability of Optical Coherence Tomography Angiography in Detection of Early Hydroxychloroquine Toxicity

Background: Chloroquine is an antimalarial drug, while hydroxychloroquine is an analogue of chloroquine. Hydroxychloroquine (HCQ) is used to treat autoimmune diseases in addition to malaria. They have toxic effects on retina. Different screening protocols were described to detect HCQ toxicity. Objective: The aim of the current work was to study the ability of optical coherence tomography angiography (OCTA) to detect early retinal changes that may occur after HCQ treatment in patients with rheumatoid arthritis. Patient and Methods: This prospective cross-sectional study included a total of 40 eyes of 20 patients who were newly or previously prescribed HCQ for rheumatoid arthritis, recruiting from the Department of Ophthalmology, Al-Zahraa University Hospital. This study was conducted between May 2018 to Dec 2019. OCTA imaging was performed via Angiovue software. Results: The superficial whole vascular density, superficial parafoveal vascular density, superficial perifoveal vascular density, deep whole vascular density, deep parafoveal vascular density, and deep perifoveal vascular density were thinner in treatment groups compared to the control group (p < 0.05). Conclusion: OCTA could be a beneficial tool for screening of HCQ retinal affection. It could detect the decrease in the deep capillary plexus at the parafoveal and perifoveal regions in patients who were receiving HCQ treatment.

Evaluation of Intravital Ranibizumab on Proliferative Diabetic Retinopathy with Macular Edema by Optical Coherence Tomography Angiography

Purpose: To evaluate the effect of ranibizumab by Optical Coherence Tomography Angiography (OCTA)in proliferative diabetic retinopathy (PDR) with macular edema and to evaluate the role of Swept Source Optical Coherence Tomography Angiography in detection and characterization of new vessels at the disc (NVD) and new vessels elsewhere (NVE). Subjects and Method: The study included patients with proliferative diabetic retinopathy (PDR) and clinically significant diabetic macular edema. Patients with central macular thickness (CMT) above 300 μm underwent intravitreal injection of 0.5 mg Ranibizumab&amp; those having CMT below 300μm had laser treatment. Results: The study was conducted on 50 cases with proliferative diabetic retinopathy with macular edema There was significant increase in best corrected visual acuity (BCVA) across time of treatment. Mean (±SD) BCVA at diagnosis, at 1monthat 3 month were 9.1±0.1, 0.8±0.1, 0.7±0.2. respectively (p&lt;0.001) Central macular thickness (CMT); Area of neovascularization (ArNV); Exuberant Vascular Proliferation (EVP)showed significant decrease across time of treatment, Conclusion: ranibizumab injections are a safe and effective alternative to Pan retinal photocoagulation for the management of PDR. OCTA is useful to monitor different NVD subtypes, their development, and the efficacy of treatment regimens as well as to define new vessel morphological details. Small scan size delineates minute morphology of NVD and misses extension of lesions beyond disc margin, while larger scan size masks fine details.

Role of wide-angle optical coherence tomography angiography in detection of proliferative diabetic retinopathy in a patient with dense asteroid hyalosis

A 56-year-old woman presented with painless diminution of vision in her left eye since the last 2 months. She is a known case of type 2 diabetes mellitus on insulin....

A direct comparison of 3\u2009T contrast-enhanced whole-heart coronary cardiovascular magnetic resonance angiography to dual-source computed tomography angiography for detection of coronary artery stenosis: a single-center experience

BackgroundIn recent years, substantial advances have been made in noninvasive cardiac imaging, including cardiac computed tomography (CT) and cardiovascular magnetic resonance (CMR). The purpose of this study was to prospectively compare the diagnostic performance of contrast-enhanced whole heart coronary CMR angiography (CCMRA) to dual-source coronary CT angiography (CCTA) for the diagnosis of significant coronary stenoses (≥50%) in patients with known or suspected coronary artery disease (CAD) referred for conventional x-ray coronary angiography.MethodsOur objective was to directly compare the diagnostic accuracy of contrast-enhanced whole-heart CCMRA (CE-CCMRA) to dual-source CCTA (DS-CCTA) for the detection of CAD. We prospectively studied 57 symptomatic patients with suspected or known CAD who were scheduled for conventional x-ray coronary angiography. Significant CAD was defined as an x-ray defined diameter reduction of ≥50% in a coronary artery with a reference diameter of ≥1.5 mm.ResultsCE-CCMRA and DS-CCTA were completed in 51 (89%) of 57 patients without complications. The acquisition times of CE-CCMRA and DS-CCTA, respectively, were 9.5 ± 3.1 min and 8.3 ± 1.4 s. On patient-based analysis, the sensitivity, specificity, positive and negative predictive value of CE-CCMRA and DS-CCTA were 93.5% versus 93.5%(P > 0.05), 85% versus 90%(P > 0.05), 90.6% versus 93.5%(P > 0.05), and 89.4% versus 90%(P > 0.05), respectively. The area under the curve (AUC) was 0.89 (95% CI: 0.79 to 0.99) for CE-CCMRA and 0.92 (95% CI: 0.83 to 1.00) for DS-CCTA.ConclusionsDS-CCTA was found to be superior to CE-CCMRA in the diagnosis of significant coronary stenoses (≥50%) in patients with suspected or known CAD scheduled for conventional x-ray coronary angiography, owing to shorter scanning times and higher spatial resolution. However, CE-CCMRA and DS-CCTA have similar diagnostic accuracies.

Contrast opacification difference of mural artery and the transluminal attenuation gradient on coronary computed tomography angiography for detection of systolic compression of myocardial bridge.

Myocardial bridges (MB) have traditionally been considered a benign condition, but recent studies have demonstrated that the clinical complications can be dangerous. The transluminal attenuation gradient (TAG) obtained from coronary computed tomography angiography (CCTA) data (Retrospective ECG-triggered method) has been used in detecting significant stenosis in coronary artery caused by atherosclerosis. Contrast opacification difference (COD) was the parameters calculated as the change between attenuation of mural artery and the median attenuation of presumptive vessel segment; it was evaluated along with TAGstandardized (TAGs) and MB length for predicting MB with systolic compression (MB-SC) in patients diagnosed as MB in left anterior descending coronary artery (LAD) by CCTA or invasive coronary angiograph (ICA). A total of 107MB patients were divided into three groups based on systolic compression (SC), including: Group 1 (MB without SC); Group 2 (MB with mild SC); and Group 3 (MB with significant SC). ANOVA and Kruskal-Wallis analysis indicated TAGs showed the most significant differences for MB identification. This study revealed that TAGs decreasing and COD increasing were dominated in MB with significant SC. COD had a higher sensitivity and a higher negative predictive value for detecting MB with significant SC than TAGs.

Diagnostic accuracy of computed tomography angiography in detection of post traumatic renal vascular injury

ObjectivesTo evaluate accuracy of computed tomography angiography (CTA) in evaluation of post traumatic renal vascular injury. Patients and methods38 patients were presented with post traumatic intermittent or persistent hematuria. Renal CTA and digital subtraction angiography (DSA) were done for all patients. ResultsCTA demonstrated pseudoaneurysm (PA) in 30 patients (78.9%) and no vascular lesions in 8 patient (21.1%). CTA had 86.11% sensitivity and 50% specificity in detection of post traumatic renal pseudoaneurysms, CTA missed diagnosis of renal arteriovenous fistula (RAVF) in 10 patients which discovered later by DSA. ConclusionCTA with MIP as non invasive technique widely replaced renal DSA in detection of posttraumatic renal pseudoaneurysm. Renal DSA is still best modality in detection of RAVF and also has the upper hand in planning of selective renal artery embolization for the management of persistent or delayed hemorrhage from renal vessels.

GW26-e3541 Diagnostic accuracy of 320-slice dynamic volume computed tomography angiography for detection of coronary artery stenosis in patients with atrial fibrillation

To evaluate the diagnostic accuracy of 320-slice dynamic volume CT angiography (CTA) in assessment of coronary artery stenosis in patients with atrial fibrillation (AF) compared with selective coronary angiography (SCA). Seventy-two patients (49males, 63.9±12.5 years) with persistent AF were

Role of computed tomography angiography in detection and staging of small bowel carcinoid tumors.

Small-bowel carcinoid tumors are the most common form (42%) of gastrointestinal carcinoids, which by themselves comprise 70% of neuroendocrine tumors. Although primary small bowel neoplasms are overall rare (3%-6% of all gastrointestinal neoplasms), carcinoids still represent the second most common (20%-30%) primary small-bowel malignancy after small bowel adenocarcinoma. Their imaging evaluation is often challenging. State-of-the-art high-resolution multiphasic computed tomography together with advanced postprocessing methods provides an excellent tool for their depiction. The manifold interactive parameter choices however require knowledge of when to use which technique. Here, we discuss the imaging appearance and evaluation of duodenal, jejunal and ileal carcinoid tumors, including the imaging features of the primary tumor, locoregional mesenteric nodal metastases, and distant metastatic disease. A protocol for optimal lesion detection is presented, including the use of computed tomography enterography, volume acquisition, computed tomography angiography and three-dimensional mapping. Imaging findings are illustrated with a series of challenging cases which illustrate the spectrum of possible disease in the small bowel and mesentery, the range of possible appearances in the bowel itself on multiphase data and extraluminal findings such as the desmoplastic reaction in mesentery and hypervascular liver metastases. Typical imaging pitfalls and pearls are illustrated.

Sensitivity of 3D Gradient Recalled Echo Susceptibility-Weighted Imaging Technique Compared to Computed Tomography Angiography for Detection of Middle Cerebral Artery Thrombus in Acute Stroke.

We aimed at comparing the sensitivity of magnetic resonance (MR) susceptibility-weighted imaging (SWI) with computed tomography angiography (CTA) in the detection of middle cerebral artery (MCA) thrombus in acute stroke. Seventy-nine patients with acute MCA stroke was selected using our search engine software; only the ones showing restricted diffusion in the MCA territory on diffusion-weighted images were included. We finally selected 35 patients who had done both MRI (including SWI) and CTA. Twenty random subjects with completely normal MRI (including SWI) exam were selected as control. Two neuroradiologists (blinded to the presence or absence of stroke) reviewed the SW images and then compared the findings with CT angiogram (in patients with stroke). The number of MCA segments showing thrombus in each patient was tabulated to estimate the thrombus burden. Thrombus was detected on SWI in one or more MCA segments in 30 out of 35 patients, on the first review. Of the 30, SWI showed thrombus in more than one MCA segments in 7 patients. CTA depicted branch occlusion in 31 cases. Thrombus was seen on both SWI and CTA in 28 patients. Thrombus was noted in two patients on SWI only, with no corresponding abnormality seen on CTA. Two patients with acute MCA showed no vascular occlusion or thrombus on either CTA or SWI. Only two case of false-positive thrombus was reported in normal control subjects. Susceptibility-weighted images had sensitivity and specificity of 86% and 90% respectively, with positive predictive value 94%. Sensitivity was 86% for SWI, compared with 89% for CTA, and this difference was statistically insignificant (P>0.05). Of all the positive cases on CTA (31) corresponding thrombus was seen on SWI in 90% of subjects (28 of 31). Susceptibility-weighted imaging has high sensitivity for detection of thrombus in acute MCA stroke. Moreover, SWI is a powerful technique for estimation of thrombus burden, which can be challenging on CTA.

GW25-e4460 Diagnostic accuracy of 320-slice dynamic volume computed tomography angiography for detection of coronary artery stenosis compared with selective coronary angiography

GW25-e4460 Diagnostic accuracy of 320-slice dynamic volume computed tomography angiography for detection of coronary artery stenosis compared with selective coronary angiography

Multidetector Computed Tomography Angiography in Detection of Active Bleeding in Renal and Liver Transplant Recipients

Objectives The aim of this study was to evaluate the effectivity of multidetector computed tomography angiography (MDCT-A) to detect active bleeding in transplant patients. Materials and Methods Between 1999 and 2006, 532 patients underwent renal or liver transplantation. MDCT-A was performed on recipients who displayed decreased hemoglobin levels or who had a hematoma during abdominal ultrasound imaging. The MDCT-A used a 16-detector CT device (Siemens, Sensation) with slices 0.75 mm thick after injection of nonionic contrast media (4 mL per second). A multiple intensity projection (MIP) technique was used to maintain angiographic images in the axial and coronal planes. Results MDCT-A detected active bleeding among 23 posttransplant patients: 10 of arterial origin and 13 venous, as proven either by angiography or during operation. Among 8 of the 11 patients who underwent angiographic imaging the arterial origin was embolized. For three patients the angiographic evaluation was not helpful to find the bleeding point. A cohort of 5 of 12 patients did not undergo angiographic evaluation and were followed by clinical and ultrasonographic findings. Seven patients underwent re-operating. Discussion Management of the patients who were suspected to have active bleeding after renal or liver transplantation was benefitted by MDCT-A as an accurate and feasible screening modality.

4.60

4.60

Computed tomography angiography in detection and characterization of ruptured anterior cerebral artery aneurysms at uncommon location for emergent surgical clipping

Introduction Cerebral subarachnoid hemorrhage may result from rupture of saccular aneurysms at uncommon location [excluding the anterior communicating artery (ACOM)] of the anterior cerebral artery (ACA). The purpose of this study was to evaluate the usefulness of helical computed tomography angiography (CTA) in detection and characterization of intracranial aneurysms at such uncommon locations before emergent surgical clipping. Materials and methods Between 1998 and 2003, records for 50 consecutive patients who underwent emergent surgical clipping for intracranial aneurysms were reviewed. Eighteen of these patients had aneurysms in the ACA. After those patients with unequivocal ACOM aneurysms were excluded, eight patients with eight aneurysms in an uncommon location of the ACA were recruited to this study. Plain computed tomography (CT) and CTA were performed in eight patients, and digital subtraction angiographies were done in three patients. Each aneurysm was evaluated for the detection, quantification, and characterization of the aneurysms with 2D multiplanar reformatted and 3D volume-rendering techniques. Results There were two small aneurysms arising from the A1 segment, one from the A2 segment, two at the junction of triplicated ACAs, two at the junction of A2 and A3 segments, and one at the junction of A2 and A3 segments of the azygos ACA. The average diameter of the aneurysmal sac was 4.44 mm (range, 2.7–7.0 mm), and the aneurysmal neck averaged 2.59 mm (range, 1.2–3.5 mm) in size. The smallest aneurysm measured 2.2×1.8×2.7 mm (neck, 1.2 mm) in the A1 segment of the left ACA. Three patients had intracerebral hematoma, seven had intraventricular hemorrhage, and three had acute hydrocephalus. Conclusion Aneurysms in uncommon locations of ACAs exhibited characteristic features. Rupture of these aneurysms can cause intracerebral hematoma, intraventricular hemorrhage, and/or acute hydrocephalus. Noninvasive CTA can reliably detect and characterize intracranial aneurysms at such uncommon location for planning of emergent surgical intervention.

Three-dimensional computed tomographic angiography in detection of cerebral aneurysms in acute subarachnoid hemorrhage.

Three-dimensional computed tomographic angiography (CTA) is a recently developed imaging modality. We demonstrate the value of this noninvasive method in replacing digital subtraction angiography (DSA) in the detection of aneurysms of the circle of Willis in patients with subarachnoid hemorrhage admitted to our institution. A helical acquisition was performed for computed tomographic scans obtained for 120 patients with a 1 mm per second table speed and a 1-mm collimation, 1:1 pitch. Axial source images were transferred on a console Advantage Windows workstation (General Electric, Milwaukee, WI) and CTA was obtained using maximum intensity projection reconstruction. All patients had undergone DSA of the circle of Willis (80 patients preoperatively and 40 postoperatively). A total of 129 aneurysms were detected in 107 patients. Three-dimensional CTA disclosed nothing abnormal in 13 patients. Ninety-two patients sustained one aneurysm, 10 patients sustained two, 3 patients sustained three, and 2 patients sustained four. All results were confirmed by DSA. In two cases, aneurysms of the middle cerebral artery were defected by CTA but not by DSA. When using angiographic views, the aneurysm was always masked by a branch of the middle cerebral artery. The sensitivity of three-dimensional CTA is comparable with that of DSA, and its specificity is 100%. Because CTA is simple, quick, noninvasive, and reliable, we think that it can eventually replace DSA.