Coronary CT in Patients with a History of PCI or CABG: Helpful or Harmful?

Improving diagnostic assessments in the ever-changing landscape of atherosclerosis

As our understanding of atherosclerotic vascular injury continues to evolve, so should our diagnostic approaches. Emerging data have recently challenged our basic understanding in linking ischemia to its adverse outcomes as well as the need for invasive testing for both diagnosis and treatment. The advent of coronary computed tomography in providing improved visualization of coronary arteries has led to the identification of both subclinical atherosclerosis and high-risk coronary lesions. Recognition of asymptomatic coronary artery disease (CAD) with objective localization of subclinical coronary atherosclerosis improves atherosclerotic cardiovascular risk assessment and allows healthcare providers to take effective primary prevention measures. Therefore, reshaping the diagnostic landscape in proposing new testing modalities would be highly dependent on local resource availability and the reading expertise of each clinical practice and medical institution. The main objective of this Review is to propose a potentially new diagnostic approach of simply using noninvasive stress testing or coronary angiography in the routine assessment of CAD.

Evaluation of the Effect of Refined Nursing Intervention on Coronary CT Imaging Microscopy

The aim is to study the benefits of using advanced medical services for coronary CT angiography. From August 2019 to August 2020, 50 patients who underwent CT angiography were selected and divided into control groups and study groups, with 25 patients in each group. The monitoring team provides basic support, and the training team provides maximum support. Experimental results showed that the positive microscopic image of the study group after the intervention was better than that of the control group, and the stress score was lower than that of the control group (P < 0.05 s and30.73 ± 9.57 min) and are short (58.32 ± 13.15seconds and53.17 ± 11.84minutes) between control groups, with significant differences. The significance is (P < 0.05. Patient care is relevant to patients with coronary CT angiography, which has been shown to improve heart rate, reduce stress, improve microscopic imaging, and provide relevant liver function tests. It is recommended to promote the show.

Exploring the best monochromatic energy level in dual energy spectral imaging for coronary stents after percutaneous coronary intervention

In this study, the optimal monochromatic energy level in dual-energy spectral CT required for imaging coronary stents after percutaneous coronary intervention (PCI) was explored. Thirty-five consecutive patients after PCI were examined using the dual-energy spectral CT imaging mode. The original images were reconstructed at 40–140 keV (10-keV interval) monochromatic levels. The in-stent and out-stent CT values at each monochromatic level were measured to calculate the signal-to-noise ratio(SNR) and contrast-to-noise ratio (CNR) for the vessel and the CT value difference between the in-stent and out-stent lumen (dCT (in–out)), which reflects the artificial CT number increase due to the beam hardening effect caused by the stents. The subjective image quality of the stent and in-stent vessel was evaluated by two radiologists using a 5-point scale. With the increase in energy level, the CT value, SNR, CNR, and dCT (in–out) all decreased. At 80 keV, the mean CT value in-stent reached (345.24 ± 93.43) HU and dCT (in–out) started plateauing. In addition, the subjective image quality of the stents and vessels peaked at 80 keV. The 80 keV monochromatic images are optimal for imaging cardiac patients with stents after PCI, balancing the enhancement and SNR and CNR in the vessels while minimizing the beam hardening artifacts caused by the stents.