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Xiong QF, Fu XR, Chen YJ, Zheng YB, Wang L, Zhang WS. Comparative Analysis of the Feasibility of Myocardial Blood Flow Index Versus CT-FFR in the Diagnosis of Suspected Coronary Artery Disease. Rev Cardiovasc Med 2024; 25:284. [PMID: 39228505 PMCID: PMC11367003 DOI: 10.31083/j.rcm2508284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/30/2024] [Accepted: 02/22/2024] [Indexed: 09/05/2024] Open
Abstract
Background Using fluid dynamic modeling, noninvasive fractional flow reserve (FFR) derived from coronary computed tomography angiography (CCTA) data provides better anatomic and functional information than CCTA, with a high diagnostic and discriminatory value for diagnosing hemodynamically significant lesions. Myocardial blood flow index (MBFI) based on CCTA is a physiological parameter that reflects myocardial ischemia. Thus, exploring the relationship between computed tomography derived fractional flow reserve (CT-FFR) and MBFI could be clinically significant. This study aimed to investigate the relationship between CT-FFR and MBFI and to analyze the feasibility of MBFI differing from CT-FFR in diagnosing suspected coronary artery disease (CAD). Methods Data from 61 patients (35 males, mean age: 59.2 ± 10.02 years) with suspected CAD were retrospectively analyzed, including the imaging data of CCTA, CT-FFR, and data of invasive coronary angiography performed within one week after hospitalization. CT-FFR and MBFI were calculated, and the correlation between MBFI or CT-FFR and invasive coronary angiography (ICA) was evaluated. Using ICA (value ≥ 0.70) as the gold standard and determining the optimal cutoff value via a diagnostic test, the diagnostic performance of MBFI or CT-FFR was evaluated. Results MBFI and CT-FFR were negatively correlated with ICA (r = -0.3670 and -0.4922, p = 0.0036 and 0.0001, respectively). Using ICA (value of ≥ 0.70) the gold standard, the optimal cutoff value was 0.115 for MBFI, and the area under the curve (AUC) was 0.833 (95% confidence interval [CI]: 0.716-0.916, Z = 5.357, p < 0.0001); using ICA (value of ≥ 0.70) the gold standard, the optimal cutoff value was 0.80 for CT-FFR, and the area under the curve (AUC) was 0.759 (95% CI: 0.632-0.859, Z = 3.665, p = 0.0002). No significant difference was observed between the AUCs of CT-FFR and MBFI (Z = 0.786, p = 0.4316). Conclusions MBFI based on CCTA can be used to evaluate myocardial ischemia similar to CT-FFR in suspected CAD; however, it should be noted that CT-FFR is a functional index based on the anatomical stenosis of the coronary artery, whereas MBFI is a physiological index reflecting myocardial mass remodeling.
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Affiliation(s)
- Qing-feng Xiong
- Image Center, Hainan Enhance International Medical Center, 571437 Boao, Hainan, China
- Image Center, Wuhan Asia Heart Hospital, 430022 Wuhan, Hubei, China
| | - Xiao-rong Fu
- Department of Pediatrics, Wuchang Hospital of Wuhan University of Science and Technology, 430062 Wuhan, Hubei, China
| | - Yi-ju Chen
- Image Center, Hainan Enhance International Medical Center, 571437 Boao, Hainan, China
| | - Ya-bo Zheng
- Image Center, Hainan Enhance International Medical Center, 571437 Boao, Hainan, China
| | - Liu Wang
- Image Center, Hainan Enhance International Medical Center, 571437 Boao, Hainan, China
| | - Wen-sheng Zhang
- Image Center, Hainan Enhance International Medical Center, 571437 Boao, Hainan, China
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2
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Maier J, Erath J, Sawall S, Fournié E, Stierstorfer K, Kachelrieß M. Raw data consistent deep learning-based field of view extension for dual-source dual-energy CT. Med Phys 2024; 51:1822-1831. [PMID: 37650780 DOI: 10.1002/mp.16684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/06/2023] [Accepted: 07/31/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Due to technical constraints, dual-source dual-energy CT scans may lack spectral information in the periphery of the patient. PURPOSE Here, we propose a deep learning-based iterative reconstruction to recover the missing spectral information outside the field of measurement (FOM) of the second source-detector pair. METHODS In today's Siemens dual-source CT systems, one source-detector pair (referred to as A) typically has a FOM of about 50 cm, while the FOM of the other pair (referred to as B) is limited by technical constraints to a diameter of about 35 cm. As a result, dual-energy applications are currently only available within the small FOM, limiting their use for larger patients. To derive a reconstruction at B's energy for the entire patient cross-section, we propose a deep learning-based iterative reconstruction. Starting with A's reconstruction as initial estimate, it employs a neural network in each iteration to refine the current estimate according to a raw data fidelity measure. Here, the corresponding mapping is trained using simulated chest, abdomen, and pelvis scans based on a data set containing 70 full body CT scans. Finally, the proposed approach is tested on simulated and measured dual-source dual-energy scans and compared against existing reference approaches. RESULTS For all test cases, the proposed approach was able to provide artifact-free CT reconstructions of B for the entire patient cross-section. Considering simulated data, the remaining error of the reconstructions is between 10 and 17 HU on average, which is about half as low as the reference approaches. A similar performance with an average error of 8 HU could be achieved for real phantom measurements. CONCLUSIONS The proposed approach is able to recover missing dual-energy information for patients exceeding the small 35 cm FOM of dual-source CT systems. Therefore, it potentially allows to extend dual-energy applications to the entire-patient cross section.
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Affiliation(s)
- Joscha Maier
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Julien Erath
- German Cancer Research Center (DKFZ), Heidelberg, Germany
- Heidelberg University, Heidelberg, Germany
| | - Stefan Sawall
- German Cancer Research Center (DKFZ), Heidelberg, Germany
- Heidelberg University, Heidelberg, Germany
| | | | | | - Marc Kachelrieß
- German Cancer Research Center (DKFZ), Heidelberg, Germany
- Heidelberg University, Heidelberg, Germany
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Böttcher B, Zsarnoczay E, Varga-Szemes A, Schoepf UJ, Meinel FG, van Assen M, De Cecco CN. Dual-Energy Computed Tomography in Cardiac Imaging. Radiol Clin North Am 2023; 61:995-1009. [PMID: 37758366 DOI: 10.1016/j.rcl.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
Dual-energy computed tomography (DECT) acquires images using two energy spectra and offers a variation of reconstruction techniques for improved cardiac imaging. Virtual monoenergetic images decrease artifacts improving coronary plaque and stent visualization. Further, contrast attenuation is increased allowing significant reduction of contrast dose. Virtual non-contrast reconstructions enable coronary artery calcium scoring from contrast-enhanced scans. DECT provides advanced plaque imaging with detailed analysis of plaque components, indicating plaque stability. Extracellular volume assessment using DECT offers noninvasive detection of myocardial fibrosis. This review aims to outline the current cardiac applications of DECT, summarize recent literature, and discuss their findings.
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Affiliation(s)
- Benjamin Böttcher
- Division of Cardiothoracic Imaging, Department of Radiology and Imaging Sciences, Emory University Hospital, 1364 Clifton Road NE, Suite D112, Atlanta, GA 30322, USA; Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Ernst-Heydemann-Strasse 6, 18057 Rostock, Germany
| | - Emese Zsarnoczay
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Clinical Science Building, 96 Jonathan Lucas Street, Suite 210, MSC 323 Charleston, SC 29425, USA; MTA-SE Cardiovascular Imaging Research Group, Medical Imaging Center, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary
| | - Akos Varga-Szemes
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Clinical Science Building, 96 Jonathan Lucas Street, Suite 210, MSC 323 Charleston, SC 29425, USA
| | - Uwe Joseph Schoepf
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Clinical Science Building, 96 Jonathan Lucas Street, Suite 210, MSC 323 Charleston, SC 29425, USA
| | - Felix G Meinel
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Centre Rostock, Ernst-Heydemann-Strasse 6, 18057 Rostock, Germany
| | - Marly van Assen
- Division of Cardiothoracic Imaging, Department of Radiology and Imaging Sciences, Emory University Hospital, 1364 Clifton Road NE, Suite D112, Atlanta, GA 30322, USA
| | - Carlo N De Cecco
- Division of Cardiothoracic Imaging and Imaging Informatics, Department of Radiology and Imaging Sciences, Emory University Hospital, Emory Healthcare, Inc. 1365 Clifton Road NE, Suite - AT503, Atlanta, GA 30322, USA.
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Panetta D, Gabelloni M, Faggioni L, Pelosi G, Aringhieri G, Caramella D, Salvadori PA. Cardiac Computed Tomography Perfusion: Contrast Agents, Challenges and Emerging Methodologies from Preclinical Research to the Clinics. Acad Radiol 2021; 28:e1-e13. [PMID: 32220550 DOI: 10.1016/j.acra.2019.12.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 12/20/2019] [Accepted: 12/24/2019] [Indexed: 12/19/2022]
Abstract
Computed Tomography (CT) has long been regarded as a purely anatomical imaging modality. Recent advances on CT technology and Contrast Agents (CA) in both clinical and preclinical cardiac imaging offer opportunities for the use of CT in functional imaging. Combined with modern ECG-gating techniques, functional CT has now become a reality allowing a comprehensive evaluation of myocardial global and regional function, perfusion and coronary angiography. This article aims at reviewing the current status of cardiac CT perfusion and micro-CT perfusion with established and experimental scanners and contrast agents, from clinical practice to the experimental domain of investigations based on animal models of heart diseases.
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Chen X, Wang G, Zhao L, Zhao J, Liu T, Zhao G, Han W. The value of coronary computed tomography angiography in assessing the cardiac circulation of an outpatient-based population. Medicine (Baltimore) 2020; 99:e23148. [PMID: 33181686 PMCID: PMC7668512 DOI: 10.1097/md.0000000000023148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
To evaluate the perfusion of coronary circulation and its related factors and the difference in the peak filling times in aortic sinus and coronary sinus by coronary computed tomography angiography (CCTA).From January 1 to August 1, 2018, 61 outpatients with angina pectoris were recruited, completed a questionnaire about risk factors and underwent CCTA, which was also used to assess the stenosis of different coronary artery segments.The duration of circulation was 9.50 ± 2.43 seconds in patients with flat T wave, which was shorter than the duration in normal subjects (P = .021). However, other cardiovascular risk factors showed no effect on the duration of circulation. In addition, the duration of circulation was closely related to the peak filling time of coronary sinus [r(s) = 0.681]. We further divided the circulation time difference (delta) values into 3 levels (<6, 6-12, and ≥12 seconds).It showed that the circulation duration (Y) was associated with:Therefore, the cardiac circulation duration was negatively related to the degree of stenosis in the 1 diagonal and proximal LCA.It compensates for the inability of CCTA to assess circulation at rest simply by determining the peak filling time in the aortic sinus and the coronary sinus. Moderate cardiac microcirculation duration was related to a low incidence of clinical symptoms and electrocardiogram disorders, which was determined mainly by the diagonal and left circumflex branch 1 of LCA.
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Kay FU. Dual-energy CT and coronary imaging. Cardiovasc Diagn Ther 2020; 10:1090-1107. [PMID: 32968662 PMCID: PMC7487394 DOI: 10.21037/cdt.2020.04.04] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 04/03/2020] [Indexed: 12/12/2022]
Abstract
Dual-energy computed tomography has been proposed for enhancing the evaluation of coronary artery disease in many fronts. However, the clinical translation of such applications has followed a slower pace of clinical translation. This paper will review the evidence supporting the use of dual-energy computed tomography in coronary artery disease (CAD) and provide some practical illustrations, while underscoring the challenges and gaps in knowledge that have contributed to this phenomenon.
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Affiliation(s)
- Fernando Uliana Kay
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Pan J, Yuan M, Yu M, Gao Y, Shen C, Wang Y, Lu B, Zhang J. Myocardial Blood Flow Quantified by Low-Dose Dynamic CT Myocardial Perfusion Imaging Is Associated with Peak Troponin Level and Impaired Left Ventricle Function in Patients with ST-Elevated Myocardial Infarction. Korean J Radiol 2020; 20:709-718. [PMID: 30993922 PMCID: PMC6470086 DOI: 10.3348/kjr.2018.0729] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 01/14/2019] [Indexed: 11/21/2022] Open
Abstract
Objective To investigate the association of myocardial blood flow (MBF) quantified by dynamic computed tomography (CT) myocardial perfusion imaging (MPI) with troponin level and left ventricle (LV) function in patients with ST-segment elevated myocardial infarction (STEMI). Materials and Methods Thirty-five STEMI patients who successfully had undergone reperfusion treatment within 1 week of their infarction were consecutively enrolled. All patients were referred for dynamic CT-MPI. Serial high-sensitivity troponin T (hs-TnT) levels and left ventricular ejection fraction (LVEF) measured by echocardiography were recorded. Twenty-six patients with 427 segments were included for analysis. Various quantitative parameters derived from dynamic CT-MPI were analyzed to determine if there was a correlation between hs-TnT levels and LVEF on admission and again at the 6-month mark. Results The mean radiation dose for dynamic CT-MPI was 3.2 ± 1.1 mSv. Infarcted territories had significantly lower MBF (30.5 ± 7.4 mL/min/100 mL versus 73.4 ± 8.1 mL/min/100 mL, p < 0.001) and myocardial blood volume (MBV) (2.8 ± 0.9 mL/100 mL versus 4.2 ± 1.1 mL/100 mL, p = 0.044) compared with those of reference territories. MBF showed the best correlation with the level of peak hs-TnT (r = −0.682, p < 0.001), and MBV showed a moderate correlation with the level of peak hs-TnT (r = −0.437, p = 0.026); however, the other parameters did not show any significant correlation with hs-TnT levels. As for the association with LV function, only MBF was significantly correlated with LVEF at the time of admission (r = 0.469, p = 0.016) and at 6 months (r = 0.585, p = 0.001). Conclusion MBF quantified by dynamic CT-MPI is significantly inversely correlated with the level of peak hs-TnT. In addition, patients with lower MBF tended to have impaired LV function at the time of their admission and at 6 months.
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Affiliation(s)
- Jingwei Pan
- Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Mingyuan Yuan
- Department of Radiology, Affiliated Zhoupu Hospital, Shanghai University of Medicine and Health Science, Shanghai, China
| | - Mengmeng Yu
- Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yajie Gao
- Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Chengxing Shen
- Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yining Wang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Bin Lu
- Department of Radiology, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiayin Zhang
- Institute of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
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Choe YH. A Glimpse on Trends and Characteristics of Recent Articles Published in the Korean Journal of Radiology. Korean J Radiol 2019; 20:1555-1561. [PMID: 31854145 PMCID: PMC6923209 DOI: 10.3348/kjr.2019.0928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Yeon Hyeon Choe
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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9
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Kang JH, Kim DH, Park SH, Baek JH. Age of Data in Contemporary Research Articles Published in Representative General Radiology Journals. Korean J Radiol 2018; 19:1172-1178. [PMID: 30386148 PMCID: PMC6201984 DOI: 10.3348/kjr.2018.19.6.1172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 09/01/2018] [Indexed: 12/13/2022] Open
Abstract
Objective To analyze and compare the age of data in contemporary research articles published in representative general radiology journals. Materials and Methods We searched for articles reporting original research studies analyzing patient data that were published in the print issues of the Korean Journal of Radiology (KJR), European Radiology (ER), and Radiology in 2017. Eligible articles were reviewed to extract data collection period (time from first patient recruitment to last patient follow-up) and age of data (time between data collection end and publication). The journals were compared in terms of the proportion of articles reporting the data collection period to the level of calendar month and regarding the age of data. Results There were 50, 492, and 254 eligible articles in KJR, ER, and Radiology, respectively. Of these, 44 (88%; 95% confidence interval [CI]: 75.8-94.8%), 359 (73%; 95% CI: 68.9-76.7%), and 211 (83.1%; 95% CI: 78-87.2%) articles, respectively, provided enough details of data collection period, revealing a significant difference between ER and Radiology (p = 0.002). The age of data was significantly greater in KJR (median age: 826 days; range: 299-2843 days) than in ER (median age: 570 days; range: 56-4742 days; p < 0.001) and Radiology (median age: 618; range: 75-4271 days; p < 0.001). Conclusion Korean Journal of Radiology did not fall behind ER or Radiology in reporting of data collection period, but showed a significantly greater age of data than ER and Radiology, suggesting that KJR should take measures to improve the timeliness of its data.
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Affiliation(s)
- Ji Hun Kang
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Dong Hwan Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Seong Ho Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
| | - Jung Hwan Baek
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
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Min JY, Ko SM, Song IY, Yi JG, Hwang HK, Shin JK. Comparison of the Diagnostic Accuracies of 1.5T and 3T Stress Myocardial Perfusion Cardiovascular Magnetic Resonance for Detecting Significant Coronary Artery Disease. Korean J Radiol 2018; 19:1007-1020. [PMID: 30386133 PMCID: PMC6201977 DOI: 10.3348/kjr.2018.19.6.1007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 04/11/2018] [Indexed: 11/15/2022] Open
Abstract
Objective To compare the diagnostic performance of cardiovascular magnetic resonance (CMR) myocardial perfusion at 1.5- and 3-tesla (T) for detecting significant coronary artery disease (CAD), with invasive coronary angiography (ICA) as the reference method. Materials and Methods We prospectively enrolled 281 patients (age 62.4 ± 8.3 years, 193 men) with suspected or known CAD who had undergone 1.5T or 3T CMR and ICA. Two independent radiologists interpreted perfusion defects. With ICA as the reference standard, the diagnostic performance of 1.5T and 3T CMR for identifying significant CAD (≥ 50% diameter reduction of the left main and ≥ 70% diameter reduction of other epicardial arteries) was determined. Results No differences were observed in baseline characteristics or prevalence of CAD and old myocardial infarction (MI) using 1.5T (n = 135) or 3T (n = 146) systems. Sensitivity, specificity, positive and negative predictive values, and area under the receiver operating characteristic curve (AUC) for detecting significant CAD were similar between the 1.5T (84%, 64%, 74%, 76%, and 0.75 per patient and 68%, 83%, 66%, 84%, and 0.76 per vessel) and 3T (80%, 71%, 71%, 80%, and 0.76 per patient and 75%, 86%, 64%, 91%, and 0.81 per vessel) systems. In patients with multi-vessel CAD without old MI, the sensitivity, specificity, and AUC with 3T were greater than those with 1.5T on a per-vessel basis (71% vs. 36%, 92% vs. 69%, and 0.82 vs. 0.53, respectively). Conclusion 3T CMR has similar diagnostic performance to 1.5T CMR in detecting significant CAD, except for higher diagnostic performance in patients with multi-vessel CAD without old MI.
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Affiliation(s)
- Jee Young Min
- Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Korea
| | - Sung Min Ko
- Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Korea
| | - In Young Song
- Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Korea
| | - Jung Geun Yi
- Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Korea
| | - Hweung Kon Hwang
- Department of Cardiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Korea
| | - Je Kyoun Shin
- Department of Thoracic Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Korea
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Sun K, Han R, Zhao R, Bai S, Wang J, Hu J, Lu B. Evaluation of dual energy computed tomography iodine mapping within the myocardial blood pool for detection of acute myocardial infarction: correlation with histopathological findings in a porcine model. Br J Radiol 2018; 91:20170569. [PMID: 29688745 DOI: 10.1259/bjr.20170569] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE We assessed the diagnostic value of "one-step" dual energy CT (DECT) in combination with coronary CT angiography and iodine mapping within the myocardial blood pool in detecting acute myocardial infarction (AMI). METHODS Five minipigs were subjected to transcatheter embolization of coronary artery with a gelatin sponge to induce AMI. Arterial-phase myocardial DECT imaging was carried out 1 h before and 24 h after embolism of the coronary. Color-coded iodine maps were used to evaluate myocardial blood pool deficits in the 17-segment model. Myocardial DECT imaging 24 h after MI induction was used for final comparison with post-mortem histology. RESULTS We found a sensitivity of 95.55% and a specificity of 95%, respectively, for AMI detection by DECT-based iodine mapping within the myocardial blood pool. The dose-length product values were 219.4 ± 60.9 mGy.cm (172-321 mGy.cm) and the effective radiation dose was 5.7 ± 1.5 mSv (4.4-8.3 mSv). CONCLUSION This experimental study demonstrated that DECT-based iodine mapping shows a high value for the detection of myocardial perfusion defects in the first-pass myocardial perfusion. Hybrid heart images obtained by coronary CT angiography and DECT-based iodine mapping may yield valuable data and help clinicians accurately identify cases requiring further treatment after AMI. Advances in knowledge: This study demonstrated that DECT-based iodine mapping is a promising new technique for the detection of myocardial perfusion defects in the first-pass myocardial perfusion.
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Affiliation(s)
- Kai Sun
- 1 Department of Radiology, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China.,2 Department of Radiology, Baotou Central Hospital, Inner Mongolia , Baotou , China
| | - Ruijuan Han
- 3 Translational Medicine Research Center, Baotou Central Hospital, Inner Mongolia , Baotou , China
| | - Ruiping Zhao
- 3 Translational Medicine Research Center, Baotou Central Hospital, Inner Mongolia , Baotou , China
| | - Shuancheng Bai
- 2 Department of Radiology, Baotou Central Hospital, Inner Mongolia , Baotou , China
| | - Junyan Wang
- 2 Department of Radiology, Baotou Central Hospital, Inner Mongolia , Baotou , China
| | - Jiang Hu
- 3 Translational Medicine Research Center, Baotou Central Hospital, Inner Mongolia , Baotou , China
| | - Bin Lu
- 1 Department of Radiology, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China
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Yan GW, Bhetuwal A, Yang GQ, Fu QS, Hu N, Zhao LW, Chen H, Fan XP, Yan J, Zeng H, Zhou Q. Congenital absence of the right coronary artery: A case report and literature review. Medicine (Baltimore) 2018; 97:e0187. [PMID: 29561437 PMCID: PMC5895321 DOI: 10.1097/md.0000000000010187] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
RATIONALE Congenital absence of the right coronary artery (RCA) is a rare congenital malformation of the cardiovascular system which may have fatal consequences. PATIENT CONCERNS A 63-year-old man with a 5-year history of chest pain after exertion which had aggravated for >1 month was advised for admission and computed tomography angiography (CTA) examination of the coronary artery to screen for coronary artery disease (CAD). DIAGNOSES The coronary artery CTA showed absence of RCA arising form the aortic root after which a selective coronary angiography (SCA) examination was done that confirmed the diagnosis of congenital absence of RCA. INTERVENTIONS As the patient refused to receive a coronary artery stent implantation citing his financial condition, only symptomatic treatment was given. OUTCOMES The patient requested to be discharged from the hospital against the advice of his doctors 1 week later. A query made by the telephone suggested that the patient's symptoms were under control by use of prescribed medications only. LESSONS Although being a rare condition, a coronary artery CTA examination can be utilized to screen for congenital absence of RCA and other varieties of cardiovascular malformation whereas SCA can be performed to confirm the diagnosis.
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Affiliation(s)
- Gao-Wu Yan
- Department of Radiology, Suining Central Hospital, Suining
| | - Anup Bhetuwal
- Sichuan Key Laboratory of Medical Imaging and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan Province, China
| | - Guo-Qing Yang
- Department of Radiology, Suining Central Hospital, Suining
| | - Quan-Shui Fu
- Department of Radiology, Suining Central Hospital, Suining
| | - Na Hu
- Department of Radiology, Suining Central Hospital, Suining
| | - Lin-Wei Zhao
- Department of Radiology, Suining Central Hospital, Suining
| | - Hong Chen
- Department of Radiology, Suining Central Hospital, Suining
| | - Xiao-Ping Fan
- Department of Radiology, Suining Central Hospital, Suining
| | - Jing Yan
- Department of Radiology, Suining Central Hospital, Suining
| | - Hao Zeng
- Department of Radiology, Suining Central Hospital, Suining
| | - Qing Zhou
- Department of Radiology, Suining Central Hospital, Suining
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