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<p><b>OBJECTIVE</b>To assess the image quality, diagnostic accuracy and effective radiation dose of prospectively ECG- triggered high-pitch spiral double scanning (Double Flash) mode of computed tomography coronary angiography (CTCA) using dual-source CT for the diagnosis of significant coronary stenoses.</p><p><b>METHODS</b>Patients underwent both CTCA in Double Flash mode and conventional coronary angiography (CAG) and were divided into two groups according to heart rate (HR), namely group A with HR <65/min (62 cases) and group B with HR between 65 and 80/min (52 cases). All the coronary segments were evaluated by two blinded and independent observers for image quality on a four-point scale and for the presence of significant coronary stenoses (defined as a diameter narrowing exceeding 50%). CAG served as the reference standard for analyzing the diagnostic accuracy of Double Flash mode images on the level of both patients and vessels. Radiation dose values were calculated using the dose-length product.</p><p><b>RESULTS</b>A total of 114 patients were enrolled and 1725 vessel segments were displayed. In terms of image quality, the diagnosable segments accounted for 98.5% (919/933) in group A and 97.3% (770/792) in group B. In the per-patient analysis, the diagnostic sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 100%, 90.5%, 88.2%, 100% and 96.7% in group A and were 100%, 88.5%, 94.5%, 100% and 96.2% in group B, respectively. The mean effective radiation dose was 1.63∓0.52 mSv.</p><p><b>CONCLUSION</b>Double Flash spiral protocol of dual-source CTCA can acquire good image quality and yield high diagnostic accuracy for assessment of coronary artery stenoses at a low radiation dose in patients with HR between 65 and 80/min.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Cardiac-Gated Imaging Techniques , Coronary Angiography , Coronary Stenosis , Diagnosis , Diagnostic Imaging , Pathology , Coronary Vessels , Diagnostic Imaging , Heart Rate , Radiation Dosage , Sensitivity and Specificity , Tomography, Spiral ComputedABSTRACT
@#Objective To evaluate the feasibility and the value of videodensitometric scale(VDS)assessing myocardial microperfusion.Methods The small coronary arteries of 11 dogs were embolized by ejecting polystyrene microbubble(dm= 100 μm),six embolized at left anterior descending branch(LAD)and five embolized at left circumflex branch(LCX).Coronary angiography was performed before and after the embolization.The myocardial contrast echocardiography(MCE)was performed in 12th hour after embolization.VDS was calculated according to coronary angiography.MCE scales were calculated.Results Among the eleven experimental dogs,VDS before embolization was 24.4±4.9 and that after embolization was 15.2±3.8.VDS after embolization was obviously lower than before embolization(P<0.05).VDS between LAD and LCX at the same stage was no difference;MCE scores after embolization were 7.6±2.4.VDS was negatively dependent with MCES after embolization(γ=-0.78,P<0.05).Conclusion As a newly quantitative index and keeping a closely correction with MCE,VDS can be used as a quantitative index to assess myocardial microperfusion in clinic.
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@#Objective To evaluate the feasibility and the value of video density scale (VDS) for assessing myocardial microperfusion.MethodsVDS and corrected TIMI frame counted (CTFC) were calculated and compared in 58 cases undergoing coronary catheter angiography.ResultsVDS of 58 cases was (22.5±5.8)and 95% confidence interval of normal myocardial microperfusion is(20.2,24.7).The CTFC was (21.1±4.5).It showed negative correlation between VDS and CTFC.ConclusionVDS is feasible to assess myocardial microperfusion quantificationally.The possibility of myocardial microperfusion dysfunction would be increased when VDS is lower than 20.
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Objective To evaluate the diagnostic significance of ECG and coronary arteriography (CAG) in coronary heart disease in different age groups. Methods totally 216 cases of suspected or CAG-confirmed coronary heart disease were retrospectively analyzed. The non-elderly group included patients aged 45-59 years, and the elderly one was older than 60. Patients in each group were further divided into subgroup A and B with or without the pain in heart front area, respectively, accompanied by ST-T change in ECG. Comparative analysis of CAG and ECG changes was done between different age groups, and between subgroup A and B. The history of pain in heart front area, serum total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), platelet count (PLT), and fibrinogen (Fg) were also analyzed for clinical diagnosis. Results In the non-elderly, positive CAG was 88.8% in subgroup A while 56.3% in group B ( P0.05). TC, LDL-C, and Fg were significantly higher in subgroup A than in subgroup B for the elderly group. But in non-elderly, TC, TG, LDL-C, and Fg in subgroup A were significantly higher than those in subgroup B(all P0.05). The history of pain in heart front area was longer in the elderly, and also in this age group, more patients showed multivessel involvement. Conclusions ST-T change of ECG accompanied by classical pain in heart front area is more valuable than single ST-T change in the diagnosis of coronary heart disease, especially among non-elderly patients. ST-T change could not be used simply as a tool to diagnose coronary heart disease. The diagnosis should be made generally considering the typical symptom of the pain in heart front area, clinical history, TC, TG, LDL-C, and Fg. CAG could increase the positive diagnostic rate of coronary heart disease and decrease the rate of misdiagnosis as well.
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This paper reported the results of balloon pulmonary valvuloplasty for 8 patients (single-balloon for 7 cases,double-balloon for 1 case).The meanpulmonary valve orifice in diameter (PVOD) was dilated from 8.4?2.2 preoperation to 16.4?1.5mm of postoperation,the systolic pressure in rightventricle (RV)was reduced from 16.9?5.3 to 9.1?3.8kPa,the pressure gradient from RV to pulmonary artery was reduced from 14.9?5.1 to 6.6?2.9 kPa,the cardiac index was increased from 3.2?0.3 to-5.1?0.7L/min m-2.The symptoms and heart murmur were nearly,subsided after treatment,the patients dischargd within 5 days after operation.PBPV is a nonoperative procedure with good efffect and.safety.