ABSTRACT
【Objective】 To evaluate the effect of one-beat acquisition with wide detector CT on the image quality and diagnostic efficiency of coronary CT angiography (CCTA) in patients with atrial fibrillation. 【Methods】 A total of 52 consecutive patients with atrial fibrillation, including 31 males, (67.32±11.45) years old, who underwent CCTA from July 2022 to February 2023, were analyzed retrospectively. All patients underwent one-beat acquisition CCTA. The subjective and objective image quality of the coronary arteries was evaluated, and using invasive coronary catheter angiography as the gold standard, the diagnostic efficacy of stenosis degrees above moderate and severe degrees was calculated, respectively. 【Results】 Subjective evaluation results: 92.31% (384/416) of the vascular segments were rated as excellent or good, and the diagnosable rate reached 98.08% (408/416, subjective score ≥3 points). Objective evaluation results: The CT value of the right coronary artery, anterior descending branch, and circumflex branch was (433.41±95.17)HU, (422.69±92.81)HU and (420.27±95.43)HU, respectively; the contrast-to-noise ratio was 38.46±7.54, 32.46±13.78 and 37.74±8.89, respectively. The total diagnostic accuracy, sensitivity, and specificity was 94.71%, 87.9% and 96.62%, respectively, for moderate stenosis and 96.15%, 83.64% and 98.06% for severe stenosis. 【Conclusion】 One-beat acquisition with wide detector CT can obtain high-quality coronary artery images and high diagnostic accuracy for patients with atrial fibrillation without radiation dose increase to patients. It has good clinical application value for patients with atrial fibrillation.
ABSTRACT
China's CDC novel coronavirus pneumonia emergency response mechanism was announced on February 17, 2020. As of February 11, novel coronavirus had infected 3 019 medical staff (including 1 716 confirmed cases; suspected cases, clinically diagnosed cases and cases of asymptomatic infections). The reports showed that more than 80% of the patients were medical workers in general wards, which might be caused by nosocomial infection due to inadequate protection. Radiographers, who encounter patients in different departments of the hospital, also have the risk of occupational exposure to novel coronavirus pneumonia caused by strong viral infection, inadequate protection, and poor immunity. Therefore, the emergency plan is formulated for this risk in order to ensure their safety and the orderly progress of the work, provide practical basis for the future improvement and development of the emergency plan for radiographers to respond to emergent public events, and also provide ideas for peers to deal with emergencies.
ABSTRACT
Objective: To explore the causes and countermeasures of venous air embolism (VAE) after injection of contrast medium during chest CTA. Methods: Totally 4 900 patients who underwent chest CTA were collected consecutively. The incidence, number, size, location, shape and other information of VAE were observed. Results: The incidence of VAE was 4.65% (228/4 900). A total of 318 air emboli were found in 228 patients, in which 285 manifested as air bubbles and 33 as air-liquid planes. There were 155 emboli located in the right atrium, 108 in the main pulmonary artery, 17 in the superior vena cava, 13 in the right ventricle, 13 in the left cephalombrachial vein and 12 in the right cephalombrachial vein, with the average diameter of (2.41±1.45) mm. Small amount of VAE was 90.35% (206/228), medium amount of VAE was 9.65% (22/228), and no large amount of VAE was found. There was no significant difference of the incidence of VAE among different genders, patient types (inpatients/outpatients), examination equipments, contrast agent types nor injection dose (all P>0.05). The incidence of VAE after coronary CTA (193/3 771, 5.12%) was higher than that after thoracic aorta CTA (25/849, 2.94%, P=0.007). Conclusion: The incidence of VAE is low. Most VAEs are asymptomatic after injection of contrast medium during chest CTA examination, but radiologists should still pay attention to VAE and take appropriate measures to avoid or reduce the incidence of VAE.
ABSTRACT
Objective: To evaluate the impact of intracoronary administration of eptifibatide oncoronary no-reflow and myocardium perfusion in patients with ST-elevation myocardial infarction (STEMI) at percutaneous coronary intervention (PCI). Methods: A total of 80 STEMI patients with emergent PCI were randomly divided into 2 groups: Eptifibatide group, the patients received intracoronary administration of eptiifbatide and Control group, the patients received the same volume of normal saline.n=40 in each group. The baseline condition, post-operative vascular recanalization, changes of platelet aggression at pre- and post-medication were compared between 2 groups. Echocardiography was examined at immediately and 24 weeks after operation;myocardial infusion imaging was examined at l week after operation. All patients were followed-up for 24 weeks to observe the incidence of major adverse cardiovascular events (MACE). Results: Compared with Control group, Eptifibatide group showed increased ratios of post-operative TIMI grade 3 (72.5%vs 92.5%) and myocardium perfusion (70.0% vs 90.0%), bothP0.05; no severe bleeding eventand no in-hospital thrombocytopeniaoccurred. MACE occurrence rates during 24-week follow-up period were 12.5% vs 22.5%, P>0.05. Conclusion: Intracoronary administration of eptiifbatide in STEMI patients at emergent PCI could effectively improve coronary blood lfow,increase myocardium perfusion and enhance cardiac function without severe bleeding events.