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Objective:To explore the predictive value of modified chronic total occlusion (CTO) scores based on coronary computed tomography angiography (CCTA) for the outcome of CTO lesions after percutaneous coronary intervention (PCI).Methods:A total of sixty-six patients who had undergone CCTA examinations were retrospectively enrolled and divided into PCI-success group ( n=48) and PCI-failure group ( n=18). Age, body mass index (BMI), calcium score (CACS), location and extent of CTO occlusive segments were recorded and compared between the two groups using paired-samples t test. In addition, the differences of gender, hypertension, hyperlipidemia, hyperuricemia, diabetes mellitus, myocardial infarction and angina pectoris were analyzed by using chi-square test and Fisher exact test. J-CTO score based on CCTA images (J-CTO CT) was calculated. Furthermore, modified-CTO score (m-CTO CT) was measured by redefining the calcification degree (mild, severe) and range (full segment, part) in the J-CTO scoring system. Predictive value of J-CTO CT and m-CTO CT on recanalization success was evaluated by the receiver operating curve (ROC) analysis. Results:There were no significant differences in patients′ clinical indices between the two groups (all P>0.05). Compared to PCI-success group, blunt cap, blending>45 degrees, lesion length>20 mm, full calcification segment of lesion (χ 2=5.012, 3.999 and 4.103, respectively; P<0.05) occurred more frequently in the PCI-failure group. In addition, the incidence of occlusive calcification was significantly increased in the PCI-failure group ( P<0.05), as well as the total occlusive calcification ( P=0.001) and severe occlusive calcification ( P=0.000). Nevertheless, the rate of mild occlusive calcification was significantly higher in the PCI-success group ( P=0.037). There were no significant differences in calcification location, calcification score and extent of calcification ( P>0.05) between the two groups. The area under ROC (AUC) of m-CTO CT (0.921) was significantly higher than that of J-CTO CT (0.847, P<0.001). Conclusions:Morphological evaluation of CCTA is helpful to predict the surgical success in patients with PCI. m-CTO CT scoring shows higher predictive value compared to traditional J-CTO CT score.
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Objective@#To explore the predictive value of modified chronic total occlusion (CTO) scores based on coronary computed tomography angiography (CCTA) for the outcome of CTO lesions after percutaneous coronary intervention (PCI).@*Methods@#A total of sixty-six patients who had undergone CCTA examinations were retrospectively enrolled and divided into PCI-success group (n=48) and PCI-failure group (n=18). Age, body mass index (BMI), calcium score (CACS), location and extent of CTO occlusive segments were recorded and compared between the two groups using paired-samples t test. In addition, the differences of gender, hypertension, hyperlipidemia, hyperuricemia, diabetes mellitus, myocardial infarction and angina pectoris were analyzed by using chi-square test and Fisher exact test. J-CTO score based on CCTA images (J-CTOCT) was calculated. Furthermore, modified-CTO score (m-CTOCT) was measured by redefining the calcification degree (mild, severe) and range (full segment, part) in the J-CTO scoring system. Predictive value of J-CTOCT and m-CTOCT on recanalization success was evaluated by the receiver operating curve (ROC) analysis.@*Results@#There were no significant differences in patients′ clinical indices between the two groups (all P>0.05). Compared to PCI-success group, blunt cap, blending>45 degrees, lesion length>20 mm, full calcification segment of lesion (χ2=5.012, 3.999 and 4.103, respectively; P<0.05) occurred more frequently in the PCI-failure group. In addition, the incidence of occlusive calcification was significantly increased in the PCI-failure group (P<0.05), as well as the total occlusive calcification (P=0.001) and severe occlusive calcification (P=0.000). Nevertheless, the rate of mild occlusive calcification was significantly higher in the PCI-success group (P=0.037). There were no significant differences in calcification location, calcification score and extent of calcification (P>0.05) between the two groups. The area under ROC (AUC) of m-CTOCT (0.921) was significantly higher than that of J-CTOCT (0.847, P<0.001).@*Conclusions@#Morphological evaluation of CCTA is helpful to predict the surgical success in patients with PCI. m-CTOCT scoring shows higher predictive value compared to traditional J-CTOCT score.
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OBJECTIVE@#Differences in clinical features, especially facial nerve canal leision between cholesteatoma in external auditory meatus and middle ear were compaired.@*METHOD@#A retrospective clinical analysis was made. Clinical data included 125 cases of middle ear cholesteatoma with facial nerve canal leision and 28 cases of cholesteatoma occurred in external auditory canal from 2003-01-2014-08 in our hospital.@*RESULT@#Clinical course of cholesteatoma in external auditory canal was 4.97 ± 7.51 years, course of middle ear cholesteatoma was 16.60 ± 14.42 years (P < 0.01). 21 cases (75%) of external auditory canal cholesteatoma were manifested as pneumatic mastoid and 110 cases (88%) of middle ear cholesteatoma were manifested as diploic mastoid respectively. 22 cases (78.6%) of facial nerve canal damage-in mastoid segment in cholesteatoma of external auditory meatus and 76 cases (60.8%) of facial nerve canal damage in tympanic segment in cholesteatoma of middle ear were observed (P < 0.01). The incidence rate of ossicular errosion in middle ear chol-esteatoma was significantly higher than that in external auditory meatus (P < 0.01). The incidence of semicircular canal defects in middle ear cholesteatoma (30.4%), was significantly higher when comparing to the incidence (10.7%) in cholesteatoma of external auditory meatus (P < 0.05).@*CONCLUSION@#The site of facial nerve canal lesion in middle ear cholesteatoma and cholesteatoma of external auditory meatus were different. More attention should be paid before and during operation to avoid facial nerve injury, including physical examinations, especial otologic exams, radiological reading and careful operation.