Cardiovascular examination with 3.0 Tesla magnetic resonance imaging: first 100 cases at Ramathibodi Hospital.

BACKGROUND: Cardiovascular magnetic resonance imaging (CMR) has been utilized for diagnosis in various cardiovascular diseases and most of those were performed on a 1.5 Tesla CMR system. Recently, a 3.0 Tesla magnetic resonance imaging system has been introduced into clinical practice, however the clinical experience on cardiovascular examination using this system is limited. Therefore, the authors' institution has integrated a team for developing a CMR program on this 3.0 Tesla system. OBJECTIVE: To describe the authors' experience on the 3.0 Tesla CMR system. MATERIAL AND METHOD: The data on patients referred to the authors' CMR unit between August 2004 and October 2005 were reviewed. RESULTS: One hundred patients were referred for CMR examination. The mean age was 56 years (2 month - 85 years) and 65 patients were male. The most common indication was to assess coronary artery disease (64 patients). The performed examination was divided into cardiac structure and function assessment (39%), stress testing (23%), coronary magnetic resonance angiography (13%), myocardial viability assessment (12%), magnetic resonance angiography (9%), and flow assessment (4%). CONCLUSION: The present study highlights that comprehensive assessment of various cardiovascular diseases can be performed on the 3.0 Tesla CMR system.

Accuracy of sixteen-slice CT scanners in detected coronary artery disease.

BACKGROUND: The coronary artery disease, now, the incidence is increasing in both developed and developing countries. The investigation is evoluted and non-invasive multislice CT scanners have been used more frequently, although the gold standard is still the coronary angiography. OBJECTIVE: To investigate the accuracy in detected coronary artery disease by using 16-slice CT scanners compared to the conventional coronary angiography. MATERIAL AND METHOD: Fifty-five patients were 43 males, 12 females, median aged 62 years (43-82 years), and average heart rates 67 beats/minute (46-147 beats/minute) had the ECG-gated CT angiography followed by coronary angiography in 3 months. The ECG-gated CT angiography was performed by using 16-slice MSCT detector (0.42-s rotation time, 16 x 0. 75-mm detector collimation). RESULTS: All patients were classified into two major groups; one was significant coronary artery stenosis which was designed by stenosis at least 50% and the other was non-significant stenosis which was designed by normal or stenosis less than 50%. The site having blooming artifact due to calcification that causes complete obliteration of the lumen or having significant motional artifacts was ruled out. There were 285 evaluable sites in 19 patients with high heart rates, more than 70 beats/minute. The sensitivity, specificity, and accuracy in significant stenosis were 72.9%, 99.6%, and 94.0% respectively. In 36 patients with a lower heart rate, there were 563 evaluable sites, the sensitivity was 86.5%, specificity was 98.5%, and accuracy was 96.6%. The overall showed 81.1% of sensitivity, 98.9% of specificity, and 95.8% of accuracy. CONCLUSION: The accuracy of the 16-slice CT angiography for patients suspected of having coronary artery disease was high. However, blooming artifacts from the calcium, respiratory artifacts, and small size of the distal and branching artery still caused limited luminal assessment. These problems have challenged the new coming generation of MDCT.

Cardiac CT angiography: comprehensive assessment of patient suspected coronary artery disease.

Coronary artery disease is the leading cause of mortality and morbidity worldwide. Although coronary angiography is currently a gold standard for diagnosis of coronary artery disease, some patients are of concern regarding small but not negligible risk of complications and discomfort of the procedure. In recent years, cardiac computerized tomographic angiography (CTA) is an attractive non-invasive modality for evaluation of chest pain in patients suspected to have coronary artery disease. The authors report a 61 year-old-man with a history of hypertension and hypercholesterolemia who presented with exertional angina pectoris for 3 weeks. Cardiac CTA was performed and revealed a severely stenotic lesion at the proximal left anterior descending coronary artery (LAD) with left ventricular ejection fraction of 53% and hypokinesia of anteroseptal and apical wall. The patient then was planned and underwent percutaneous coronary interventional procedure. This case highlights the utility of comprehensive information from cardiac CTA as a modality for coronary interventional procedure planning.