ABSTRACT
AIMS: To identify causes of misinterpretation in second generation, dual-source coronary computed tomography angiography (CCTA). METHODS: A retrospective re-interpretation was performed on 100 consecutive CCTA studies, previously performed with a 2×128 slice dual-source CT. Results were compared with coronary angiography (CA). CCTA and CA images were interpreted by 2 independent readers. At CCTA vessel diameter, image quality, plaque characteristics and localization (bifurcation vs. non) were described for all segments. Finally, aortic contrast-to-noise ratio (CNR) and the total Agatston calcium score were quantified. Agreement between CCTA and CA was assessed with the Kappa statistic after categorizing the stenosis severity at significant (≥50%) and critical (≥70%) cut-offs, and independent predictors of disagreement were determined by multivariable logistic regression, including patient characteristics such as body mass index (BMI), heart rate (HR), age and gender. RESULTS: Per-segment sensitivity and specificity at ≥50% and ≥70% stenosis was of 83-95%, and 73-97%, respectively. There was a substantial agreement between CCTA and CA (kappa-50%=0.78, SE=0.03; kappa-70%=0.72, SE=0.03). Worse motion-related quality score, smaller vessel diameter, calcification within the segment of interest and LAD location were independent predictors of disagreement at 50% stenosis. The same factors, excluded LAD location, in addition to bifurcation-location of the coronary lesion predicted misdiagnosis at 70% stenosis. HR per se and BMI did not predict disagreement. CONCLUSION: According to the literature a substantial agreement between CCTA and CA was found. However, discrepancies exist and are mainly related with motion-related degradation of image quality, specific vessel anatomy and plaque characteristics. Awareness of such potential limitations may help guiding interpretation of CCTA.
Subject(s)
Computed Tomography Angiography/methods , Coronary Angiography/methods , Coronary Artery Disease/diagnostic imaging , Electrocardiography/methods , Female , Heart Rate , Humans , Male , Middle Aged , Reproducibility of Results , Retrospective Studies , Sensitivity and Specificity , Severity of Illness IndexABSTRACT
Objetivo: Analisar a prevalência de lesões dos tecidos moles causadas por próteses removíveis, em pacientes atendidos na Clínica Asa Branca da Faculdade de Odontologia de Caruaru (FOC), Pernambuco, Brasil. Método: Um estudo transversal foi realizado por meio da revisão de 842 prontuários de pacientes atendidos no ano de 2005, todavia, foram excluídos 232 prontuários por apresentarem dados incompletos ou ausentes. Resultados: Verificou-se que dos 610 prontuários, 39,5% (n=241) dos pacientes apresentavam algum tipo de lesão causada por prótese removível. As lesões encontradas foram estomatite protética (n=206/78,0%), hiperplasia fibrosa (n=39/14,8%), queilite angular(n=13 - 4,9%) e hiperplasia papilar inflamatória (n=6/2,3%); 84,1% (n=222) eram do sexo feminino, sendo observada uma razão de feminilidade de 5,02:1; 24,8% (n=151) tinham de 41 a 50 anos; e 56,4% residiam na própria cidade onde é oferecido o serviço. Conclusão: A prevalência de lesões causadas por prótese removível é alta, quando comparada às demais lesões dos tecidos moles, principalmente estomatite protética.
