[Visualization of sinus node arteries by multislice spiral computed tomography coronary angiography].

OBJECTIVE: To assess the capabilities of multislice spiral computed tomography coronary angiography (MSCT-CA) to visualize the anatomy of the sinus node artery (SNA). MATERIAL AND METHODS: The retrospective analysis of coronary artery examinations covered 46 patients with the referral diagnosis of coronary heart disease. MSCT-CA showed no evidence of coronary artery stenosis. This sample included 23 (50%) men and 23 (50%) women; the mean age of the patients was 52.4 +/- 9.1 years; the mean height was 170 +/- 6.67 cm; the mean weight was 80.7 +/- 12.1 kg. X-ray computed tomography was carried out using a SOMATOM Definition AS+ 128-slice computed tomography scanner with retrospective ECG synchronization, reconstructed slice thicknesses of 1 and 3-mm. The Spearman correlation test was used for statistical data analysis. RESULTS: The SNA was visualized in 83% of the patients. It originated from the right coronary artery (RCA) and the circumflex branch of the left coronary artery in 84 and 16% of cases, respectively. No significant association was found between the type of heart blood supply and that of sinus node one (r = 0.06). In 18% of cases, the SNA was visualized only at the level of the ostium, allowing the assessment of the origin of the artery, and at the level of its mid-third in 32%; the distal SNA bed was visualized up to its division; in 10% of them the artery could be visualized all the way, including the division (the dissipation site). Unclear visualization of the proximal SNA was observed among 17% of the patients in whom the SNA could not be visualized with a heart rate (HR) of more than 80 beats/min in 62.5% of the patients, less than 41 beats/min in 12.5%, and 60-61 beats/min in 25%. HR was not found to be associated with the quality of SNA visualization (r = 0.09). CONCLUSION: MSCT can assess the anatomy of SNA up to the distal bed and dissipation site. In the overwhelming majority of the patients, the SNA originated from the RCA (84%) regardless of the type of heart blood supply. The best SNA visualization was noted with a HR of 50 to 80 beats per minute. There was no statistical relationship of the quality of visualization to HR.

[Computerized tomography in the diagnosis of congenital heart disease].

The aim of the work was to evaluate the possibility to use CT techniques (SCT and MRT) for the diagnosis of congenital heart disease. A total of 426 patient aged 0-54 years were examined (171 by MRT and 255 by SCT. SCT of the heart with bolus injection of a contrast medium was performed on an Evolution C-150 superfast tomograph in the step-scanning regime and prospective synchronization with ECG (slice thickness 1.5-3 mm). Fasting SCT was used to examine children in the first year of life during quiet (unforced) breathing. Contrast material (Omnipack-300, 350; Visipack-270, 320) was administered at a dose of 1.5-2.0 ml/ kg b.w. at 0.2-0.6 ml/s. MRT was performed using a conventional MR tomograph with a 1 T field and pulsed spin-echo sequences synchronized with ECG for obtaining the anatomic picture and gradient echo-signals (cine-MRT) for the assessment of functional parameters (slice thickness 4-7 mm). Babies were examined under medicamentous sedation. All images were treated and analysed using an Advantage Windows 2.0 workstation and a program package for heart image analysis. A rational procedure of CT and image analysis was developed in the course of the study. It provided data on the formation of all segments and intercommunications of the heart, mutual localization of its cavities and major vessels, permitted to perform morphometry of selected cardiac structures and detect anatomic defects. The informative and diagnostic value of methods for comprehensive evaluation of the heart and mediastinum in patients with congenital heart disease was assessed. Methods of choice for the diagnosis of abnormalities and follow-up of the patients in different periods after surgery were identified.

[Spiral computed tomography in aortic aneurysm diagnostics].

10-year experience of use of spiral computed tomography (CT) with bolus intravascular contrasting allowed the authors to determine the advantages of this method in aortic aneurysm diagnostics and to show the importance of its application in dynamic monitoring. The article also covers drawbacks of the method, which are not so significant as the advantages, because the CT method answers practically all surgeon's questions, including the length, localization of aneurism, presence of congenital vascular anomalies, fistulas, hemorrhages or prosthesis infection in postoperative period. CT meets all the diagnostic requirements and bears minimal risk while quickly giving enough information about anomalies of bloodstream and surrounding tissues in a certain patient.

[The problem of the accurate noninvasive diagnosis of left ventricular myocardial hypertrophy in essential hypertension: the role of magnetic resonance tomography]. / Problema tochnoi neinvazivnoi diagnostiki gipertrofii miokarda levogo zheludochka pri éssentsial'noi gipertonii: rol' magnitno-rezonansnoi tomografii.

MR-tomography was compared to echocardiography for efficacy in diagnosis of left ventricular hypertrophy in 55 patients with stage II essential (WHO criteria). Left ventricular myocardial mass estimated at echocardiography appeared significantly greater than this mass estimated at MR tomography: 244.0 +/- 9.0 g (MRT) and 359.8 +/- 15.6 g (echo-CG), respectively (p < 0.001).