Accuracy of ultra-high–resolution computed tomography with a 0.3-mm detector for quantitative assessment of coronary artery stenosis grading in comparison with conventional computed tomography: A phantom study

Author(s):  
Minoru Yamada ◽  
Yoshitake Yamada ◽  
Takehiro Nakahara ◽  
Shigeo Okuda ◽  
Takayuki Abe ◽  
...  
2018 ◽  
Vol 82 (7) ◽  
pp. 1844-1851 ◽  
Author(s):  
Sadako Motoyama ◽  
Hajime Ito ◽  
Masayoshi Sarai ◽  
Yasuomi Nagahara ◽  
Keiichi Miyajima ◽  
...  

Author(s):  
Sebastian Gassenmaier ◽  
Ilias Tsiflikas ◽  
Simon Greulich ◽  
Jens Kuebler ◽  
Florian Hagen ◽  
...  

Abstract Objectives To evaluate computed tomography fractional flow reserve (FFRCT) values in distal parts of the coronaries in an asymptomatic cohort of marathon runners without any coronary stenosis for potentially false-positive values. Methods Ninety-eight asymptomatic male marathon runners (age 53 ± 7 years) were enrolled in a prospective monocentric study and underwent coronary computed tomography angiography (CCTA). CCTA data were analyzed for visual coronary artery stenosis. FFRCT was evaluated in 59 participants without coronary artery stenosis in proximal, mid, and distal coronary sections using an on-site software prototype. Results In participants without coronary artery stenosis, abnormal FFRCT values ≤ 0.8 in distal segments were found in 22 participants (37%); in 19 participants in the LAD; in 5 participants in the LCX; and in 4 participants in the RCA. Vessel diameters in participants with FFRCT values > 0.80 compared to ≤ 0.80 were 1.6 ± 0.3 mm versus 1.5 ± 0.3 mm for distal LAD (p = 0.025), 1.8 ± 0.3 mm versus 1.6 ± 0.5 mm for distal LCX (p = 0.183), and 2.0 ± 0.4 mm versus 1.5 ± 0.2 mm for distal RCA (p < 0.001). Conclusions Abnormal FFRCT values of ≤ 0.8 frequently occurred in distal coronary segments in subjects without any anatomical coronary artery stenosis. This effect is only to some degree explainable by small distal vessel diameters. Therefore, the validity of hemodynamic relevance evaluation using FFRCT in distal coronary artery segment stenosis is reduced. Key Points • Abnormal FFRCT values (≤ 0.8) occurred in over a third of the subjects in the distal LAD despite the absence of coronary artery stenosis.. • Therefore, the validity of hemodynamic relevance evaluation in distal coronary artery segment stenosis is reduced. • Decision-making based on abnormal FFRCT values in distal vessel sections should be performed with caution and only in combination with visual assessment of the grade of stenosis..


2013 ◽  
Vol 82 (2) ◽  
pp. 264-269 ◽  
Author(s):  
Matthias Dettmer ◽  
Nicola Glaser-Gallion ◽  
Paul Stolzmann ◽  
Florian Glaser-Gallion ◽  
Juergen Fornaro ◽  
...  

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Patricia M Carrascosa ◽  
Carlos Capuñay ◽  
Jorge Carrascosa ◽  
Alejandro Deviggiano ◽  
Alejandro Goldsmit ◽  
...  

Introduction: MDCT coronary angiography has been evolving as a noninvasive method for the assessment of coronary artery disease (CAD). More recently, It has been demonstrated that MDCT identifies reduced contrast enhancement in ischemic and/or scarred myocardial segments. Objective: to determine the ability of rest-stress multidetector computed tomography (RS-MDCT) to detect myocardial ischemia and to assess the relationship between MDCT myocardial perfusion abnormalities and coronary artery stenosis. Methods: Forty seven patients underwent stress/rest 99mTc sestamibi SPECT and RS-MDCT, using a 16-row detector scanner (Philips Brilliance-16). Myocardial segments were classified by SPECT as normal, ischemic or scarred. SPECT results were then compared with MDCT regional myocardial contrast enhancement. The results of MDCT coronary angiography were also analyzed in 20 patients who underwent invasive catheterization. Results: The presence of a reduction in contrast enhancement at rest by MDCT identified scar by SPECT with 96% sensitivity and 98% specificity. A stress-induced reduction in contrast enhancement by MDCT identified ischemia by SPECT with 77% sensitivity and 99% specificity. The segment-based sensitivity and specificity for the detection of significant stenosis by MDCT were 92% and 98%, respectively. Conclusion: Our results showed that a rest-dipyridamole stress MDCT protocol can identify the presence of myocardial ischemia as well as the severity of coronary artery stenosis in patients with suspected coronary artery disease.


Sign in / Sign up

Export Citation Format

Share Document