Coronary computed tomography for the interventionalist

2010 ◽  
pp. 182-197
Author(s):  
P.J. de Feijter ◽  
C. Schultz
Keyword(s):  
Computed Tomography ◽  
Coronary Atherosclerosis ◽  
Invasive Coronary Angiography ◽  
Invasive Technique ◽  
Ct Scanner ◽  
Diagnostic Quality ◽  
Coronary Computed Tomography ◽  
Non Invasive ◽  
Coronary Ct ◽  
Ct Scanners

In recent years coronary computed tomography (CT) has developed as a spectacular non-invasive technique to visualize the coronary arteries and its manifestations of coronary atherosclerosis. The coronary CT scanner has rapidly evolved from the initial 4-and 16-slice CT scanners, to the now considered state-of-the-art 64-slice CT scanners, while 256- and 320-slice CT-prototype scanners have now been introduced for clinical evaluation. It is expected that the CT technique will further evolve and eventually will become of sufficient diagnostic quality that it may replace invasive coronary angiography (CA) to reliably assess both non-obstructive and obstructive coronary lesions.

scholarly journals Low Dose versus Standard Single Heartbeat Acquisition Coronary Computed Tomography Angiography

2018 ◽  
Vol 8 ◽  
pp. 52
Author(s):  
Ernesto Di Cesare ◽  
Alessandra Di Sibio ◽  
Antonio Gennarelli ◽  
Margherita Di Luzio ◽  
Ines Casazza ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Comparative Analysis ◽  
Image Quality ◽  
Radiation Dose ◽  
Effective Dose ◽  
Computed Tomography Angiography ◽  
Coronary Computed Tomography Angiography ◽  
Ct Scanner ◽  
Diagnostic Quality ◽  
Coronary Computed Tomography

Purpose: The aim of this study was to compare image quality and mean radiation dose between two groups of patients undergoing coronary computed tomography angiography (CCTA) using a 640-slice CT scanner with two protocols with different noise level thresholds expressed as standard deviation (SD). Materials and Methods: Two-hundred and sixty-eight patients underwent a CCTA with 640 slice CT scanner. In the experimental group (135 patients), an SD 51 protocol was employed; in the control group (133 patients), an SD 33 protocol was used. Mean effective dose and image quality with both objective and subjective measures were assessed. Image quality was subjectively assessed using a five-point scoring system. Segments scoring 2, 3, and 4 were considered having diagnostic quality, while segments scoring 0 and 1 were considered having nondiagnostic quality. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) between the two groups as well as the effective radiation dose (ED) was finally assessed. Results: Comparative analysis considering diagnostic quality (2, 3, and 4 score) and nondiagnostic (score 0 and 1) quality demonstrated that image quality of SD 51 group is not significantly lower than that of S33 group. The noise was significantly higher in the SD 51 group than in the SD 33 group (P < 0.0001). The SNR and CNR were higher in the SD 33 group than in SD 51 group (P < 0.0001). Mean effective dose was 49% lower in the SD 51 group than in SD 33 group; indeed mean effective dose was 1.43 mSv ± 0.67 in the SD 51 group while it was 2.8 mSv ± 0.57 in the SD 33 group. Conclusion: Comparative analysis shows that using a 640-slice CT with a 51 SD protocol, it is possible to reduce the mean radiation dose while maintaining good diagnostic image quality.

Invasive and non-invasive (computed tomography) angiography

ESC CardioMed ◽  
2018 ◽  
pp. 1348-1353
Author(s):  
Stephan Achenbach
Keyword(s):  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Computed Tomography Angiography ◽  
Coronary Computed Tomography Angiography ◽  
Invasive Coronary Angiography ◽  
Coronary Computed Tomography ◽  
Non Invasive ◽  
Artery Disease

For diagnosis and treatment planning of patients with stable coronary artery disease, coronary angiography is of particular importance. Invasive coronary angiography is a robust and accurate method for the identification of coronary artery stenoses and occlusions, with the option for immediate intervention. Due to its invasiveness, its small, but not negligible risk for complications, and the fact that angiographic stenosis severity does not closely correspond with ischaemia, coronary angiography is not a first-line test in patients with suspected coronary artery disease. Invasive coronary angiography should be performed when non-invasive testing indicates the presence of relevant ischaemia, when symptoms are compelling and cannot be controlled by medication, or when symptoms are accompanied by reduced left ventricular ejection fraction. In order to determine the presence or absence of ischaemia, invasive coronary angiography can be complemented by fractional flow reserve measurements. Coronary computed tomography angiography is a non-invasive alternative method to visualize the coronary lumen, but requires careful patient selection, data acquisition, and processing. It is not as stable and robust as invasive coronary angiography. However, the use of coronary computed tomography angiography can be considered in patients with a low-to-intermediate risk for coronary artery disease in order to rule out coronary artery stenoses when patient characteristics indicate a high likelihood of fully diagnostic image quality.

Non-invasive coronary angiography with multi-detector computed tomography: comparison to conventional X-ray angiography

2005 ◽  
Vol 21 (1) ◽  
pp. 63-72 ◽  
Author(s):  
Paul Schoenhagen ◽  
Arthur E. Stillman ◽  
Sandy S. Halliburton ◽  
Stacie A. Kuzmiak ◽  
Tracy Painter ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Angiography ◽  
Invasive Coronary Angiography ◽  
X Ray ◽  
Non Invasive ◽  
Multi Detector Computed Tomography

scholarly journals Comparison of diagnostic accuracy of computed tomography virtual endoscopy and flexible fibre-optic laryngoscopy in the evaluation of neck anatomic structures and neoplasms

2020 ◽  
pp. 197140092095723
Author(s):  
Angela Guarnizo ◽  
Rafael Glikstein ◽  
Vered Tsehmaister-Abitbul ◽  
Ionut Busca ◽  
Samy El-Sayed ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Diagnostic Accuracy ◽  
Virtual Endoscopy ◽  
Observer Agreement ◽  
Invasive Technique ◽  
Fibre Optic ◽  
Vocal Cords ◽  
Non Invasive ◽  
Laryngeal Lesions ◽  
Mcnemar’S Test

Background and purpose Computed tomography virtual endoscopy (CT-VE) is a non-invasive technique which allows visualisation of intraluminal surfaces by tridimensional reconstruction of air/soft tissues. The aim of this study was to compare the diagnostic accuracy of CT-VE and flexible fibre-optic laryngoscopy (FFL) in identifying normal neck anatomic structures and pharyngeal and laryngeal lesions. Methods Forty-two patients with a history of neck cancer were assessed by two ENT surgeons using FFL and by one neuroradiologist using CT-VE in order to evaluate the visualisation of the epiglottis, vallecula, glossoepiglottic folds, pyriform sinuses, vocal cords and mass pathology. The visualisation of the structures in both modalities was assessed according to the following score: 0 = not visualised, 1 = partial visualisation, 2 = complete and clear visualisation. A weighted kappa coefficient was used to evaluate the inter-observer agreement. McNemar’s test was performed to compare the two diagnostic tests. Results The inter-observer agreement between FFL and CT-VE was fair in the assessment of the vocal cords ( k = 0.341); moderate in the assessment of the glossoepiglottic folds ( k = 0.418), epiglottis ( k = 0.513) and pyriform sinuses ( k = 0.477); and substantial in the assessment of the vallecula ( k = 0.618) and the tumour (0.740). McNemar’s test showed no significant difference between the two tests ( p<0.05). Conclusion CT-VE is a non-invasive technique with a diagnostic accuracy comparable to FFL in terms of visualisation of anatomical structures and pharyngeal and laryngeal lesions.

Sign in / Sign up

Export Citation Format

Share Document