Abstract 152: Tri-Dimentional Fusion Image of Multidetector 64-Slice-Computed Tomography and Single-Photon Emission Computed Tomography enables us to Evaluate Complicated Hemodynamics in Patients with Coronary Artery Lesions after Kawasaki Disease

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Masanori Abe ◽  
Makoto Watanabe ◽  
Ryuji Fukazawa ◽  
Shunichi Ogawa
Keyword(s):  
Myocardial Infarction ◽  
Computed Tomography ◽  
Coronary Artery ◽  
Kawasaki Disease ◽  
Myocardial Ischemia ◽  
Fusion Imaging ◽  
Emission Computed Tomography ◽  
Coronary Artery Lesions ◽  
Collateral Arteries ◽  
Fusion Images

Introduction: An important complication of Kawasaki disease (KD) is myocardial ischemia and acute myocardial infarction which occurs by thrombosis in coronary aneurysms and severe stenosis. The most characteristic features of coronary artery lesions (CALs) are dilation or aneurysm in acute stage and stenosis after convalescence stage. As these lesions exist singly or multiply in one coronary branch or multiple branches, coronary hemodynamics can be complicated. Ordinal methods have less potential for detection of these diseased states. Recently, Fusion imaging from coronary CT angiography (CTA) /SPECT has been thought good method for evaluation of location and severity of myocardial damages in adults. Therefore, we evaluate CALs, ischemia, and infarction after KD by Fusion imaging. Patients and Method: Seventeen patients (16 males and 1 female, age10 to 34 y) were subject. Eight patients had coronary artery bypass grafting (CABG). These tests were performed 8 to 30 years after onset of KD. CTA are performed by 64-slice-CT (LightSpeed VCT:GE Healthcare) ,and SPECT (Infinia:GE) by Tc-tetrofosmin was performed at rest and at stress after infusing adenosine. CTA and SPECT images were fused by the software (CardIQ Fusion:GE). Results and findings: In all cases, we had enough good images to detect the location of CALs and the area of ischemia. 1) Fusion images showed that no patient had significant stenotic findings at the anastomosis of bypass-graft at least several years after CABG. 2) Coronary native small branches arose from giant aneurysm were occluded by thrombosis and sub-aneurysmal lesions were infracted which were not detected by ordinal method. 3) Minimum sized myocardial ischemic lesions along to the normal visual epicardial coronary artery were detected and were suspected the existence of abnormal micro-coronary circulation caused by fibrous plaque or micro-thrombosis. 4) Collateral arteries at the stenotic and/or occluded lesions with or without ischemia were clearly detected by Fusion method. conclusion: Fusion images can visualize morphologically and functionally complicated CALs, myocardial ischemia ,and myocardial infarction after KD. Also, we can realize that peripheral coronary vessels are damaged with myocardial ischemia.

Localization of Post-Infarction Myocardial Ischemia by 201T1 Emission Computed Tomography

1985 ◽  
Vol 24 (05) ◽  
pp. 201-205
Author(s):  
C. A. Nienaber ◽  
H. Heinemann ◽  
R. Montz ◽  
R. P. Spielmann
Keyword(s):  
Myocardial Infarction ◽  
Computed Tomography ◽  
Coronary Artery ◽  
Myocardial Ischemia ◽  
Coronary Vessels ◽  
Emission Computed Tomography ◽  
Infarct Zone ◽  
Significant Stenosis ◽  
Emission Computed ◽  
History Of

SummaryIn 41 patients with a history of a single myocardial infarction, the location of myocardial ischemia was studied by 201T1 emission computed tomography immediately and 3 h after intravenous dipyridamole. Distant ischemia was distinguished from periinfarctional ischemia by the presence of transient thallium defects in, or slow thallium washout from, myocardium not supplied by the infarct-related coronary artery. Distant ischemia occurred in 13 patients and was always accompanied by peri-infarctional ischemia. Peri-infarctional ischemia without distant ischemia was observed in 15 patients. The occurrence of distant ischemia was found to be dependent on the severity of stenosis in non-infarct coronary vessels. Twelve (86%) of 14 patients with non-infarct stenosis of 75% or greater had distant ischemia, but only 1 (4%) of 27 patients with non-infarct stenosis of less than 75%. In the presence of distant ischemia, peri-infarctional ischemia was in 11 patients (85%) associated with collaterals supplying the infarct zone, whereas in 13 (87%) of the patients with peri-infarctional ischemia only, incomplete obstruction of the infarct vessel was observed. It is concluded that, by the distinction between peri-infarctional and distant is-chemia, the presence of significant stenosis in non-infarct vessels can be non-invasively predicted from tomographic thallium scintigraphy with dipyridamole.Dedicated to Prof. Dr. med. C. Schneider on the occasion of his 60th birthday.

The 30-Year Outcome for Patients After Myocardial Infarction Due to Coronary Artery Lesions Caused By Kawasaki Disease

2010 ◽  
Vol 32 (2) ◽  
pp. 176-182 ◽  
Author(s):  
Etsuko Tsuda ◽  
Takuya Hirata ◽  
Osamu Matsuo ◽  
Tadaaki Abe ◽  
Hisashi Sugiyama ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Kawasaki Disease ◽  
Coronary Artery Lesions

scholarly journals Adult Patients of Kawasaki Disease with Acute Myocardial Infarction Who had not been Pointed Out Coronary Artery Lesions Previously

2003 ◽  
Vol 53 (1) ◽  
pp. 178-178
Author(s):  
Yasuhiko Mori ◽  
Hiroshi Katayama ◽  
Tatsuo Shimizu ◽  
Toshio Shimizu ◽  
Kenichi Okumura ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Coronary Artery ◽  
Kawasaki Disease ◽  
Adult Patients ◽  
Coronary Artery Lesions

scholarly journals Quantification of myocardial ischemia and subtended myocardial mass at adenosine stress cardiac computed tomography: a feasibility study

2021 ◽  
Author(s):  
F. Y. van Driest ◽  
R. J. van der Geest ◽  
A. Broersen ◽  
J. Dijkstra ◽  
M. el Mahdiui ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Myocardial Ischemia ◽  
Perfusion Defect ◽  
Visual Analysis ◽  
Left Ventricular ◽  
Coronary Artery Lesion ◽  
Adenosine Stress ◽  
Coronary Artery Lesions ◽  
Myocardial Mass

AbstractCombination of coronary computed tomography angiography (CCTA) and adenosine stress CT myocardial perfusion (CTP) allows for coronary artery lesion assessment as well as myocardial ischemia. However, myocardial ischemia on CTP is nowadays assessed semi-quantitatively by visual analysis. The aim of this study was to fully quantify myocardial ischemia and the subtended myocardial mass on CTP. We included 33 patients referred for a combined CCTA and adenosine stress CTP protocol, with good or excellent imaging quality on CTP. The coronary artery tree was automatically extracted from the CCTA and the relevant coronary artery lesions with a significant stenosis (≥ 50%) were manually defined using dedicated software. Secondly, epicardial and endocardial contours along with CT perfusion deficits were semi-automatically defined in short-axis reformatted images using MASS software. A Voronoi-based segmentation algorithm was used to quantify the subtended myocardial mass, distal from each relevant coronary artery lesion. Perfusion defect and subtended myocardial mass were spatially registered to the CTA. Finally, the subtended myocardial mass per lesion, total subtended myocardial mass and perfusion defect mass (per lesion) were measured. Voronoi-based segmentation was successful in all cases. We assessed a total of 64 relevant coronary artery lesions. Average values for left ventricular mass, total subtended mass and perfusion defect mass were 118, 69 and 7 g respectively. In 19/33 patients (58%) the total perfusion defect mass could be distributed over the relevant coronary artery lesion(s). Quantification of myocardial ischemia and subtended myocardial mass seem feasible at adenosine stress CTP and allows to quantitatively correlate coronary artery lesions to corresponding areas of myocardial hypoperfusion at CCTA and adenosine stress CTP.

scholarly journals Quantification of myocardial ischemia and subtended myocardial mass at adenosine stress cardiac computed tomography. A feasibility study

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
F Van Driest ◽  
R J Van Der Geest ◽  
A Broersen ◽  
J Dijkstra ◽  
M El Mahdiui ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Myocardial Ischemia ◽  
Perfusion Defect ◽  
Visual Analysis ◽  
Left Ventricular ◽  
Coronary Artery Lesion ◽  
Adenosine Stress ◽  
Coronary Artery Lesions ◽  
Myocardial Mass

Abstract Introduction Combination of computed tomography angiography (CTA) and adenosine stress CT myocardial perfusion (CTP) allows for coronary artery lesion assessment as well as myocardial ischemia. Nowadays, ischemia on CTP is assessed semi-quantitatively by visual analysis. The aim of this study was to fully quantify myocardial ischemia and the subtended myocardial mass on CTP. Methods We included 33 patients referred for a combined CTA and adenosine stress CTP with good or excellent imaging quality on CTP. Firstly, the coronary artery tree was automatically extracted from CTA and the relevant coronary artery lesions (≥50%) were manually defined (Fig. 1A). Secondly, epi- and endocardial contours along with CTP deficits were manually defined in short-axis images (Fig. 1D, 1E). Thirdly, a Voronoi-based algorithm was used to quantify the subtended myocardial mass (Fig. 1B). Fourthly, the perfusion defect and subtended myocardial mass were spatially registered to the CTA and measured in grams (Fig. 1F, 1C). Finally, this can be used to quantitatively correlate the perfusion defect to the subtended myocardial mass. Results Voronoi-based segmentation was successful in all cases. We assessed a total of 64 relevant coronary artery lesions. Average values for left ventricular mass, total subtended mass and perfusion defect mass were 118, 69 and 7 grams respectively. In 19/33 patients (58%) the total perfusion defect mass could be distributed over the relevant coronary artery lesion(s). Conclusions Quantification of myocardial ischemia and subtended myocardial mass using a Voronoi-based segmentation algorithm seem feasible at adenosine stress CTP and allows for quantitative correlation of coronary artery lesions to corresponding areas of myocardial hypoperfusion. FUNDunding Acknowledgement Type of funding sources: None. Figure 1

Magnetocardiographic recognition of abnormal depolarization and repolarization in patients with coronary artery lesions caused by Kawasaki disease

2019 ◽  
Vol 34 (10) ◽  
pp. 1571-1579
Author(s):  
Wataru Tamaki ◽  
Etsuko Tsuda ◽  
Syuji Hashimoto ◽  
Tamami Toyomasa ◽  
Mikiya Fujieda
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Coronary Artery Lesions
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