Objective To prospectively investigate the diagnostic accuracy for coronary artery stenosis of prospectively electrocardiogram-triggered spiral acquisition mode (high pitch mode) dual-source computed tomography corona...Objective To prospectively investigate the diagnostic accuracy for coronary artery stenosis of prospectively electrocardiogram-triggered spiral acquisition mode (high pitch mode) dual-source computed tomography coronary angiography (CTCA) in patients with relatively higher heart rates (HR) compared with catheter coronary angiography (CCA). Methods Forty-seven consecutive patients with relatively higher HR (>65 and <100 bpm) (20 male, 27 female; age 55±10 years) who both underwent dual-source CTCA and CCA were prospectively included in this study. All patients were performed CTCA using high pitch mode setting at 20%-30% of the R-R interval for the image acquisition. All coronary segments were evaluated by two blinded and independent observers with regard to image quality on a three-point scale (1: excellent to 3: non-diagnostic) and for the presence of significant coronary stenoses (defined as diameter narrowing exceeding 50%). Considered CCA as the standard of reference, the sensitivity, specificity, positive predictive value and negative predictive value were calculated. Radiation dose values were calculated using the dose-length product. Results Image quality was rated as being score 1 in 92.4% of segments, score 2 in 6.1% of segmentsand score 3 in 1.5% of segments. The average image quality score per segment was 1.064±0.306. The HR variability of patients with image score 1, 2 and 3 were 2.29±1.06 bpm, 5.17±1.37 bpm, 8.88±1.53 bpm, respectively. The average HR variability of patients with different image scores were significantly different (F=170.402, P=0.001). The sensitivity, specificity, positive and negative predictive values were 92.6%, 97.0%, 87.6%, 98.3%, respectively, per segment and 90.0%, 95.2%, 85.3%, 96.9%, respectively, per vessel and 100%, 63.6%, 90.0%, 100%, respectively, per patient. The effective radiation dose was on average 0.86±0.16 mSv. Conclusion In patients with HR more than 65 bpm and below 100 bpm without cardiac arrhythmia, the prospectively electrocardiogram-gated high-pitch spiral acquisition mode with image acquired timing set at 20%-30% of the R-R interval provides a high diagnostic accuracy for the assessment of coronary stenoses combined with a 1.5% of non-diagnostic coronary segments and a radiation dose below 1 mSv.展开更多
Objective: To make a further understanding of the features of the carotid body tumor (CBT) by digital subtraction angiography (DSA) so as to explore the clinical value of DSA diagnosis and interventional therapy for C...Objective: To make a further understanding of the features of the carotid body tumor (CBT) by digital subtraction angiography (DSA) so as to explore the clinical value of DSA diagnosis and interventional therapy for CBT. Methods: DSA data from 12 cases of CBT were analyzed retrospectively. A consensus interpretation of the DSA appearances in all of the patients was reached after dynamic observation by 2 experienced radiologists in a double blind manner. Results: Definite diagnosis in all cases could be made by DSA. The DSA features of the CBT included bigger bifurcation angles of the internal and external carotid arteries, displacement of internal and external carotid arteries, CBT supplied by external carotid arteries in most cases and the significant increase of tumor blood vessels in bifurcation. Invasion of internal or external carotid arteries was found in 6 cases. Smaller stained area of the tumor and significantly reduced intraoperative bleeding were found after embolization of the supplying arteria in 2 cases. Conclusion: DSA is the effective method for the diagnosis and preoperative assessment of CBT. Preoperative embolization of CBT may contribute to the reduced intraoperative bleeding.展开更多
基金Supported by the Ministry of Science and Technology of Inner Mongolia, China (20110504)
文摘Objective To prospectively investigate the diagnostic accuracy for coronary artery stenosis of prospectively electrocardiogram-triggered spiral acquisition mode (high pitch mode) dual-source computed tomography coronary angiography (CTCA) in patients with relatively higher heart rates (HR) compared with catheter coronary angiography (CCA). Methods Forty-seven consecutive patients with relatively higher HR (>65 and <100 bpm) (20 male, 27 female; age 55±10 years) who both underwent dual-source CTCA and CCA were prospectively included in this study. All patients were performed CTCA using high pitch mode setting at 20%-30% of the R-R interval for the image acquisition. All coronary segments were evaluated by two blinded and independent observers with regard to image quality on a three-point scale (1: excellent to 3: non-diagnostic) and for the presence of significant coronary stenoses (defined as diameter narrowing exceeding 50%). Considered CCA as the standard of reference, the sensitivity, specificity, positive predictive value and negative predictive value were calculated. Radiation dose values were calculated using the dose-length product. Results Image quality was rated as being score 1 in 92.4% of segments, score 2 in 6.1% of segmentsand score 3 in 1.5% of segments. The average image quality score per segment was 1.064±0.306. The HR variability of patients with image score 1, 2 and 3 were 2.29±1.06 bpm, 5.17±1.37 bpm, 8.88±1.53 bpm, respectively. The average HR variability of patients with different image scores were significantly different (F=170.402, P=0.001). The sensitivity, specificity, positive and negative predictive values were 92.6%, 97.0%, 87.6%, 98.3%, respectively, per segment and 90.0%, 95.2%, 85.3%, 96.9%, respectively, per vessel and 100%, 63.6%, 90.0%, 100%, respectively, per patient. The effective radiation dose was on average 0.86±0.16 mSv. Conclusion In patients with HR more than 65 bpm and below 100 bpm without cardiac arrhythmia, the prospectively electrocardiogram-gated high-pitch spiral acquisition mode with image acquired timing set at 20%-30% of the R-R interval provides a high diagnostic accuracy for the assessment of coronary stenoses combined with a 1.5% of non-diagnostic coronary segments and a radiation dose below 1 mSv.
文摘Objective: To make a further understanding of the features of the carotid body tumor (CBT) by digital subtraction angiography (DSA) so as to explore the clinical value of DSA diagnosis and interventional therapy for CBT. Methods: DSA data from 12 cases of CBT were analyzed retrospectively. A consensus interpretation of the DSA appearances in all of the patients was reached after dynamic observation by 2 experienced radiologists in a double blind manner. Results: Definite diagnosis in all cases could be made by DSA. The DSA features of the CBT included bigger bifurcation angles of the internal and external carotid arteries, displacement of internal and external carotid arteries, CBT supplied by external carotid arteries in most cases and the significant increase of tumor blood vessels in bifurcation. Invasion of internal or external carotid arteries was found in 6 cases. Smaller stained area of the tumor and significantly reduced intraoperative bleeding were found after embolization of the supplying arteria in 2 cases. Conclusion: DSA is the effective method for the diagnosis and preoperative assessment of CBT. Preoperative embolization of CBT may contribute to the reduced intraoperative bleeding.
