Objective:Coronary artery anatomical variations and anomalies are an important topic due to their potential clinical manifestations.This study aims to investigate the prevalence of coronary artery anatomical variation...Objective:Coronary artery anatomical variations and anomalies are an important topic due to their potential clinical manifestations.This study aims to investigate the prevalence of coronary artery anatomical variations and anomalies in symptomatic patients with coronary computed tomography angiography(CCTA).Methods:This is a retrospective study that included all symptomatic patients who had CCTA in a tertiary care hospital in Saudi Arabia during a period of seven years.Results:The total number of included patients was 507(60%males)with a mean age of 57.4 years.Approximately 41%had luminal stenoses,averaging 49.7%.The total num-ber of patients with coronary anatomical variations(CAV)and coronary artery anomalies(CAA)was 217(43%).CAV prevalence was 26%,which included 14%non-right coronary dominance,5%short left main coronary artery(LMCA),and 7%division variations(trifurcation and quadrifurcarion)of the LMCA.The prevalence of CAA was 29%,which included 5%origin anomalies,22%myocardial bridge,and 2%course anomalies.Conclusions:A high prevalence of coronary artery anatomic variations and anomalies in symptomatic patients is reported in this study.Systematic reviews,meta-analyses,reporting guidelines,and unified definitions and classifications of cor-onary variations and anomalies are lacking in the literature,presenting potential opportunities for future research and publications.展开更多
Objectives To investigate the morphologic characteristics of intramural hematoma(IMH)on CT angiography(CTA),and evaluate the possible correlation of serum C-reactive protein(CRP)with morphologic characteristics of IMH...Objectives To investigate the morphologic characteristics of intramural hematoma(IMH)on CT angiography(CTA),and evaluate the possible correlation of serum C-reactive protein(CRP)with morphologic characteristics of IMH.Material and Methods Forty-two patients who were initially diagnosed as IMH by aortic CTA and also had serum CRP examination on the same day of CTA were enrolled in this retrospective study,including 30 males and 12 females,with the mean age of 61±14 years old.The volumetric CT data were retrospectively processed and analyzed on post-processing workstation.Based on the thickness of IMH and the length-area curve,the crosssectional area of true lumen and total vessel were measured,the hematoma-vessel ratio(HVR)was calculated.Imaging characteristics were compared between patients who had pathological elevated CRP(>0.8 mg/dl)and those did not.Spearman correlation analyses of CRP level and morphological characteristics of IMH were performed,and the receiver operating characteristic(ROC)curve was used to evaluate the diagnostic validity of CRP.Results Of all 42 IMH patients,the mean serum CRP was 3.94±4.71 mg/dl,and the mean HVR was 46.7%±14.2%.HVR in patients with elevated CRP was significantly higher than those with normal CRP(49.7%±15.0%vs.40.7%±10.5%,P=0.030).HVR was mildly correlated with CRP in all patients(r=0.48,P<0.001).CRP levels differed neither between patients with Stanford type A and B(P=0.207),nor between patients with and without intimal disruption(P=0.230).To discriminate HVR>47%(the mean value),the area under curve(AUC)were 0.700(95%CI:0.535-0.865)for CRP at a cutoff point of 3.55 mg/dl,with a sensitivity of 54.5%and a specificity of 90.0%.Conclusion CRP was mildly correlated with the severity of cross-sectional hematoma area of IMH,but not with Stanford types and the presence of intimal disruption.展开更多
目的探讨基于冠状动脉CT血管成像(CCTA)的人工智能(AI)诊断系统及CT无创血流储备分数(CT-FFR)在评估高海拔地区冠状动脉临界病变结构及功能学中的应用价值。方法前瞻性收集2022年1月~2023年10月青海大学附属医院冠心病临界病变患者164例...目的探讨基于冠状动脉CT血管成像(CCTA)的人工智能(AI)诊断系统及CT无创血流储备分数(CT-FFR)在评估高海拔地区冠状动脉临界病变结构及功能学中的应用价值。方法前瞻性收集2022年1月~2023年10月青海大学附属医院冠心病临界病变患者164例,按居住地海拔进行分组,其中2000~3000m为A组(n=83),3000m以上为B组(n=81),再将两组患者按冠脉狭窄程度细分为50%~60%亚组(n=84)和61%~70%亚组(n=80)。将患者冠状动脉CT血管成像数据导入AI辅助诊断及CT-FFR测量系统,以冠脉造影及冠脉传统血流储备分数(FFR)为金标准,分别评价AI及CT-FFR在高海拔地区冠脉临界病变诊断中的应用。结果以FFR为金标准,CT-FFR与FFR的一致性为83.75%。B组钙化斑块、易损斑块高于A组(P=0.037、0.020);B组冠状动脉多支病变、61%~70%狭窄程度发生率均高于A组(P<0.05);A组、B组在61%~70%亚组钙化斑块、易损斑块发生率均高于50%~60%亚组(P<0.05)。B组CT-FFR值低于A组(0.76±0.04 vs 0.88±0.05,P<0.01);A、B两组在61%~70%亚组CT-FFR值≤0.80、<0.70的发生率高于50%~60%亚组(P<0.05)。结论AI诊断系统及CT-FFR对评估高海拔地区冠状动脉临界病变的结构特征及血流动力学改变的结果与冠脉造影、FFR一致性高,具有较高的诊断敏感度和特异度。展开更多
文摘Objective:Coronary artery anatomical variations and anomalies are an important topic due to their potential clinical manifestations.This study aims to investigate the prevalence of coronary artery anatomical variations and anomalies in symptomatic patients with coronary computed tomography angiography(CCTA).Methods:This is a retrospective study that included all symptomatic patients who had CCTA in a tertiary care hospital in Saudi Arabia during a period of seven years.Results:The total number of included patients was 507(60%males)with a mean age of 57.4 years.Approximately 41%had luminal stenoses,averaging 49.7%.The total num-ber of patients with coronary anatomical variations(CAV)and coronary artery anomalies(CAA)was 217(43%).CAV prevalence was 26%,which included 14%non-right coronary dominance,5%short left main coronary artery(LMCA),and 7%division variations(trifurcation and quadrifurcarion)of the LMCA.The prevalence of CAA was 29%,which included 5%origin anomalies,22%myocardial bridge,and 2%course anomalies.Conclusions:A high prevalence of coronary artery anatomic variations and anomalies in symptomatic patients is reported in this study.Systematic reviews,meta-analyses,reporting guidelines,and unified definitions and classifications of cor-onary variations and anomalies are lacking in the literature,presenting potential opportunities for future research and publications.
基金Fund supported by the Clinical Research Supporting Fund of Chinese PLA General Hospital(2016FC-TSYS-1039)~~
文摘Objectives To investigate the morphologic characteristics of intramural hematoma(IMH)on CT angiography(CTA),and evaluate the possible correlation of serum C-reactive protein(CRP)with morphologic characteristics of IMH.Material and Methods Forty-two patients who were initially diagnosed as IMH by aortic CTA and also had serum CRP examination on the same day of CTA were enrolled in this retrospective study,including 30 males and 12 females,with the mean age of 61±14 years old.The volumetric CT data were retrospectively processed and analyzed on post-processing workstation.Based on the thickness of IMH and the length-area curve,the crosssectional area of true lumen and total vessel were measured,the hematoma-vessel ratio(HVR)was calculated.Imaging characteristics were compared between patients who had pathological elevated CRP(>0.8 mg/dl)and those did not.Spearman correlation analyses of CRP level and morphological characteristics of IMH were performed,and the receiver operating characteristic(ROC)curve was used to evaluate the diagnostic validity of CRP.Results Of all 42 IMH patients,the mean serum CRP was 3.94±4.71 mg/dl,and the mean HVR was 46.7%±14.2%.HVR in patients with elevated CRP was significantly higher than those with normal CRP(49.7%±15.0%vs.40.7%±10.5%,P=0.030).HVR was mildly correlated with CRP in all patients(r=0.48,P<0.001).CRP levels differed neither between patients with Stanford type A and B(P=0.207),nor between patients with and without intimal disruption(P=0.230).To discriminate HVR>47%(the mean value),the area under curve(AUC)were 0.700(95%CI:0.535-0.865)for CRP at a cutoff point of 3.55 mg/dl,with a sensitivity of 54.5%and a specificity of 90.0%.Conclusion CRP was mildly correlated with the severity of cross-sectional hematoma area of IMH,but not with Stanford types and the presence of intimal disruption.
文摘目的探讨基于冠状动脉CT血管成像(CCTA)的人工智能(AI)诊断系统及CT无创血流储备分数(CT-FFR)在评估高海拔地区冠状动脉临界病变结构及功能学中的应用价值。方法前瞻性收集2022年1月~2023年10月青海大学附属医院冠心病临界病变患者164例,按居住地海拔进行分组,其中2000~3000m为A组(n=83),3000m以上为B组(n=81),再将两组患者按冠脉狭窄程度细分为50%~60%亚组(n=84)和61%~70%亚组(n=80)。将患者冠状动脉CT血管成像数据导入AI辅助诊断及CT-FFR测量系统,以冠脉造影及冠脉传统血流储备分数(FFR)为金标准,分别评价AI及CT-FFR在高海拔地区冠脉临界病变诊断中的应用。结果以FFR为金标准,CT-FFR与FFR的一致性为83.75%。B组钙化斑块、易损斑块高于A组(P=0.037、0.020);B组冠状动脉多支病变、61%~70%狭窄程度发生率均高于A组(P<0.05);A组、B组在61%~70%亚组钙化斑块、易损斑块发生率均高于50%~60%亚组(P<0.05)。B组CT-FFR值低于A组(0.76±0.04 vs 0.88±0.05,P<0.01);A、B两组在61%~70%亚组CT-FFR值≤0.80、<0.70的发生率高于50%~60%亚组(P<0.05)。结论AI诊断系统及CT-FFR对评估高海拔地区冠状动脉临界病变的结构特征及血流动力学改变的结果与冠脉造影、FFR一致性高,具有较高的诊断敏感度和特异度。
