AIM: To assess the incidence, location, morphology and clinical association of myocardial bridging in a Saudi population using coronary computed tomographic angiography(CCTA). METHODS: A total of 350 CCTA of Saudi pat...AIM: To assess the incidence, location, morphology and clinical association of myocardial bridging in a Saudi population using coronary computed tomographic angiography(CCTA). METHODS: A total of 350 CCTA of Saudi patients were included in this study(236 men, 114 women) with a mean age of 56.3 years. All patients were examined for appropriateness criteria of CCTA indications(typical chest pain, recent onset cardiomyopathy, left bundle branch block, etc.). The scans were retrospectively reviewed for the presence of myocardial bridging and any other pathological association. RESULTS: Myocardial bridging was found in 89 of 350(22.5%) patients. Most of the intramuscular segments were of the superficial type and found in the mid left anterior descending(LAD)(24.6%), followed by distal LAD(3.7%), diagonal branches(2%), ramus intermedius artery(1.4%) and obtuse marginal artery(0.8%). No myocardial bridging was detected in the right coronary or circumflex arteries. No significant differences were found between males and females(P = 0.14). Coronary artery atherosclerosis was found in 51 of 89(57.3%) patients with MB. Atherosclerotic plaques were not detected in the intramuscular or distal segment of bridging arteries. Dynamic compression was observed in 35(94.5%) patients with full encasement. No evidence of myocardial hypoperfusion was found in the territories supplied by the bridging arteries. CONCLUSION: CCTA is excellent in analyzing myocardial bridging in a Saudi population and the results are comparable to other populations. However, finding the real incidence may need a large multicenter study.展开更多
Objective To investigate the feasibility of subtraction coronary computed tomographic(CT)angiography(SubCCTA)to decline calcium artifacts and improve diagnostic accuracy in the presence of coronary calcification and a...Objective To investigate the feasibility of subtraction coronary computed tomographic(CT)angiography(SubCCTA)to decline calcium artifacts and improve diagnostic accuracy in the presence of coronary calcification and analyze the factors that influence SubCCTA.Methods A total of 294 patients suspected of having coronary artery diseases underwent coronary computed tomographic angiography(CCTA)and SubCCTA.Coronary stenoses were blindly evaluated by two experienced radiologists,which were compared with invasive coronary angiography(ICA).Multiple statistical indexes were adopted to analyze the value of SubCCTA for the diagnosis of calcium stenoses.Results The diagnosable rate of SubCCTA was 67.2%(n=197),and the non-diagnosable rate was 32.8%(n=97).Using SubCCTA,the false positive rate decreased from 56.5%to 17.4%,and the corresponding diagnostic accuracy was increased from 83.6%to 92.9%.Univariate logistic regression analysis showed that height(OR=1.029,95%CI=1.001–1.058),weight(OR=1.025,95%CI=1.004–1.046),left ventricular size(OR=1.018,95%CI=1.007–1.030),cardiothoracic ratio(OR=39.917,95%CI=1.244–1281.098),the average heart rate(OR=0.866,95%CI=0.836–0.896)and heart rate range(OR=0.882,95%CI=0.853–0.912)might be the factors influencing SubCCTA.Conclusion This study suggested that SubCCTA could help improve diagnostic accuracy in the presence of calcium plaques.Moreover,several factors were discovered for the first time to possibly influence SubCCTA,which will be helpful in improving the subtracted image quality.展开更多
Introduction: The aim of our study was to assess the incremental value of Coronary Computed Tomography Angiography (CCTA) added to classical coronary angiography, for complex characterization of coronary lesions and p...Introduction: The aim of our study was to assess the incremental value of Coronary Computed Tomography Angiography (CCTA) added to classical coronary angiography, for complex characterization of coronary lesions and prediction of procedural complexity in patients with significant left main (LM) stenoses. Material and Methods: Thirty-six patients with LM disease were enrolled in the study, and each subject underwent CCTA followed by coronary angiography and percutaneous revascularization. Results: Logistic regression analysis indicated a good correlation between the angiographic-calculated and the CCTA-derived Syntax scores for the whole group (r = 0.87, p < 0.0001) and for the high risk subgroup (r = 0.86, p < 0.0001), but not for the low and intermediate risk (r = 0.38, p = 0.21 and r = 0.62, p = 0.07 respectively). In cases which required complex PCI procedures, both angiographic and CCTA Syntax score were significantly higher than those who did not require complex revascularization procedures (24.5 +/-11.5 vs 32.2 +/-14.6, p = 0.09 for Angio Syntax, 35.3 +/-11.5 vs 25.2 +/-11.3, p = 0.01 for CCTA). In the same time, Ca scoring was significantly higher and plaque volumes were significantly larger in cases requiring complex revascularization procedures (299.5 +/-359.6 vs 917.3 +/-495.4, p = 0.04 for calcium score, 79.7 +/-28.5 vs 108.7 +/-25.3 mm3, p = 0.002 for plaque volumes). Multivariate analysis identified the following CCTA parameters as significant predictors of increased risk for complex intervention in LM lesions: plaque volume (OR 8.00, p = 0.008), Ca scoring (OR 6.37, p = 0.02) and CCTA Syntax score (OR 6.87, p = 0.01). Conclusions: CCTA derived parameters provide incremental information to classical coronary angiography for preoperative assessment of lesion severity in complex left main stenosis. CCTA derived Syntax score significantly correlates with the classical Coronary Angiography Syntax score and identifies the subgroup of patients who will be more exposed to procedural complications during the revascularization interventions.展开更多
Objective To evaluate the clinical value of three dimensional computerized tomography angiography in the diagnosis and treatment of spontaneous subarachnoid hemorrhage. Methods 616 cases were diagnosed as suspected in...Objective To evaluate the clinical value of three dimensional computerized tomography angiography in the diagnosis and treatment of spontaneous subarachnoid hemorrhage. Methods 616 cases were diagnosed as suspected intracranial aneurysms in 3D CTA system. Computed tomographic scans and CTA studies were展开更多
A large field of view is in high demand for disease diagnosis in clinical applications of optical coherence tomography(OCT)and OCT angiography(OCTA)imaging.Due to limits on the optical scanning range,the scanning spee...A large field of view is in high demand for disease diagnosis in clinical applications of optical coherence tomography(OCT)and OCT angiography(OCTA)imaging.Due to limits on the optical scanning range,the scanning speed,or the data processing speed,only a relatively small region could be acquired and processed for most of the current clinical OCT systems at one time and could generate a mosaic image of multiple adjacent small-region images with registration algorithms for disease analysis.In this work,we investigated performing cross-correlation(instead of phase-correlation)in the workflow of the Fourier–Mellin transform(FMT)method(called dual-cross-correlation-based translation and rotation registration,DCCTRR)for calculating translation and orientation offsets and compared its performance to the FMT method used on OCTA images alignment.Both phantom and in vivo experiments were implemented for comparisons,and the results quantitatively demonstrate that DCCTRR can align OCTA images with a lower overlap rate,which could improve the scanning efficiency of large-scale imaging in clinical applications.展开更多
AIM: To assess the diagnostic accuracy of computed tomographic venography(CTV) for splanchnic vein thrombosis(SVT) detection in necrotizing acute pancreatitis(AP) patients.METHODS:Forty-three patients with necrotizing...AIM: To assess the diagnostic accuracy of computed tomographic venography(CTV) for splanchnic vein thrombosis(SVT) detection in necrotizing acute pancreatitis(AP) patients.METHODS:Forty-three patients with necrotizing AP who underwent both CTV and digital subtraction angiography(DSA)within 3 d were analyzed in this retrospective comparative study.All CTV procedures were performed with a dual-source CT scanner.The presence and location of SVT were determined via blinded imaging data analyses.RESULTS:According to the DSA results,17(39.5%)of the total 43 patients had SVT.The sensitivity,specificity,positive and negative predictive values of CTV for SVT detection were 100%(95%CI:77.1%-100%),92.3%(95%CI:73.4%-98.7%),89.5%(95%CI:65.5%-98.2%)and 100%(95%CI:82.8%-100%),respectively.CONCLUSION:CTV is an effective examination for SVT detection in patients with necrotizing AP with high positive and negative predictive values.展开更多
BACKGROUND ： Digital subtraction angiography （DSA） is always regarded as the golden standard for diagnosis of intracranial aneurysm; however, the procedure is complex, traumatic, expensive and easy to induce vascul...BACKGROUND ： Digital subtraction angiography （DSA） is always regarded as the golden standard for diagnosis of intracranial aneurysm; however, the procedure is complex, traumatic, expensive and easy to induce vascular complication. Three-dimensional computed tomography angiography （3D-CTA） can make up deficiencies of DSA; therefore, it is used in clinical therapy wider and wider. OBJECTIVE ： To evaluate the clinical effect of 3D-CTA on disruption and hemorrhage of intracranial aneurysm pre- and post-operation and compare with the effect of DSA. DESIGN ： Auto-control contrast observation SETTING ： Department of Neurosurgery, Shengjing Hospital of China Medical University PARTICIPANTS ： A number of 106 patients with disruption and hemorrhage of intracranial aneurysm were selected from the Department of Neurosurgery, Shengjing Hospital of China Medical University from January 2003 to April 2006. All patients were diagnosed with cranial operation and consent. There were 47 males and 59 females aged from 3-76 years with the mean age of （47±13） years. Among them, 82 patients had extensive subarachnoid hemorrhage （SAH）, 7 had hemorrhage at longitudinal fissure, and 17 had hemorrhage at ambiens cistema and lateral fissure. Moreover, intraventricular hematocele was accompanied on 13 patients and hematom on 9 patients. METHODS： （1） 3D-CTA examination： Siemens SOMATOM Sensation 64 CT was used in this study. The thickness was 1 mm and interval of reconstruction was 0.8 mm. Localizing section was plainly scanned as the standard of canthus line. Scan ranged from 30 mm below sella to 50 mm above sella. Non-ion contrast medium of Omnipaque 350 （concentration of iodine was 350 g/L） was inserted into anterior vein of elbow with 18G trochar retained with high-pressured injectoc pum. The speed was 4.5 mL/s and the total volume was 80-100 mL with the means of 90 mL. Scan started at 10-20 s after injection of contrast medium. Original image was dealt with Leonardo workstation and retreated with Syngo software. Volume rendering and maximum intensity projection were used to reconstructed images, （2） All 106 patients suffered from occlusion of aneurysm clamp. Before operation, 3D-CTA was undertaken and DSA was followed. After operation, patients were rechecked with 3D-CTA. MAIN OUTCOME MEASURES： Comparisons between 3D-CTA and DSA. RESULTS ： All 106 patients were involved in the final analysis. （1） Examination of 3D-CTA and DSA： Among 118 patients with aneurysm, 110 were checked with 3D-CTA and the detected rate was 93.2% （110/118）. Among other 8 cases, 3 were negative and checked again with DSA; 1 had pericallosal aneurysm, 1 ophthalmic aneurysm, and 1 anterior choroidal artery of aneurysm. 3D-CTA results of other 5 cases were suspicious, and then, they were regarded as having aneurysm with DSA. Before operation, correlation among site, body, neck of aneurysm and peripheral anatomic structure were shown sufficiently. After operation, 82 patients were rechecked with 3D-CTA, which was complete occlusion, precise, unobvious constriction, emphraxis or remains as compared with 3D-CTA those pre-operation. （2） Characteristics of 3D-CTA： With multiple vessels and angles, 3D-CTA observed the relationship between aneurysm neck and carried artery and showed thrombosis in cavity of aneurysm, calcification of aneurysm wall and peripheral structure of vessel at the same time. However, DSA could not detect the reactions mentioned above. It could delete image of cranium, simulate image of operative route, eliminate artifact induced by metal, but not distinguish blood stream direction. Meanwhile, posterior communicating artery was always poor during circle of Willis artery showing. CONCLUSION： （1） 3D-CTA is characterized by simple operation and non-invasive showing vascular stereo structure and correlation. Therefore, it is significant for diagnosis and designing plan of operative approach and focal location pre-operation and evaluating effect post-operation. （2） 3D-CTA does not completely replace DSA on the diagnosis of intracranial aneurysm.展开更多
Although the average age of diagnosis for aorticdissection is 63,[1] this case demonstrates the need toconsider AD in younger patients, particularly in thepresence of risk factors or in the absence of anotherreasonabl...Although the average age of diagnosis for aorticdissection is 63,[1] this case demonstrates the need toconsider AD in younger patients, particularly in thepresence of risk factors or in the absence of anotherreasonable diagnosis. This case suggests PCP use as aprecipitant for hypertension and sympathomimetic stresson the aorta. Despite high sensitivity, false negativeCTA imaging for AD can occur. If pretest probabilityremains high, further imaging must be obtained. Duringresuscitation in the ED, focused point-of-care ultrasoundcan also assist with medical decision making.展开更多
文摘AIM: To assess the incidence, location, morphology and clinical association of myocardial bridging in a Saudi population using coronary computed tomographic angiography(CCTA). METHODS: A total of 350 CCTA of Saudi patients were included in this study(236 men, 114 women) with a mean age of 56.3 years. All patients were examined for appropriateness criteria of CCTA indications(typical chest pain, recent onset cardiomyopathy, left bundle branch block, etc.). The scans were retrospectively reviewed for the presence of myocardial bridging and any other pathological association. RESULTS: Myocardial bridging was found in 89 of 350(22.5%) patients. Most of the intramuscular segments were of the superficial type and found in the mid left anterior descending(LAD)(24.6%), followed by distal LAD(3.7%), diagonal branches(2%), ramus intermedius artery(1.4%) and obtuse marginal artery(0.8%). No myocardial bridging was detected in the right coronary or circumflex arteries. No significant differences were found between males and females(P = 0.14). Coronary artery atherosclerosis was found in 51 of 89(57.3%) patients with MB. Atherosclerotic plaques were not detected in the intramuscular or distal segment of bridging arteries. Dynamic compression was observed in 35(94.5%) patients with full encasement. No evidence of myocardial hypoperfusion was found in the territories supplied by the bridging arteries. CONCLUSION: CCTA is excellent in analyzing myocardial bridging in a Saudi population and the results are comparable to other populations. However, finding the real incidence may need a large multicenter study.
基金supported by Hubei Health Committee of China(No.WJ2019M119).
文摘Objective To investigate the feasibility of subtraction coronary computed tomographic(CT)angiography(SubCCTA)to decline calcium artifacts and improve diagnostic accuracy in the presence of coronary calcification and analyze the factors that influence SubCCTA.Methods A total of 294 patients suspected of having coronary artery diseases underwent coronary computed tomographic angiography(CCTA)and SubCCTA.Coronary stenoses were blindly evaluated by two experienced radiologists,which were compared with invasive coronary angiography(ICA).Multiple statistical indexes were adopted to analyze the value of SubCCTA for the diagnosis of calcium stenoses.Results The diagnosable rate of SubCCTA was 67.2%(n=197),and the non-diagnosable rate was 32.8%(n=97).Using SubCCTA,the false positive rate decreased from 56.5%to 17.4%,and the corresponding diagnostic accuracy was increased from 83.6%to 92.9%.Univariate logistic regression analysis showed that height(OR=1.029,95%CI=1.001–1.058),weight(OR=1.025,95%CI=1.004–1.046),left ventricular size(OR=1.018,95%CI=1.007–1.030),cardiothoracic ratio(OR=39.917,95%CI=1.244–1281.098),the average heart rate(OR=0.866,95%CI=0.836–0.896)and heart rate range(OR=0.882,95%CI=0.853–0.912)might be the factors influencing SubCCTA.Conclusion This study suggested that SubCCTA could help improve diagnostic accuracy in the presence of calcium plaques.Moreover,several factors were discovered for the first time to possibly influence SubCCTA,which will be helpful in improving the subtracted image quality.
文摘Introduction: The aim of our study was to assess the incremental value of Coronary Computed Tomography Angiography (CCTA) added to classical coronary angiography, for complex characterization of coronary lesions and prediction of procedural complexity in patients with significant left main (LM) stenoses. Material and Methods: Thirty-six patients with LM disease were enrolled in the study, and each subject underwent CCTA followed by coronary angiography and percutaneous revascularization. Results: Logistic regression analysis indicated a good correlation between the angiographic-calculated and the CCTA-derived Syntax scores for the whole group (r = 0.87, p < 0.0001) and for the high risk subgroup (r = 0.86, p < 0.0001), but not for the low and intermediate risk (r = 0.38, p = 0.21 and r = 0.62, p = 0.07 respectively). In cases which required complex PCI procedures, both angiographic and CCTA Syntax score were significantly higher than those who did not require complex revascularization procedures (24.5 +/-11.5 vs 32.2 +/-14.6, p = 0.09 for Angio Syntax, 35.3 +/-11.5 vs 25.2 +/-11.3, p = 0.01 for CCTA). In the same time, Ca scoring was significantly higher and plaque volumes were significantly larger in cases requiring complex revascularization procedures (299.5 +/-359.6 vs 917.3 +/-495.4, p = 0.04 for calcium score, 79.7 +/-28.5 vs 108.7 +/-25.3 mm3, p = 0.002 for plaque volumes). Multivariate analysis identified the following CCTA parameters as significant predictors of increased risk for complex intervention in LM lesions: plaque volume (OR 8.00, p = 0.008), Ca scoring (OR 6.37, p = 0.02) and CCTA Syntax score (OR 6.87, p = 0.01). Conclusions: CCTA derived parameters provide incremental information to classical coronary angiography for preoperative assessment of lesion severity in complex left main stenosis. CCTA derived Syntax score significantly correlates with the classical Coronary Angiography Syntax score and identifies the subgroup of patients who will be more exposed to procedural complications during the revascularization interventions.
文摘Objective To evaluate the clinical value of three dimensional computerized tomography angiography in the diagnosis and treatment of spontaneous subarachnoid hemorrhage. Methods 616 cases were diagnosed as suspected intracranial aneurysms in 3D CTA system. Computed tomographic scans and CTA studies were
基金supported by the Natural Science Foundation of Jiangsu Province(No.BK20210227).
文摘A large field of view is in high demand for disease diagnosis in clinical applications of optical coherence tomography(OCT)and OCT angiography(OCTA)imaging.Due to limits on the optical scanning range,the scanning speed,or the data processing speed,only a relatively small region could be acquired and processed for most of the current clinical OCT systems at one time and could generate a mosaic image of multiple adjacent small-region images with registration algorithms for disease analysis.In this work,we investigated performing cross-correlation(instead of phase-correlation)in the workflow of the Fourier–Mellin transform(FMT)method(called dual-cross-correlation-based translation and rotation registration,DCCTRR)for calculating translation and orientation offsets and compared its performance to the FMT method used on OCTA images alignment.Both phantom and in vivo experiments were implemented for comparisons,and the results quantitatively demonstrate that DCCTRR can align OCTA images with a lower overlap rate,which could improve the scanning efficiency of large-scale imaging in clinical applications.
文摘AIM: To assess the diagnostic accuracy of computed tomographic venography(CTV) for splanchnic vein thrombosis(SVT) detection in necrotizing acute pancreatitis(AP) patients.METHODS:Forty-three patients with necrotizing AP who underwent both CTV and digital subtraction angiography(DSA)within 3 d were analyzed in this retrospective comparative study.All CTV procedures were performed with a dual-source CT scanner.The presence and location of SVT were determined via blinded imaging data analyses.RESULTS:According to the DSA results,17(39.5%)of the total 43 patients had SVT.The sensitivity,specificity,positive and negative predictive values of CTV for SVT detection were 100%(95%CI:77.1%-100%),92.3%(95%CI:73.4%-98.7%),89.5%(95%CI:65.5%-98.2%)and 100%(95%CI:82.8%-100%),respectively.CONCLUSION:CTV is an effective examination for SVT detection in patients with necrotizing AP with high positive and negative predictive values.
文摘BACKGROUND ： Digital subtraction angiography （DSA） is always regarded as the golden standard for diagnosis of intracranial aneurysm; however, the procedure is complex, traumatic, expensive and easy to induce vascular complication. Three-dimensional computed tomography angiography （3D-CTA） can make up deficiencies of DSA; therefore, it is used in clinical therapy wider and wider. OBJECTIVE ： To evaluate the clinical effect of 3D-CTA on disruption and hemorrhage of intracranial aneurysm pre- and post-operation and compare with the effect of DSA. DESIGN ： Auto-control contrast observation SETTING ： Department of Neurosurgery, Shengjing Hospital of China Medical University PARTICIPANTS ： A number of 106 patients with disruption and hemorrhage of intracranial aneurysm were selected from the Department of Neurosurgery, Shengjing Hospital of China Medical University from January 2003 to April 2006. All patients were diagnosed with cranial operation and consent. There were 47 males and 59 females aged from 3-76 years with the mean age of （47±13） years. Among them, 82 patients had extensive subarachnoid hemorrhage （SAH）, 7 had hemorrhage at longitudinal fissure, and 17 had hemorrhage at ambiens cistema and lateral fissure. Moreover, intraventricular hematocele was accompanied on 13 patients and hematom on 9 patients. METHODS： （1） 3D-CTA examination： Siemens SOMATOM Sensation 64 CT was used in this study. The thickness was 1 mm and interval of reconstruction was 0.8 mm. Localizing section was plainly scanned as the standard of canthus line. Scan ranged from 30 mm below sella to 50 mm above sella. Non-ion contrast medium of Omnipaque 350 （concentration of iodine was 350 g/L） was inserted into anterior vein of elbow with 18G trochar retained with high-pressured injectoc pum. The speed was 4.5 mL/s and the total volume was 80-100 mL with the means of 90 mL. Scan started at 10-20 s after injection of contrast medium. Original image was dealt with Leonardo workstation and retreated with Syngo software. Volume rendering and maximum intensity projection were used to reconstructed images, （2） All 106 patients suffered from occlusion of aneurysm clamp. Before operation, 3D-CTA was undertaken and DSA was followed. After operation, patients were rechecked with 3D-CTA. MAIN OUTCOME MEASURES： Comparisons between 3D-CTA and DSA. RESULTS ： All 106 patients were involved in the final analysis. （1） Examination of 3D-CTA and DSA： Among 118 patients with aneurysm, 110 were checked with 3D-CTA and the detected rate was 93.2% （110/118）. Among other 8 cases, 3 were negative and checked again with DSA; 1 had pericallosal aneurysm, 1 ophthalmic aneurysm, and 1 anterior choroidal artery of aneurysm. 3D-CTA results of other 5 cases were suspicious, and then, they were regarded as having aneurysm with DSA. Before operation, correlation among site, body, neck of aneurysm and peripheral anatomic structure were shown sufficiently. After operation, 82 patients were rechecked with 3D-CTA, which was complete occlusion, precise, unobvious constriction, emphraxis or remains as compared with 3D-CTA those pre-operation. （2） Characteristics of 3D-CTA： With multiple vessels and angles, 3D-CTA observed the relationship between aneurysm neck and carried artery and showed thrombosis in cavity of aneurysm, calcification of aneurysm wall and peripheral structure of vessel at the same time. However, DSA could not detect the reactions mentioned above. It could delete image of cranium, simulate image of operative route, eliminate artifact induced by metal, but not distinguish blood stream direction. Meanwhile, posterior communicating artery was always poor during circle of Willis artery showing. CONCLUSION： （1） 3D-CTA is characterized by simple operation and non-invasive showing vascular stereo structure and correlation. Therefore, it is significant for diagnosis and designing plan of operative approach and focal location pre-operation and evaluating effect post-operation. （2） 3D-CTA does not completely replace DSA on the diagnosis of intracranial aneurysm.
文摘Although the average age of diagnosis for aorticdissection is 63,[1] this case demonstrates the need toconsider AD in younger patients, particularly in thepresence of risk factors or in the absence of anotherreasonable diagnosis. This case suggests PCP use as aprecipitant for hypertension and sympathomimetic stresson the aorta. Despite high sensitivity, false negativeCTA imaging for AD can occur. If pretest probabilityremains high, further imaging must be obtained. Duringresuscitation in the ED, focused point-of-care ultrasoundcan also assist with medical decision making.
