scholarly journals Use of coronary computed tomography angiography in the diagnosis and/or exclusion of coronary disease - Initial experience of one center and determination of the local acuity of the method, in comparison with coronary angiography

2018 ◽  
Vol 3 (1) ◽  
Author(s):  
Pedro PG ◽  
Carôla B ◽  
Conduto R ◽  
Oliveira P ◽  
Pereira M ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Angiography ◽  
Coronary Disease ◽  
Computed Tomography Angiography ◽  
Coronary Computed Tomography Angiography ◽  
Initial Experience ◽  
Coronary Computed Tomography

scholarly journals The Functional Severity Assessment of Coronary Stenosis Using Coronary Computed Tomography Angiography-Based Myocardial Mass at Risk and Minimal Lumen Diameter

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Kenji Sadamatsu ◽  
Kazuhiro Nagaoka ◽  
Yasuaki Koga ◽  
Kotaro Kagiyama ◽  
Kohei Muramatsu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Angiography ◽  
Computed Tomography Angiography ◽  
Predictive Value ◽  
Coronary Stenosis ◽  
Coronary Computed Tomography Angiography ◽  
Quantitative Coronary Angiography ◽  
Myocardial Mass ◽  
Coronary Computed Tomography ◽  
Minimal Lumen Diameter

Background. We investigated whether or not the addition of myocardial mass at risk (MMAR) to quantitative coronary angiography was useful for diagnosing functionally significant coronary stenosis in the daily practice. Methods. We retrospectively enrolled 111 consecutive patients with 149 lesions who underwent clinically indicated coronary computed tomography angiography and subsequent elective coronary angiography with fractional flow reserve (FFR) measurement. MMAR was calculated using a workstation-based software program with ordinary thin slice images acquired for the computed tomography, and the minimal lumen diameter (MLD) and the diameter stenosis were measured with quantitative coronary angiography. Results. The MLD and MMAR were significantly correlated with the FFR, and the MMAR-to-MLD ratio (MMAR/MLD) showed a good correlation. The area under the receiver operating characteristic curve (AUC) of MMAR/MLD for FFR ≤ 0.8 was 0.746, and the sensitivity, specificity, positive predictive value, and negative predictive value were 60%, 83%, 68%, and 77%, respectively, at a cut-off value of 29.5 ml/mm. The addition of MMAR/MLD to diameter stenosis thus made it possible to further discriminate lesions with FFR ≤ 0.8 (AUC = 0.750). For the proximal left coronary artery lesions, in particular, MMAR/MLD showed a better correlation with the FFR, and the AUC of MMAR/MLD for FFR ≤ 0.8 was 0.919 at a cut-off value of 31.7 ml/mm. Conclusions. The index of MMAR/MLD correlated well with the physiological severity of coronary stenosis and showed good accuracy for detecting functional significance. The MMAR/MLD might be a useful parameter to consider when deciding the indication for revascularization.

scholarly journals Efficacy of Coronary Computed Tomography Angiography for the De Novo Detection of Chronic Total Occlusion Prior to Coronary Angiography: A Preliminary and Retrospective Study

2020 ◽  
Vol 29 (04) ◽  
pp. 223-228
Author(s):  
Dae Hyun Lee ◽  
S. Kambhampati ◽  
M. Mohammed ◽  
R. Goli ◽  
D. Thiemann ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Angiography ◽  
Computed Tomography Angiography ◽  
Predictive Value ◽  
Chronic Total Occlusion ◽  
De Novo ◽  
Coronary Computed Tomography Angiography ◽  
Coronary Intervention ◽  
Total Occlusion ◽  
Coronary Computed Tomography

AbstractCoronary computed tomography angiography (CCTA) offers high-resolution anatomic characterization of the coronary vasculature but may be suboptimal for lesions dependent on real-time visualization of flow including chronic total occlusion (CTO). In CTOs, heavy calcification and distal vessel opacification from collateralization may confound luminal assessment. Several studies have examined the role of CCTA in characterizing known CTOs to guide percutaneous coronary intervention (PCI). However, the efficacy of CCTA in the de novo diagnosis of CTOs prior to coronary angiography (CAG) has not been demonstrated. A total of 233 consecutive patients who presented for CAG within a 3-month period of having CCTA were retrospectively reviewed. Those patients with prior diagnosis of CTO or prior bypass of the occluded vessels were excluded. Sensitivity and specificity analysis of CCTA in identifying CTOs using CAG as the gold standard was performed. The prevalence of CTO was 21.11% in the population that met criteria for analysis (n = 199). The sensitivity of CCTA in predicting CTO was 57.1%, while the specificity was 96.8%. The positive predictive value and negative predictive value of CCTA in detection of CTO were 82.8 and 89.4%, respectively. Our study shows that CCTA has excellent specificity but poor sensitivity in the detection of CTO thus limiting its clinical use in de novo diagnosis. Further studies to determine the effect of de novo CTO diagnosis on clinically important procedural factors, such as radiation exposure, contrast use, and need for repeat procedures, are warranted and may implicate a role for CCTA in this setting.

Sign in / Sign up

Export Citation Format

Share Document