Diagnostic performance of quantitative coronary computed tomography angiography and quantitative coronary angiography to predict hemodynamic significance of intermediate-grade stenoses
Abstract Fractional flow reserve (FFR) during invasive coronary angiography has become an established tool for guiding treatment. However, only one-third of intermediate-grade coronary artery stenosis (ICAS) are hemodynamically significant and require coronary revascularization. Additionally, the severity of stenosis visually established by coronary computed tomography angiography (CCTA) does not reliably correlate with the functional severity. Therefore, additional angiographic morphologic descriptors affecting hemodynamic significance are required. To evaluate quantitative stenosis analysis and plaque descriptors by CCTA in predicting the hemodynamic significance of ICAS and to compare it with quantitative catheter coronary angiography (QCA). QCA was performed in 65 patients (mean age 63 ± 9 years; 47 men) with 76 ICAS (40–70 %) on CCTA. Plaque descriptors were determined including circumferential extent of calcification, plaque composition, minimal lumen diameter (MLD) and area, diameter stenosis percentage (Ds %), area stenosis percentage and stenosis length on CCTA. MLD and Ds % were also analyzed on QCA. FFR was measured on 52 ICAS lesions on CCTA and QCA. The diagnostic values of the best CCTA and QCA descriptors were calculated for ICAS with FFR ≤ 0.80. Of the 76 ICAS on CCTA, 52 (68 %) had a Ds % between 40 and 70 % on QCA. Significant intertechnique correlations were found between CCTA and QCA for MLD ...
Myocardial extracellular volume fraction (ECV) derived from CT delayed enhancement (CTDE) may allow assessment of diffuse myocardial fibrosis. However, the amount of contrast medium required for ECV estimation has not been established. Since ECV estimation by CT is typically performed in combination with coronary CT angiography (CCTA) in clinical settings, we aimed to investigate whether reliable ECV estimation is possible using the contrast dose optimized for CCTA without additional contrast administration.
ConclusionSurgical clipping remains a safe and useful treatment option for pericallosal artery aneurysms in a low-resource neurosurgical facility.
Objective: To explore the value of whole-brain perfusion parameters combined with multiphase computed tomography angiography (MP-CTA) in predicting the hemorrhagic transformation (HT) of ischemic stroke. Methods: A total of 64 patients with ischemic stroke who underwent noncontrast computed tomography, computed tomography perfusion imaging, and computed tomography angiography before treatment from August 2017 to June 2019 were included retrospectively. The perfusion parameters cerebral blood volume (CBV), cerebral blood flow (CBF), time to peak (TTP), mean transit time (MTT), time to maximum (Tmax), and permeability surfac...
Discussion: Despite some discrepancy regarding the incidence, both cohorts show a non-negligible long-term risk of aneurysm recurrence and de novo aneurysm formation, which warrants life-long imaging follow-up.Abbreviations: SD: standard deviation; DSA: digital subtraction angiography; CTA: computed tomography angiography; MRA: magnetic resonance angiography; MCA: middle cerebral artery; ACA: anterior cerebral artery; ACommA: anterior communicating artery; ICA: internal carotid artery; ADPKD: autosomal dominant polycystic kidney disease; MeSH: Medical Subject Headings. PMID: 32048571 [PubMed - as supplied by publisher]
This study assessed predictors of pulmonary thromboembolism (PE) resolution and their implications for clinical outcome.MethodA total of 150 patients with acute PE diagnosed by computed tomography pulmonary angiography (CTPA) were included. All patients received anticoagulant therapy for 3 ‐6 months and were followed‐up for at least 2 years. D‐dimer levels in plasma were assayed at the first admission and during follow‐up.ResultsThe rate of CTPA ‐confirmed PE resolution was 48.67% at 6 months, 68% at 12 months, and 78.67% at 24 months. Thirty‐nine patients had recurrent thrombosis after anticoagulation therapy ...
The recent article from McCluskey et al “Radiological Eye Deviation as a Predictor of Large Vessel Occlusion in Acute Ischaemic Stroke” J of Stroke and Cerebrovasc Dis. 2019; 28:2318-23231 provides valuable information that may lead to early stroke intervention. They found that subjective visual detection of radiographic eye deviation on nonenhanced computed tomography (NECT) brain is strongly associated with large vessel occlusion (LVO). This compelling association may expedite patients for timely angiographic testing and endovascular therapy.
AbstractBackgroundAtrial myxoma remains a rare clinical entity with an incidence of surgically resected cases of 0.5 –0.7 per million population and prevalence of
ConclusionsWe successfully developed a deep learning model that can automatically detect aneurysms. The model performed well for aneurysms of different sizes or in different locations. This finding indicates that the deep learning model has the potential to vastly improve clinician performance by providing automated aneurysm detection.
CONCLUSIONS: Renal artery re-intervention following renal denervation with the most commonly applied RF renal denervation system (Symplicity™) is rare. Most events were identified within 1 year. PMID: 32038027 [PubMed - as supplied by publisher]
Coronary Computed Tomography Angiography (CCTA) has been a well established non-invasive technique for the assessment of coronary artery disease (CAD). Despite the advances in CT technology, the artifacts caused by cardiac motion at high heart rates still remain a major issue in the interpretation of cardiac CT images since they affect delineation of coronary anatomy and reduce the ability of physicians to accurately assess stenotic coronary lesions [1,2]. Another deficiency of CCTA is the difficulty in evaluating vessel segments with extensive calcified plaque.