Comparison of quantitative flow ratio and fractional flow reserve with myocardial perfusion scintigraphy and cardiovascular magnetic resonance as reference standard. A Dan-NICAD substudy

This study is a predefined post hoc analysis of the Dan-NICAD study (NCT02264717). Patients with suspected coronary artery disease by coronary computed tomography angiography (CCTA) were randomized 1:1 to MPS or CMR and were referred to invasive coronary angiography with FFR and predefined QFR assessment. Paired data with FFR, QFR and MPS or CMR were available for 232 vessels with stenosis in 176 patients. Perfusion defects were detected in 57 vessel territories (25%). For QFR and FFR the diagnostic accuracy was 61% and 57% (p  = 0.18) and area under the receiver operating curve was 0.64 vs. 0.58 (p = 0.22). Stenoses with absolute indication for stenting due to diameter stenosis >  90% by visual estimate were not classified as significant by either QFR or MPS/CMR in 21% (7 of 34) of cases. The diagnostic performance of QFR and FFR was similar but modest with MPS or CMR as reference. Comparable performance levels for QFR and FFR are encouraging for this pressure wire-free di agnostic method.
Source: The International Journal of Cardiovascular Imaging - Category: Radiology Source Type: research

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Abstract Pulmonary embolism (PE) is a condition characterised by an obstruction of the pulmonary arterial system by one or more emboli. Advanced clinical practitioners are often faced with ruling out a diagnosis of PE in patients with non-specific symptoms such as dyspnoea and pleuritic chest pain, which can be fairly mild and therefore a diagnosis of PE easily missed. PEs can be a challenge to diagnose, especially in elderly people, since it can be difficult to differentiate their symptoms from other less serious illnesses. Widely used scoring tools are helpful to calculate a patient's probability of having a PE....
Source: British Journal of Nursing - Category: Nursing Authors: Tags: Br J Nurs Source Type: research
This study combined the SIEA system with the DIEP system and explored the relationship between the two systems and body mass index (BMI) to theoretically provide a reference for flap choice in the preoperative surgical plan.MethodsThis study analysed preoperative computed tomography angiography (CTA) data from patients who received systematically postoperative treatment for unilateral breast cancer and were scheduled for breast reconstruction from 2013 to 2018 in our centre. All patients included had no past medical history that might have influenced the diameter of the SIEA, and their CTA data showed the presence of SIEA....
Source: Aesthetic Plastic Surgery - Category: Cosmetic Surgery Source Type: research
Conclusion: In symptomatic patients with CAD, very low hs-cTn concentrations, including hs-cTnI concentrations less than 2.5 ng/L, do not generally allow users to safely exclude inducible myocardial ischemia. Primary Funding Source: European Union, Swiss National Science Foundation, Kommission für Technologie und Innovation (Innosuisse), Swiss Heart Foundation, Cardiovascular Research Foundation Basel, University of Basel, University Hospital Basel, Roche, Abbott, and Singulex. PMID: 31905377 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - Category: Internal Medicine Authors: Tags: Ann Intern Med Source Type: research
ConclusionAdding CTP and/or a delayed-phase CTA to NCCT with arterial-phase CTA improves the decision-maker ’s confidence level and creates a trend towards a lower threshold for mechanical thrombectomy.
Source: Neuroradiology - Category: Radiology Source Type: research
This article investigates the technical developments in wide-detector CT scanners, summarizes their clinical applications in the cardiothoracic area, and provides a review of the recent literature. PMID: 31854147 [PubMed - in process]
Source: Korean Journal of Radiology - Category: Radiology Tags: Korean J Radiol Source Type: research
Publication date: Available online 17 December 2019Source: Academic RadiologyAuthor(s): Keling Liu, Kaiyue Diao, Sixian Hu, Xu Xu, Jinge Zhang, Wanlin Peng, Chunchao Xia, Kai Zhang, Yuming Li, Yingkun Guo, Sen He, Yong He, Zhenlin LiRationale and ObjectivesTo investigate the feasibility of “one-stop” myocardial computed tomography perfusion (CTP) imaging (combined anatomy, perfusion, and function) in coronary artery disease using 16-cm wide detector CT, compared to conventional coronary CT angiography (CCTA).Materials and Methods442 patients with suspected coronary artery disease were randomly divided into two ...
Source: Academic Radiology - Category: Radiology Source Type: research
Conclusion: NBOMe ingestion implicates the risk of peripheral vasospasms with severe, limb-threatening ischemia.
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Brief Report Source Type: research
Advances in X-ray computed tomography (CT) over the past 20 years have enabled non-invasive imaging of the coronary arteries, as well as cardiac structure and function. Coronary computed tomography angiography (CTA) has emerged as an accurate non-invasive imaging modality for identifying the anatomic severity of coronary stenoses (1 –3). Similar to other anatomic coronary imaging, coronary CTA alone has been limited in its ability to define the hemodynamic significance of coronary stenoses (4). Since the identification of the presence and severity of ischemia are important parameters for selecting between invasive an...
Source: Journal of Cardiovascular Computed Tomography - Category: Radiology Authors: Source Type: research
Abstract Background: Functional assessment to rule out myocardial ischemia using coronary computed tomography angiography (CCTA) is extremely important and data on the Brazilian population are still limited. Objective: To assess the diagnostic performance of myocardial perfusion by CCTA in the detection of severe obstructive coronary artery disease (CAD) compared with single-photon emission computerized tomography (SPECT). To analyze the importance of anatomical knowledge to understand the presence of myocardial perfusion defects on SPECT imaging that is not identified on computed tomography (CT) scan. Method: A total of 3...
Source: Arquivos Brasileiros de Cardiologia - Category: Cardiology Source Type: research
Abstract Background: Functional assessment to rule out myocardial ischemia using coronary computed tomography angiography (CCTA) is extremely important and data on the Brazilian population are still limited. Objective: To assess the diagnostic performance of myocardial perfusion by CCTA in the detection of severe obstructive coronary artery disease (CAD) compared with single-photon emission computerized tomography (SPECT). To analyze the importance of anatomical knowledge to understand the presence of myocardial perfusion defects on SPECT imaging that is not identified on computed tomography (CT) scan. Method: A total of 3...
Source: Arquivos Brasileiros de Cardiologia - Category: Cardiology Source Type: research
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