Computed Tomography Angiography Combined With Knowledge-Based Iterative Algorithm for Transcatheter Aortic Valve Implantation Planning: Image Quality and Radiation Dose Exposure With Low-kV and Low-Contrast-Medium Protocol

Objective To evaluate image quality and radiation dose exposure of low-kV setting and low-volume contrast medium (CM) computed tomography angiography (CTA) protocol for transcatheter aortic valve implantation (TAVI) planning in comparison with standard CTA protocol. Methods Sixty-patients were examined with 256-row MDCT for TAVI planning: 32 patients (study group) were evaluated using 80-kV electrocardiogram-gated protocol with 60 mL of CM and IMR reconstruction; 28 patients underwent a standard electrocardiogram-gated CTA study (100 kV; 80 mL of CM; iDose4 reconstruction). Subjective and objective image quality was evaluated in each patient at different aortic levels. Finally, we collected radiation dose exposure data (CT dose index and dose-length product) of both groups. Results In study protocol, significant higher mean attenuation values were achieved in all measurements compared with the standard protocol. There were no significant differences in the subjective image quality evaluation in both groups. Mean dose-length product of study group was 56% lower than in the control one (P
Source: Journal of Computer Assisted Tomography - Category: Radiology Tags: Cardiovascular Imaging Source Type: research

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Japanese Survey of Radiation Dose Associated With Coronary Computed Tomography Angiography - 2013 Data From a Multicenter Registry in Daily Practice. Circ J. 2020 Feb 18;: Authors: Tanabe Y, Kido T, Kimura F, Kobayashi Y, Matsunaga N, Yoshioka K, Yoshimura N, Mochizuki T Abstract BACKGROUND: Although coronary computed tomography angiography (CTA) is frequently used for identifying coronary artery disease, no studies have investigated the radiation dose in detail in Japan. The aim of this study was to estimate the radiation dose of coronary CTA in Japanese clinical practice and to identify the indepe...
Source: Circulation Journal - Category: Cardiology Authors: Tags: Circ J Source Type: research
AbstractMyocardial ischemia is caused by a mismatch between myocardial oxygen consumption and oxygen delivery in coronary artery disease (CAD). Stratification and decision-making based on ischemia improves the prognosis in patients with CAD. Non-invasive tests used to evaluate myocardial ischemia include stress electrocardiography, echocardiography, single-photon emission computed tomography, and magnetic resonance imaging. Invasive fractional flow reserve is considered the reference standard for assessment of the hemodynamic significance of CAD. Computed tomography (CT) angiography has emerged as a first-line imaging moda...
Source: Japanese Journal of Radiology - Category: Radiology Source Type: research
ConclusionSternal wire complications secondary to migration beyond the sternum are rare but potentially fatal. Precise wire location and risk assessment with CT are more appropriate when wire location cannot be clearly delineated by plain film radiography.
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: CASE REPORT Source Type: research
Authors: Alderwish E, Schultz E, Kassam Z, Poon M, Coplan N Abstract There is a broad differential diagnosis for patients presenting with acute chest pain. History, physical examination, electrocardiogram, and serial troponin assays are pivotal in assessing patients with suspected acute coronary syndrome. However, if the initial workup is equivocal, physicians are faced with a challenge to find the optimal strategy for further triage. Risk stratification scores have been validated for patients with known acute coronary syndrome, such as the TIMI and GRACE scores, but there may be limitations in undifferentiated che...
Source: Reviews in Cardiovascular Medicine - Category: Cardiology Tags: Rev Cardiovasc Med Source Type: research
ConclusionsClinicians may consider deferring immediate cardiac catheterization and attribute electrocardiogram changes to acute pancreatitis in patients presenting with angina pectoris and acute pancreatitis if confirmed by normal cardiac enzymes and elevated levels of lipase and amylase. However, when clinical signs and electrocardiogram findings are highly suggestive of myocardial ischemia/injury, immediate noninvasive coronary computed tomography angiography may be the best approach to make an early diagnosis.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
Abstract Clinical data: Infant, 7 months, female, referred to our department at one month of age, suspecting of congenital heart disease for further investigation. Chest radiography: Demonstrates cardiomegaly and prominent pulmonary vascular markings. Electrocardiography: Shows right ventricular hypertrophy and left anterior fascicular block. Echocardiography: Evidenced common atrioventricular valve with two orifices and the left superior pulmonary vein draining on the brachiocephalic vein. Computed tomography angiography: This complementary imaging exam was performed to confirm the diagnosis. Diagnosis: The patient presen...
Source: Revista Brasileira de Cirurgia Cardiovascular - Category: Cardiovascular & Thoracic Surgery Source Type: research
Rationale: Although implantation of Amplatzer membranous ventricular septal defect occluder (AVSDO) is an alternation to surgical treatment, the interventional therapy is disapproved by FDA due to high incidence of complete atrioventricular block (cAVB) post closure during early and middle term follow-up. However, long-term outcomes of the accumulating numbers of patients who had received AVSDO in the past decades, still remain an issue of concern and late occurrence of potentially catastrophic heart block long after hospital discharge is especially worrying, but rarely documented. We firstly reported a pediatric case wi...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
ConclusionsCardiac substructure delineation using E-CTA was feasible and inclusion in optimization led to modest improvements in sparing of radiosensitive cardiac substructures for some patients.
Source: Practical Radiation Oncology - Category: Cancer & Oncology Source Type: research
Rationale: Coronary angiography (CAG) findings of acute myocardial infarction (AMI) in pregnant women are characterized by a high incidence of normal coronary arteries. This is the first report of AMI with normal coronary arteries during pregnancy, showing coronary spasm and pregnancy-related acquired protein S (PS) deficiency. Patient concerns: A 30-year-old Japanese woman was admitted to an emergency department. One hour before admission, she developed sudden onset of precordial discomfort, back pain, and dyspnea. She was a primigravida at 39 weeks’ gestation and had no abnormality in the pregnancy thus far. S...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Rationale: Acute myocardial infarction is usually caused by coronary atherosclerotic plaque disruption (rupture or erosion), also including other uncommon etiologies. Pulmonary epithelioid hemangioendothelioma (PEH) is a rare low to intermediate malignant vascular tumor originating from vascular endothelial cells. Here, we report a rare case of acute ST-segment elevation myocardial infarction (STEMI) due to extrinsic compression of left coronary artery from PEH. Patient concerns: A 63-year-old woman with pulmonary nodules received left pulmonary nodulectomy, and the pathological examination indicated PEH. Five months ...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
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