Curved multiplanar reconstructions for the evaluation of contrast-enhanced electron beam CT of the coronary arteries.

Achenbach, Stephan; Moshage, Werner; Ropers, Dieter; Bachmann, K.

doi:10.2214/ajr.170.4.9530029

Cited by 93 publications

(38 citation statements)

References 10 publications

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“…Our findings are comparable with those from recent reports of the accuracy of 64-slice CT for the detection of coronary artery stenoses (sensitivity: 93-99%, specificity: 86-97% and NPV 98-99%) analyzed by a combination of conventional methods. [2][3][4][13][14][15] In the present study, there was only 1 FN finding on the AGV image, which was a very rare lesion located in the just proximal portion of the left circumflex artery where the vessel branches out from the mid-portion of the stent, and the sensitivity of the AGV image was the same as that with the conventional methods. Our results show that the AGV image is a reliable method of identifying significant stenoses.…”

Section: Discussionsupporting

confidence: 40%

Diagnostic Accuracy of Angiographic View Image for the Detection of Coronary Artery Stenoses by 64-Detector Row CT A Pilot Study Comparison With Conventional Post-Processing Methods and Axial Images Alone

Jinzaki

Satô

Tanami

et al. 2009

Circ J

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Circ J 2009; 73: 691 -698 ecent advances in multidetector-row computed tomography (MDCT) have enabled non-invasive evaluation of coronary artery stenoses with high accuracy. [1][2][3][4] Diagnostic evaluation of coronary artery stenoses includes review of the originally reconstructed axial images, as well as various post-processing images. The important role of post-processing images is to integrate the series of axial CT sections into a form that is easier to interpret and the axial images can be made to appear similar to other, more familiar images such as those from invasive angiography. [5][6][7][8][9] In these aspects, current methods, such as volume rendering (VR), partial maximum intensity projection (partial MIP), curved multiplanar reconstruction (curved MPR), or cross-sectional images, fall short. VR enables overview of the coronary artery to third parties, but it is not usually used for the evaluation of coronary artery stenoses. For coronary artery stenoses, partial MIP, curved MPR or cross-sectional images are used, but these conventional methods are quite different from the images obtained with invasive coronary angiography (CAG), and it can be difficult for a third person to understand which artery or segment is being analyzed.The angiographic view (AGV) image is a MIP image in which contrast media in the ventricles is eliminated. 7 This image is similar to that from invasive CAG and thus familiar to cardiologists. This type of MIP image clearly demonstrates the distribution of high-density lesions, such as coronary calcifications and stents, in the 1 image. If coronary artery stenoses can also be identified on the AGV image with high accuracy, it will be the post-processing method with most promise for accurately showing the distribution of coronary lesions that is understandable by third parties such as referral physicians and the patients.In this study, we evaluated the accuracy of the AGV image in comparison with axial images alone and a combination of conventional methods for coronary stenoses detection. (Received August 18, 2008; revised manuscript received November 21, 2008; accepted December 7, 2008; released online February 18, 2009 Toshihisa Anzai, MD**; Akio Kawamura, MD**; Koji Ueno, MD**; Sachio Kuribayashi, MD Background:The angiographic view (AGV) image is a new post-processing method that is similar to conventional coronary angiography (CAG). The purpose of this study was to evaluate its accuracy for coronary stenosis detection by 64-detector row computed tomography (CT). Methods and Results:CT evaluation results of 17 patients were compared with the results of invasive CAG on a coronary segment basis concerning the presence of stenoses >50% diameter reduction. All images of the 3 viewing methods (combination of conventional methods, AGV image alone, and axial images alone) were evaluated in consensus by 3 cardiovascular radiologists. Among 196 assessable segments, invasive CAG showed significant coronary artery stenoses in 44 segments. 43 of 44 lesions were detected with the ...

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Section: Discussionsupporting

confidence: 40%

Diagnostic Accuracy of Angiographic View Image for the Detection of Coronary Artery Stenoses by 64-Detector Row CT A Pilot Study Comparison With Conventional Post-Processing Methods and Axial Images Alone

Jinzaki

Satô

Tanami

et al. 2009

Circ J

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“…Another limitation of all noninvasive angiographic methods is the relative inability to visualize collateral vessels. The main determinant of false positive results for diagnosing ≥50 % coronary luminal stenosis is small vessel size, and the diameter of stenotic segments tends to be underestimated by CTA [ 84 ]. New research with dual energy (which can better discern calcifi cation and contrast) and with higher-defi nition detectors will continue to minimize these limitations.…”

Section: Limitations Of Computed Tomography Angiographymentioning

confidence: 99%

Computed Tomograph Cardiovascular Imaging

Budoff

2015

Coronary Artery Disease

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Cardiac computed tomography (CT) is a robust technology for the noninvasive assessment of a spectrum of cardiovascular disease processes. The predominant use of cardiac CT is fi rst detection of atherosclerosis and subsequently detection of stenosis, perfusion imaging, wall motion and ultimately valve disease. Although the technology has been clinically available for more than 25 years, cardiologists and even radiologists are largely unaware of its full capabilities. This chapter reviews cardiac CT's current clinical uses and its potential for even greater utility in the near future. Advances in spatial and temporal resolution, electrocardiographic (ECG) triggering methodology, radiation dose reduction, and image reconstruction software have helped in the evaluation of coronary artery anatomy and vessel patency, providing the ability to noninvasively diagnose or rule out signifi cant epicardial CAD. Cardiac CT allows the 3-dimensional (3D) simultaneous imaging of additional cardiac structures-including the coronary veins, pulmonary veins, atria, ventricles, aorta, and thoracic arterial and venous structures-and defi nition of their spatial relationships for the comprehensive assessment of a variety of cardiovascular disease processes. This chapter details the role of cardiac CT for the assessment of cardiovascular pathology with an emphasis on the detection of coronary atherosclerosis.

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“…Curved MPR with coronary CT angiography has been reported with high sensitivity and specificity (Achenbach et al, 1998). Significant stenosis and occlusions of the coronary arteries can be visualized with an accuracy that exceeds 90%, since the CT value is preserved, making it fairly easy to delineate calcifications from the lumen.…”

Section: Curved Multiplanar Reformation (Curved Mpr)mentioning

confidence: 99%

“…The drawback of curved MPR is that only one vessel can be visualized in one image and that side branches are not depicted unless separate reconstructions are rendered for every side branch (Achenbach et al, 1998). Angiographic view is better in evaluating multiple branches.…”

Section: Curved Multiplanar Reformation (Curved Mpr)mentioning

confidence: 99%