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Impact of multi-detector row computed tomography on the tactics of cardiovascular surgery: from qualitative
Hiroshi Imagawa1, Kanji Kawachi, Shinji Takano
1Second Department of Surgery, Ehime University School of Medicine, Ehime, Japan.
Insights
Multi-detector row computed tomography effectively visualizes coronary bypass grafts and arterial branches in cardiovascular surgery. This imaging technique shows promise for assessing graft patency and left ventricular volumes.
Area of Science:
- Cardiovascular Imaging
- Medical Technology
- Surgical Assessment
Background:
- Multi-detector row computed tomography (MDCT) offers advanced imaging capabilities.
- Its role in cardiovascular surgery requires detailed assessment.
Purpose of the Study:
- To evaluate the efficacy of MDCT in cardiovascular surgery.
- To assess MDCT's performance in visualizing coronary bypass grafts, arterial degeneration, small vessels, and left ventricular volumes.
Main Methods:
- MDCT images were reconstructed using volume-rendering and maximum-intensity-profile methods.
- Graft patency, atheromatous degeneration, small vessel imaging, and left ventricular volumes were assessed.
- Aortic wall and calcification volumes were used to evaluate arterial atherosclerotic degeneration.
Main Results:
- MDCT demonstrated 98% accuracy for bypass graft patency with 98% sensitivity and 100% specificity.
- Atheromatous degeneration assessment matched intraoperative findings in over 70% of cases.
- MDCT detected over 92% of arterial branches ≥3 mm in diameter and showed a positive linear correlation with left ventricular volumes.
Conclusions:
- MDCT provides clear visualization of coronary bypass grafts and aortic arterial branches.
- MDCT assessment of atheromatous degeneration is comparable to intraoperative findings.
- MDCT is an efficient and promising imaging modality for cardiovascular surgery, correlating closely with cine-angiography for ventricular volumes.
Objective:
We assessed the role of multi-detector row computed tomography in cardiovascular surgery.
Methods:
The efficacy of multi-detector row computed tomography was assessed concerning the graft patency of coronary artery bypass, arterial atheromatous degeneration, small vessel imaging, and left ventricular volume measurement. Images were reconstructed using both the volume-rendering and the maximum-intensity-profile methods. Arterial atherosclerotic degeneration was assessed by aortic wall volume and aortic calcification volume.
Results:
In the assessment of bypass graft patency, multi-detector row computed tomography showed a 98% correct positive ratio with sensitivity and specificity of 98% and 100%, respectively. Atheromatous degeneration showed matching results in more than 70% of cases compared with intraoperative findings. More than 92% of arterial branches with diameters of 3 mm or greater were detected by preoperative multi-detector row computed tomography images, though only 6% of branches with diameters of 2 mm or less could be visualized. There was a positive linear correlation between left ventricular volumes determined by multi-detector row computed tomography and those calculated from cine angiography.
Conclusion:
Multi-detector row computed tomography clearly visualized coronary bypass grafts and aortic arterial branches, providing detailed vascular images. Atheromatous degeneration assessed by multi-detector row computed tomography was equivalent with intraoperative findings in more than 70% of cases. Left ventricular volumes measured by multi-detector row computed tomography correlated closely with those determined by cine-angiography. Multi-detector row computed tomography is an efficient and promising modality in cardiovascular surgery.
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