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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
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Multidetector computed tomography diagnosis and cine imaging of left main coronary arterial dissection

Eduard Ghersin1, Jennifer E Runco Therrien, Tanyanan Tanawuttiwat

  • 1Department of Radiology, Cardiovascular Division, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33101, USA. eghersin@med.miami.edu

Journal of Thoracic Imaging
|May 26, 2012
PubMed

Insights

Coronary artery dissection (CD) is a rare cause of heart attack. This study highlights a novel use of CT scans for primary diagnosis of left main CD, even when invasive angiography misses it.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Coronary artery dissection (CD) is an uncommon cause of acute myocardial ischemia.
  • Invasive coronary angiography is the standard diagnostic method for CD.
  • Electrocardiogram-gated multidetector computerized tomography (ECG-MDCT) is typically used for follow-up imaging.

Observation:

  • This report details the first use of retrospective ECG-MDCT for primary diagnosis of left main coronary artery dissection.
  • Dynamic cine imaging with ECG-MDCT provided detailed interrogation of the dissection.
  • The left main CD was not evident on invasive coronary angiography.

Findings:

  • Retrospective ECG-MDCT enabled primary diagnosis of a left main coronary artery dissection.
  • Dynamic cine interrogation revealed the extent and nature of the dissection.
  • This technique identified a case of CD missed by conventional angiography.

Implications:

  • ECG-MDCT may serve as a valuable primary diagnostic tool for coronary artery dissection.
  • This imaging modality offers a non-invasive alternative or adjunct to angiography.
  • Further research could establish ECG-MDCT's role in the initial management of CD.

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