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Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Radiological Investigation III: Pulmonary Angiogram and PET Scan01:13

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Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
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Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
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Corrected coronary opacification decrease from coronary computed tomography angiography: Validation with quantitative

Dominik C Benz1, Christoph Gräni1, Paola Ferro1

  • 1Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland.

Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology
|July 8, 2017
PubMed
Summary
This summary is machine-generated.

Corrected coronary opacification (CCO) decrease from coronary computed tomography angiography (CCTA) moderately predicts coronary artery stenosis relevance. Its high negative predictive value aids in ruling out significant lesions, impacting patient diagnosis.

Keywords:
Corrected coronary opacificationquantitative PET myocardial perfusion imagingrelative flow reserve

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Area of Science:

  • Cardiovascular Imaging
  • Radiology
  • Nuclear Medicine

Background:

  • Assessing functional significance of coronary artery stenosis is crucial.
  • Corrected coronary opacification (CCO) decrease from coronary computed tomography angiography (CCTA) is a proposed metric.
  • Validation against quantitative myocardial perfusion imaging (MPI) is needed.

Purpose of the Study:

  • To validate CCO decrease derived from CCTA against 13N-ammonia positron emission tomography (PET) MPI.
  • To determine the diagnostic accuracy of CCO decrease in predicting abnormal relative flow reserve (RFR).

Main Methods:

  • Retrospective analysis of 39 patients with hybrid CCTA/PET-MPI.
  • Calculation of CCO decrease from CCTA by measuring lumen attenuation.
  • Determination of RFR by comparing stress myocardial blood flow (MBF) in stenotic versus reference territories.

Main Results:

  • Relative flow reserve (RFR) was abnormal in 27% of vessel territories.
  • CCO decrease showed 73% sensitivity, 70% specificity, and 70% accuracy for predicting abnormal RFR.
  • A high negative predictive value (88%) was observed for CCO decrease.

Conclusions:

  • CCTA-derived CCO decrease demonstrates moderate accuracy in predicting abnormal RFR.
  • The high negative predictive value of CCO decrease is clinically relevant for excluding functional significance of coronary stenosis.