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Sample records for coronaries scanner results

  1. Myocardium scintigraphy and coronaries scanner: results and respective contribution of these two examinations; Scintigraphie myocardique et scanner coronaire: resultats et apport respectif des deux examens

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    Songy, B.; Balestrini, V.; Sablayrolles, J.L.; Vigoni, F.; Lussato, D. [Centre cardiologique du Nord (CCN), Saint-Denis, (France); Faccio, F. [fondation San Geronimo, Santa Fe, (Argentina)

    2009-05-15

    The objective were to evaluate the results and the respective contribution of the myocardium scintigraphy and the coro-scanner. It exists an excellent correlation between a normal scanner and a normal scintigraphy (97%). 30% of patients having non tight stenosis at scanner and 60% of these ones having tight stenosis have a scintigraphy ischemia; An abnormal scanner, whatever be the the degree of stenosis must be completed by a test of myocardium ischemia. The actual limitations of the coro-scanner (64 gills) are in relation with its spatial resolution (quantification) and temporal resolution (right coronary). The choice of the diagnosis examination to realize in first intention must depend on the age and prevalence of the coronary disease. (N.C.)

  2. A 128-slice CT scanner helpful in localising coronary sinus ostium during CRT-D implantation – case report

    International Nuclear Information System (INIS)

    Jaźwiec, Przemysław; Jagielski, Dariusz; Gać, Paweł

    2014-01-01

    Cardiac resynchronization therapy (CRT) has become a successful treatment option for symptomatic heart failure in patients with poor left ventricular (LV) systolic function and broad QRS complex in the surface electrocardiogram (ECG). In this report we present a case of a 70-year-old woman with advanced heart failure due to ischaemic heart disease who underwent an upgrade from VVIR stimulator (pacemaker, PM) to cardiac resynchronization therapy defibrillator (CRT-D). The first attempt was unsuccessful due to problems with inefficient cannulation of the orifice of the coronary sinus (CS). After performing a 3D reconstruction with a 128-slice CT scanner, it was possible to carry out the up-grade to CRT-D resulting in enormous clinical improvement. The case represents an example of the usefulness of 3D reconstruction with the 128-slice CT scanner used after failed CRT-D implantation due to difficulties with efficient cannulation of the coronary sinus orifice in a rare anatomical variant

  3. In vitro imaging of coronary artery stents: Are there differences between 16- and 64-slice CT scanners?

    International Nuclear Information System (INIS)

    Wolf, Florian; Feuchtner, Gudrun M.; Homolka, Peter; Langenberger, Herbert; Stadler, Alfred; Bader, Till R.; Weber, Michael; Lammer, Johannes; Loewe, Christian

    2008-01-01

    Purpose: To compare the performance of 64-slice with 16-slice CT scanners for the in vitro evaluation of coronary artery stents. Methods and materials: Twelve different coronary artery stents were placed in the drillings of a combined heart and chest phantom, which was scanned with a 16- and 64-slice CT scanner. Coronal reformations were evaluated for artificial lumen narrowing, intraluminal attenuation values, and false widening of the outer stent diameter as an indicator of artifacts outside the stent. Results: Mean artificial lumen narrowing was not significantly different between the 16- and 64-slice CT scanner (44% versus 39%; p = 0.408). The differences between the Hounsfield Units (HU) measurements inside and outside the stents were significantly lower (p = 0.001) with 64- compared to 16-slice CT. The standard deviation of the HU measurements inside the stents was significantly (p = 0.002) lower with 64- than with 16-slice CT. Artifacts outside the stents were not significantly different between the scanners (p = 0.866). Conclusion: Visualization of the in-stent lumen is improved with 64-slice CT when compared with 16-slice CT as quantified by significantly lesser intraluminal image noise and less artificial rise in intraluminal HU measurement, which is the most important parameter for the evaluation of stent patency in vivo

  4. Diagnostic accuracy of prospective ECG gated coronary computed tomography on a 256 slices scanner: Daily practice experience

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    Ahmed M. Fareed

    2014-03-01

    Conclusions: In a highly prevalence diseased population, prospective ECG-gated CTCA using 256-slice scanner is highly accurate for detection and quantification of the degree of coronary luminal stenosis in comparison to ICA.

  5. Comparison of coronary artery calcium screening image quality between C-150 and e-Speed electron beam scanners.

    Science.gov (United States)

    Budoff, Matthew J; Shinbane, Jerold S; Oudiz, Ronald J; Child, Janis; Carson, Sivi; Chau, Alex; Tseng, Philip; Gao, Yanlin; Mao, Songshou

    2005-03-01

    The newest generation of electron beam tomographic scanner (e-Speed) has increased spatial and temporal resolution compared with the C-150 XP scanner. The aim of this study was to evaluate coronary artery calcium screening image quality between the e-Speed and C-150 scanners (GE Imatron, San Francisco, CA). Studies from 41 patients (14 women and 27 men) who underwent serial coronary artery calcium screening with the C-150 (first study) and the e-Speed (second study) were analyzed. Individual computed tomography (CT) slices were assessed for coronary artery motion artifacts, and CT Hounsfield units (HU) and noise values (CT HU standard deviation) at 16 discrete cardiac sites were measured and averaged. With the e-Speed scanner, there were significant decreases in right coronary artery motion artifacts compared with the C-150 scanner (0.3% versus 1.8%, P Image quality is significantly improved with use of the e-Speed scanner, due to its improved temporal and spatial resolution, compared with the C-150 scanner.

  6. Assessment of coronary calcification using calibrated mass score with two different multidetector computed tomography scanners in the Copenhagen General Population Study

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    Fuchs, Andreas [Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Groen, Jaap M. [Department of Radiology, University of Groningen, University Medical Center Groningen (Netherlands); Department of Medical Physics, OLVG, Amsterdam (Netherlands); Arnold, Ben A. [Image Analysis, 1380 Burkesville Road, Columbia, KY (United States); Nikolovski, Sasho [Department of Radiology, University of Groningen, University Medical Center Groningen (Netherlands); Knudsen, Andreas D., E-mail: dehlbaek@gmail.com [Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Kühl, J. Tobias [Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Nordestgaard, Børge G. [Department of Clinical Biochemistry and the Copenhagen General Population Study, Herlev Hospital, University of Copenhagen (Denmark); Greuter, Marcel J.W. [Department of Radiology, University of Groningen, University Medical Center Groningen (Netherlands); Kofoed, Klaus F. [Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Department of Radiology, The Diagnostic Centre, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark)

    2017-03-15

    Objective: Population studies have shown coronary calcium score to improve risk stratification in subjects suspected for cardiovascular disease. The aim of this work was to assess the validity of multidetector computed tomography (MDCT) for measurement of calibrated mass scores (MS) in a phantom study, and to investigate inter-scanner variability for MS and Agaston score (AS) recorded in a population study on two different high-end MDCT scanners. Materials and methods: A calcium phantom was scanned by a first (A) and second (B) generation 320-MDCT. MS was measured for each calcium deposit from repeated measurements in each scanner and compared to known physical phantom mass. Random samples of human subjects from the Copenhagen General Population Study were scanned with scanner A (N = 254) and scanner B (N = 253) where MS and AS distributions of these two groups were compared. Results: The mean total MS of the phantom was 32.9 ± 0.8 mg and 33.1 ± 0.9 mg (p = 0.43) assessed by scanner A and B respectively – the physical calcium mass was 34.0 mg. Correlation between measured MS and physical calcium mass was R{sup 2} = 0.99 in both scanners. In the population study the median total MS was 16.8 mg (interquartile range (IQR): 3.5–81.1) and 15.8 mg (IQR: 3.8–63.4) in scanner A and B (p = 0.88). The corresponding median total AS were 92 (IQR: 23–471) and 89 (IQR: 40–384) (p = 0.64). Conclusion: Calibrated calcium mass score may be assessed with very high accuracy in a calcium phantom by different generations of 320-MDCT scanners. In population studies, it appears acceptable to pool calcium scores acquired on different 320-MDCT scanners.

  7. Early results of coronary artery bypass grafting with coronary endarterectomy for severe coronary artery disease

    Directory of Open Access Journals (Sweden)

    Toischer Karl

    2009-09-01

    Full Text Available Abstract Background Despite the existence of controversial debates on the efficiency of coronary endarterectomy (CE, it is still used as an adjunct to coronary artery bypass grafting (CABG. This is particularly true in patients with endstage coronary artery disease. Given the improvements in cardiac surgery and postoperative care, as well as the rising number of elderly patient with numerous co-morbidities, re-evaluating the pros and cons of this technique is needed. Methods Patient demographic information, operative details and outcome data of 104 patients with diffuse calcified coronary artery disease were retrospectively analyzed with respect to functional capacity (NYHA, angina pectoris (CCS and mortality. Actuarial survival was reported using a Kaplan-Meyer analysis. Results Between August 2001 and March 2005, 104 patients underwent coronary artery bypass grafting (CABG with adjunctive coronary endarterectomy (CE in the Department of Thoracic-, Cardiac- and Vascular Surgery, University of Goettingen. Four patients were lost during follow-up. Data were gained from 88 male and 12 female patients; mean age was 65.5 ± 9 years. A total of 396 vessels were bypassed (4 ± 0.9 vessels per patient. In 98% left internal thoracic artery (LITA was used as arterial bypass graft and a total of 114 vessels were endarterectomized. CE was performed on right coronary artery (RCA (n = 55, on left anterior descending artery (LAD (n = 52 and circumflex artery (RCX (n = 7. Ninety-five patients suffered from 3-vessel-disease, 3 from 2-vessel- and 2 from 1-vessel-disease. Closed technique was used in 18%, open technique in 79% and in 3% a combination of both. The most frequent endarterectomized localization was right coronary artery (RCA = 55%. Despite the severity of endstage atherosclerosis, hospital mortality was only 5% (n = 5. During follow-up (24.5 ± 13.4 months, which is 96% complete (4 patients were lost caused by unknown address 8 patients died (cardiac

  8. Assessment of radiation exposure on a dual-source computed tomography-scanner performing coronary computed tomography-angiography

    International Nuclear Information System (INIS)

    Kirchhoff, S.; Herzog, P.; Johnson, T.; Boehm, H.; Nikolaou, K.; Reiser, M.F.; Becker, C.H.

    2010-01-01

    Objective: The radiation exposure of a dual-source-64-channel multi-detector-computed-tomography-scanner (Somatom-Defintion, Siemens, Germany) was assessed in a phantom-study performing coronary-CT-angiography (CTCA) in comparison to patients' data randomly selected from routine scanning. Methods: 240 CT-acquisitions of a computed tomography dose index (CTDI)-phantom (PTW, Freiburg, Germany) were performed using a synthetically generated Electrocardiography (ECG)-signal with variable heart rates (30-180 beats per minute (bpm)). 120 measurements were acquired using continuous tube-output; 120 measurements were performed using ECG-synchronized tube-modulation. The pulsing window was set at minimum duration at 65% of the cardiac cycle between 30 and 75 bpm. From 90-180 bpm the pulsing window was set at 30-70% of the cardiac cycle. Automated pitch adaptation was always used. A comparison between phantom CTDI and two patient groups' CTDI corresponding to the two pulsing groups was performed. Results: Without ECG-tube-modulation CDTI-values were affected by heart-rate-changes resulting in 85.7 mGray (mGy) at 30 and 45 bpm, 65.5 mGy/60 bpm, 54.7 mGy/75 bpm, 46.5 mGy/90 bpm, 34.2 mGy/120 bpm, 27.0 mGy/150 bpm and 22.1 mGy/180 bpm equal to effective doses between 14.5 mSievert (mSv) at 30/45 bpm and 3.6 mSv at 180 bpm. Using ECG-tube-modulation these CTDI-values resulted: 32.6 mGy/30 bpm, 36.6 mGy/45 bpm, 31.4 mGy/60 bpm, 26.8 mGy/75 bpm, 23.7 mGy/90 bpm, 19.4 mGy/120 bpm, 17.2 mGy/150 bpm and 15.6 mGy/180 bpm equal to effective doses between 5.5 mSv at 30 bpm and 2.6 mSv at 180 bpm. Significant CTDI-differences were found between patients with lower/moderate and higher heart rates in comparison to the phantom CTDI-results. Conclusions: Dual source CTCA is particularly dose efficient at high heart rates when automated pitch adaptation, especially in combination with ECG-based tube-modulation is used. However in clinical routine scanning for patients with higher heart rates

  9. Chronic total coronary occlusion: treatment results.

    Science.gov (United States)

    Kirk Christensen, Martin; Freeman, Phillip Fischer; Rasmussen, Jeppe Groendal; Villadsen, Anton Boel; Raungaard, Bent; Eggert Jensen, Svend; Thuesen, Leif

    2017-08-01

    To describe the clinical and procedural coronary chronic total occlusion (CTO) treatment results in a Nordic PCI centre during the implementation of a CTO treatment program. In a retrospective registry study, we assessed; (1) indication for the procedure, (2) Canadian Cardiovascular Society angina pectoris score (CCS)/New York Heart Association (NYHA) heart failure score, (3) lesion complexity and (4) adverse events during hospital stay and three months following the index procedure. The study cohort included 503 patients (594 lesions). From 2010 to 2013 96% of procedures were performed with antegrade wire-escalation technique and 4% performed using retrograde techniques, from 2013-2016 the corresponding numbers were 83% and 17.0%. The procedural success rate was 69%, increasing from 64% before to 72% (p = .06) after routinely using the retrograde approach. No individual patient characteristic, lesion variable or score was strongly associated with procedural success or failure. There were 4% serious procedure related complications. In patients with PCI of a CTO lesion only, 87% were in CCS or NYHA functional class ≥2 before the index procedure vs. 22% at follow-up. Routine use of retrograde techniques tended to increase the procedural success rate. Clinical results after three months were acceptable, but the complication rate was higher than for non-CTO PCI. Individual patient and lesion characteristics had a low predictability for procedural success. Therefore, clinical symptoms, objective signs of myocardial ischemia and procedural risk should be focus points in coronary chronic total occlusion treatment strategies.

  10. Comparison of Myocardial Perfusion Scintigraphy and Coronary Angiography Results

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    Umut Elboga

    2017-05-01

    Full Text Available Aim: Coronary artery disease (CAD is one of the most frequent causes of mortality and morbidity worldwide. Coronary angiography is the gold standard for the anatomical diagnosis of coronary artery stenosis. Myocardial Perfusion Scintigraphy (MPS is a non-invasive imaging modality used for the diagnosis of CAD. In this study, we aimed to compare the findings of MPS and coronary angiogram. Material and Method: Eighty-one patients (37 males, 44 females; mean age 55 ± 10.95 years with angina and detected perfusion defects on MPS were included in this study. All of the patients underwent coronary angiogram. A narrowing %u2265 50% was considered pathological on the coronary angiography. Results: Findings of the coronary angiogram and MPS were compared and found consistent in 51 (63% patients. A coronary narrowing < 50% was detected by coronary angiogram in 4 (5% of the remaining patients. Coronary angiogram was found to be normal in the remaining 26 patients (32% and these patients were evaluated as cardiac syndrome X (CSX known as microvascular angina (MA. Discussion: The findings showed that MPS is superior to coronary angiogram in the early diagnosis of myocardial perfusion disorders at the microvascular level. Therefore, we concluded that MPS should be the primary diagnostic tool to begin treatment before an anatomically large narrowing occurs in the coronaries.

  11. Initial results of the quality control in 11 computed tomography scanners at Curitiba

    International Nuclear Information System (INIS)

    Kodlulovich, S; Oliveira, L.; Jakubiak, R.R.; Miquelin, C.A.

    2008-01-01

    The aim of this study was to evaluate the image quality of 11 scanners installed in public and private centers of Curitiba, Brazil. This sample represents 30% of the CT scanners in the city so far. The ACR CT accreditation phantom was used to verify the accomplishment of the scanners performance to the international quality requirements. The results indicate that efforts should be concentrated in the maintenance of the equipments and specific training of the technicians. Most of the scanners have showed some non-conformity. In 27,5% of the sample the positioning requirement wasn't accomplished. The CT number accuracy evaluation showed that in 72,3 % of the scanners the CT numbers were out of the tolerance range, reaching values 35% greater than the limit. The low contrast resolution criteria weren't accomplished in 9% of the scanners. The main concern is that there isn't a specific program to evaluate the image quality of the CT scanners neither to estimate the CT doses in the procedures. (author)

  12. Coronary CT angiography: Diagnostic value and clinical challenges.

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    Sabarudin, Akmal; Sun, Zhonghua

    2013-12-26

    Coronary computed tomography (CT) angiography has been increasingly used in the diagnosis of coronary artery disease due to improved spatial and temporal resolution with high diagnostic value being reported when compared to invasive coronary angiography. Diagnostic performance of coronary CT angiography has been significantly improved with the technological developments in multislice CT scanners from the early generation of 4-slice CT to the latest 320- slice CT scanners. Despite the promising diagnostic value, coronary CT angiography is still limited in some areas, such as inferior temporal resolution, motion-related artifacts and high false positive results due to severe calcification. The aim of this review is to present an overview of the technical developments of multislice CT and diagnostic value of coronary CT angiography in coronary artery disease based on different generations of multislice CT scanners. Prognostic value of coronary CT angiography in coronary artery disease is also discussed, while limitations and challenges of coronary CT angiography are highlighted.

  13. Volumetric Single-Beat Coronary Computed Tomography Angiography: Relationship of Image Quality, Heart Rate, and Body Mass Index. Initial Patient Experience With a New Computed Tomography Scanner.

    Science.gov (United States)

    Latif, Muhammad Aamir; Sanchez, Frank W; Sayegh, Karl; Veledar, Emir; Aziz, Muhammad; Malik, Rehan; Haider, Imran; Agatston, Arthur S; Batlle, Juan C; Janowitz, Warren; Peña, Constantino; Ziffer, Jack A; Nasir, Khurram; Cury, Ricardo C

    2016-01-01

    Cardiac computed tomography (CT) image quality (IQ) is very important for accurate diagnosis. We propose to evaluate IQ expressed as Likert scale, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) from coronary CT angiography images acquired with a new volumetric single-beat CT scanner on consecutive patients and assess the IQ dependence on heart rate (HR) and body mass index (BMI). We retrospectively analyzed the data of the first 439 consecutive patients (mean age, 55.13 [SD, 12.1] years; 51.47% male), who underwent noninvasive coronary CT angiography in a new single-beat volumetric CT scanner (Revolution CT) to evaluate chest pain at West Kendall Baptist Hospital. Based on patient BMI (mean, 29.43 [SD, 5.81] kg/m), the kVp (kilovolt potential) value and tube current were adjusted within a range of 80 to 140 kVp and 122 to 720 mA, respectively. Each scan was performed in a single-beat acquisition within 1 cardiac cycle, regardless of the HR. Motion correction software (SnapShot Freeze) was used for correcting motion artifacts in patients with higher HRs. Autogating was used to automatically acquire systolic and diastolic phases for higher HRs with electrocardiographic milliampere dose modulation. Image quality was assessed qualitatively by Likert scale and quantitatively by SNR and CNR for the 4 major vessels right coronary, left main, left anterior descending, and left circumflex arteries on axial and multiplanar reformatted images. Values for Likert scale were as follows: 1, nondiagnostic; 2, poor; 3, good; 4, very good; and 5, excellent. Signal-to-noise ratio and CNR were calculated from the average 2 CT attenuation values within regions of interest placed in the proximal left main and proximal right coronary artery. For contrast comparison, a region of interest was selected from left ventricular wall at midcavity level using a dedicated workstation. We divided patients in 2 groups related to the HR: less than or equal to 70 beats/min (bpm) and

  14. Directional atherectomy for treatment of restenosis within coronary stents: clinical, angiographic and histologic results

    NARCIS (Netherlands)

    B.H. Strauss (Bradley); V.A.W.M. Umans (Victor); R-J. van Suylen (Robert-Jan); P.J. de Feyter (Pim); J. Marco (Jean); G. Robertson; J. Renkin; G.R. Heyndrickx (Guy); V.D. Vuzevski (Vojislav); F.T.B. Bosman (Fré); P.W.J.C. Serruys (Patrick)

    1992-01-01

    textabstractAbstract OBJECTIVES: The safety and long-term results of directional coronary atherectomy in stented coronary arteries were determined. In addition, tissue studies were performed to characterize the development of restenosis. METHODS: Directional coronary atherectomy was performed in

  15. Evaluation of a laser scanner for large volume coordinate metrology: a comparison of results before and after factory calibration

    International Nuclear Information System (INIS)

    Ferrucci, M; Muralikrishnan, B; Sawyer, D; Phillips, S; Petrov, P; Yakovlev, Y; Astrelin, A; Milligan, S; Palmateer, J

    2014-01-01

    Large volume laser scanners are increasingly being used for a variety of dimensional metrology applications. Methods to evaluate the performance of these scanners are still under development and there are currently no documentary standards available. This paper describes the results of extensive ranging and volumetric performance tests conducted on a large volume laser scanner. The results demonstrated small but clear systematic errors that are explained in the context of a geometric error model for the instrument. The instrument was subsequently returned to the manufacturer for factory calibration. The ranging and volumetric tests were performed again and the results are compared against those obtained prior to the factory calibration. (paper)

  16. Initial experience with prospectively triggered, sequential CT coronary angiography on a 128-slice scanner; Erste Erfahrungen mit der sequenziellen, prospektiv getriggerten CT-Koronarangiografie an einem 128-Schicht-Computertomografen

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    Anders, K.; Baum, U.; Kuefner, M.A.; Kuettner, A.; Uder, M. [Universitaetsklinikum Erlangen (Germany). Radiologisches Inst.; Gauss, S.; Achenbach, S.; Daniel, W.G.; Ropers, D. [Universitaetsklinikum Erlangen (Germany). Medizinische Klinik 2

    2009-04-15

    Purpose: Spiral CT angiography (CTA) of the coronaries using low-pitch scanning and ECG-gated image reconstruction is a robust method for detecting or excluding relevant coronary plaque. However, the resulting dose exposure is considerable. The aim of the present study was to evaluate image quality and artifacts as well as to record dose values for sequential coronary CTA using a 128-slice scanner with a temporal resolution of 150 ms. Materials und Methods: 20 patients with a regular heart rate and without contraindications for oral/I.V. beta blockers, who were referred for CTA of the coronaries for exclusion or detection of relevant plaques, were examined by sequential CTA with the following parameters: 120 kV, 200 ref mAs, collimation 2 x 64 x 0.6, table feed of 34.5 mm at a detector width of 38.4 mm. A total acquisition time of 380 ms per table position allowed for mild shifting of the reconstruction window within the cardiac cycle of {+-} 5 %. 50 ml of contrast agent were injected at 5 ml/s followed by a 50 ml split bolus (20 % contrast). The individual start delay was determined by a test bolus scan (10 ml contrast + 50 ml saline flush at 5 ml/s). The image quality for each segment, coronary artery, and patient was determined on a 4-point scale. Dose values were estimated based on the individual dose length product as provided by the scanner's patient protocol. Artifacts were evaluated to determine the cause (calcium vs. motion). Results: All patients received beta blocker pretreatment. The mean heart rate was 62 {+-} 5 beats/min. 5 % (13/286) of all segments in 5/20 patients were rated as non-diagnostic. The mean dose length product was 213 mGy x cm, and the mean effective dose was 3.6 mSv. Calcifications were the major cause of non-diagnostic images. However breathing or other motion artifacts occurred as well. (orig.)

  17. Image quality and radiation dose of coronary CT angiography performed with whole-heart coverage CT scanner with intra-cycle motion correction algorithm in patients with atrial fibrillation.

    Science.gov (United States)

    Andreini, Daniele; Pontone, Gianluca; Mushtaq, Saima; Mancini, Maria Elisabetta; Conte, Edoardo; Guglielmo, Marco; Volpato, Valentina; Annoni, Andrea; Baggiano, Andrea; Formenti, Alberto; Ditali, Valentina; Perchinunno, Marco; Fiorentini, Cesare; Bartorelli, Antonio L; Pepi, Mauro

    2018-04-01

    To evaluate image quality, coronary evaluability and radiation exposure of coronary CT angiography (CCTA) performed with whole-heart coverage cardiac-CT in patients with atrial fibrillation (AF). We prospectively enrolled 164 patients with AF who underwent a clinically indicated CCTA with a 16-cm z-axis coverage scanner. In all patients CCTA was performed using prospective ECG-triggering with targeted RR interval. We evaluated image quality, coronary evaluability and effective dose (ED). Patients were divided in two subgroups based on heart rate (HR) during imaging. Group 1: 64 patients with low HR (ethics committee approved the study protocol. In a segment-based analysis, coronary evaluability was 98.4 % (2,577/2,620 segments) in the whole population, without significant differences between groups (1,013/1,024 (98.9 %) and 1,565/1,596 (98.1 %), for groups 1 and 2, respectively, p=0.15). Mean ED was similar in both groups (3.8±1.9 mSv and 3.9±2.1 mSv in groups 1 and 2, respectively, p=0.75) CONCLUSIONS: The whole-heart-coverage scanner could evaluate coronary arteries with high image quality and without increase in radiation exposure in AF patients, even in the high HR group. • Last-generation CT scanner improves coronary artery assessment in AF patients. • The new CT scanner enables low radiation exposure in AF patients. • Diagnostic ICA maybe avoided in AF patients with suspected CAD. • Whole-heart coverage CT scanner enables low radiation exposure in AF patients.

  18. Results of a comparison study using tomographic and segmented gamma scanner technology

    International Nuclear Information System (INIS)

    Hurd, J.R.; Estep, R.J.; Dittrich, S.; Grimes, L.V.; Gomez, C.D.

    2004-01-01

    In order to support the many on-going research and programmatic activities at Los Alamos Plutonium and Chemistry and Metallurgy Research (CMR) Facilities in as accurate, efficient, and cost-effective manner possible, every reasonable effort is made to equip the nondestructive assay (NDA) laboratories with the most modern and technologically advanced instrumentation available. Recently, new state-of-the-art tomographic gamma scanner (TGS) instruments were installed to replace aging and outmoded segmented gamma scanner (SGS) instruments. Through the implementation of a translation axis, in addition to the vertical and rotation axes of the SGS, the TGS technique is able to employ axial tomography to determine the spatial distribution and quantity of nuclear material using high-resolution gamma-ray spectroscopy. Because the attenuation matrix and source distributions are known more accurately than with the SGS technology, biases due to matrix and source distributions should be reduced. In principle, a single calibration should suffice for the determination of isotopic mass for a wide range of material and matrix types. A number of questions naturally arise concerning these purported advantages of the TGS. Perhaps the most fundamental of these is to understand how the TGS measurement results compare with those of a typical SGS on the same well-characterized standards differing in matrix and material type. To that end, the TGS operating parameters were optimized to assay 55-gallon drum waste identical to that measured by our SGS. The calibration and measurement results on these standards, placed in typical low-density waste matrices, are presented and discussed. These results should enable more confident use of the TGS as well as point the way toward even more studies to enable more effective employment of the new TGS technology.

  19. Transluminal coronary angioplasty (TCA) techniques, indications and results

    International Nuclear Information System (INIS)

    Kober, G.; Lang, H.; Vallbracht, C.; Bussmann, W.D.; Hopf, R.; Kunkel, B.; Kaltenbach, M.

    1985-01-01

    Transluminal coronary angioplasty (TCA) was introduced in 1977 for dilatation of coronary stenoses. From October 1977 to December 1984 1087 procedures have been performed in Frankfurt. The mean success rate was 77% with an increase from 58% to 84% since 1977. Recurrences were seen within the first year in 15% of the patients, which could be treated successfully in a high percentage with a second TCA. Emergency bypass operations were necessary in 5.2%. Four patients (fatality rate 0.37%) died as the consequence of the intervention. Within few years TCA has become an established procedure for myocardial revascularisation, with a high success rate. Major progress has been possible in the last few years due to technical developments, which are still going on. They may lead to further improvement of the results and enlargement of the indication for TCA. (orig.) [de

  20. Automatic Tree Data Removal Method for Topography Measurement Result Using Terrestrial Laser Scanner

    Science.gov (United States)

    Yokoyama, H.; Chikatsu, H.

    2017-02-01

    Recently, laser scanning has been receiving greater attention as a useful tool for real-time 3D data acquisition, and various applications such as city modelling, DTM generation and 3D modelling of cultural heritage sites have been proposed. And, former digital data processing were demanded in the past digital archive techniques for cultural heritage sites. However, robust filtering method for distinguishing on- and off-terrain points by terrestrial laser scanner still have many issues. In the past investigation, former digital data processing using air-bone laser scanner were reported. Though, efficient tree removal methods from terrain points for the cultural heritage are not considered. In this paper, authors describe a new robust filtering method for cultural heritage using terrestrial laser scanner with "the echo digital processing technology" as latest data processing techniques of terrestrial laser scanner.

  1. A quality score for coronary artery tree extraction results

    Science.gov (United States)

    Cao, Qing; Broersen, Alexander; Kitslaar, Pieter H.; Lelieveldt, Boudewijn P. F.; Dijkstra, Jouke

    2018-02-01

    Coronary artery trees (CATs) are often extracted to aid the fully automatic analysis of coronary artery disease on coronary computed tomography angiography (CCTA) images. Automatically extracted CATs often miss some arteries or include wrong extractions which require manual corrections before performing successive steps. For analyzing a large number of datasets, a manual quality check of the extraction results is time-consuming. This paper presents a method to automatically calculate quality scores for extracted CATs in terms of clinical significance of the extracted arteries and the completeness of the extracted CAT. Both right dominant (RD) and left dominant (LD) anatomical statistical models are generated and exploited in developing the quality score. To automatically determine which model should be used, a dominance type detection method is also designed. Experiments are performed on the automatically extracted and manually refined CATs from 42 datasets to evaluate the proposed quality score. In 39 (92.9%) cases, the proposed method is able to measure the quality of the manually refined CATs with higher scores than the automatically extracted CATs. In a 100-point scale system, the average scores for automatically and manually refined CATs are 82.0 (+/-15.8) and 88.9 (+/-5.4) respectively. The proposed quality score will assist the automatic processing of the CAT extractions for large cohorts which contain both RD and LD cases. To the best of our knowledge, this is the first time that a general quality score for an extracted CAT is presented.

  2. Estimated Uncertainty in Segmented Gamma Scanner Assay Results due to the Variation in Drum Tare Weights

    International Nuclear Information System (INIS)

    Bosko, A.; Croft, St.; Gulbransen, E.

    2009-01-01

    General purpose gamma scanners are often used to assay unknown drums that differ from those used to create the default calibration. This introduces a potential source of bias into the matrix correction when the correction is based on the estimation of the mean density of the drum contents from a weigh scale measurement. In this paper we evaluate the magnitude of this bias that may be introduced by performing assay measurements with a system whose matrix correction algorithm was calibrated with a set of standard drums but applied to a population of drums whose tare weight may be different. The matrix correction factors are perturbed in such cases because the unknown difference in tare weight gets reflected as a bias in the derived matrix density. This would be the only impact if the difference in tare weight was due solely to the weight of the lid or base, say. But in reality the reason for the difference may be because the steel wall of the drum is of a different thickness. Thus, there is an opposing interplay at work which tends to compensate. The purpose of this work is to evaluate and bound the magnitude of the resulting assay uncertainty introduced by tare weight variation. We compare the results obtained using simple analytical models and the 3-D ray tracing with ISOCS software to illustrate and quantify the problem. The numerical results allow a contribution to the Total Measurement Uncertainty (TMU) to be propagated into the final assay result. (authors)

  3. Image quality and radiation dose of coronary CT angiography performed with whole-heart coverage CT scanner with intra-cycle motion correction algorithm in patients with atrial fibrillation

    International Nuclear Information System (INIS)

    Andreini, Daniele; Fiorentini, Cesare; Pontone, Gianluca; Mushtaq, Saima; Mancini, Maria Elisabetta; Conte, Edoardo; Guglielmo, Marco; Volpato, Valentina; Annoni, Andrea; Baggiano, Andrea; Formenti, Alberto; Ditali, Valentina; Pepi, Mauro; Perchinunno, Marco; Bartorelli, Antonio L.

    2018-01-01

    To evaluate image quality, coronary evaluability and radiation exposure of coronary CT angiography (CCTA) performed with whole-heart coverage cardiac-CT in patients with atrial fibrillation (AF). We prospectively enrolled 164 patients with AF who underwent a clinically indicated CCTA with a 16-cm z-axis coverage scanner. In all patients CCTA was performed using prospective ECG-triggering with targeted RR interval. We evaluated image quality, coronary evaluability and effective dose (ED). Patients were divided in two subgroups based on heart rate (HR) during imaging. Group 1: 64 patients with low HR (<75 bpm), group 2: 100 patients with high HR (≥75 bpm). Written informed consent was obtained from all patients and the institutional ethics committee approved the study protocol. In a segment-based analysis, coronary evaluability was 98.4 % (2,577/2,620 segments) in the whole population, without significant differences between groups (1,013/1,024 (98.9 %) and 1,565/1,596 (98.1 %), for groups 1 and 2, respectively, p=0.15). Mean ED was similar in both groups (3.8±1.9 mSv and 3.9±2.1 mSv in groups 1 and 2, respectively, p=0.75) The whole-heart-coverage scanner could evaluate coronary arteries with high image quality and without increase in radiation exposure in AF patients, even in the high HR group. (orig.)

  4. Whole-heart MR coronary angiography - first results

    International Nuclear Information System (INIS)

    Ozgun, M.; Quante, M.; Fischbach, R.; Heindel, W.; Maintz, D.; Hoffmeier, A.; Botnar, R.

    2006-01-01

    Purpose: To evaluate a new coronary MR angiography technique covering the whole coronary artery tree in one data set acquisition. Materials and methods: Six healthy volunteers and 15 patients with known CAD were examined with a navigator gated and corrected (NAV) free-breathing 3D steady-state free precession sequence covering the whole heart (WH-MRA) (TR=5.4, TE-2.7, SENSE factor=2, 160 slices, 0.75 mm reconstructed slice thickness, in-plane resolution =0.99 x 0.99 mm 2 , scan time 14 min [50% NAV efficiency]) and a vessel targeted 3D SSFP MRA sequence (t-MRA) (TR=5.6 ms, TE-2.8 ms, 20 slices of 1.5 mm reconstructed slice thickness, in-plane resolution =0.99 x 0.99 mm 2 , scan time=7 min [50% NAV efficiency]). Subjective image quality (4-point scale) and objective image quality parameters including vessel sharpness, vessel diameter and CNR were calculated for WH-MRA and t-MRA. In patients, the accuracy for detection of stenosis larger than 50% was compared to the accuracy of X-ray coronary angiography (XA), which was considered the standard. Results: WH-MRA demonstrated good vessel visibility in healthy subjects (100%) whereas vessel visibility in patients was limited (78% in an 8 segment evaluation). Vessel sharpness was inferior to that of t-MRA in patients (37 vs. 42%) but equal in healthy subjects (42%). Vessel diameter did not differ significantly between WH-MRA and t-MRA. CNR was significantly reduced for WH-MRA (CNR 7.4 vs. 11.5). The diagnostic accuracy for the detection of CAD was comparable for both MRA approaches (85.5 vs. 86.2%). Conclusion: WH-MRA allows good coronary artery visualization in healthy subjects and patients and provides a simplified scanning procedure and advantages in 3D post-processing. Regarding image parameters and the detection of CAD, the results are comparable to those acquired with t-MRA. The major disadvantage remains the high number of diagnostically insufficient images. (orig.)

  5. Point Cloud Analysis for Uav-Borne Laser Scanning with Horizontally and Vertically Oriented Line Scanners - Concept and First Results

    Science.gov (United States)

    Weinmann, M.; Müller, M. S.; Hillemann, M.; Reydel, N.; Hinz, S.; Jutzi, B.

    2017-08-01

    In this paper, we focus on UAV-borne laser scanning with the objective of densely sampling object surfaces in the local surrounding of the UAV. In this regard, using a line scanner which scans along the vertical direction and perpendicular to the flight direction results in a point cloud with low point density if the UAV moves fast. Using a line scanner which scans along the horizontal direction only delivers data corresponding to the altitude of the UAV and thus a low scene coverage. For these reasons, we present a concept and a system for UAV-borne laser scanning using multiple line scanners. Our system consists of a quadcopter equipped with horizontally and vertically oriented line scanners. We demonstrate the capabilities of our system by presenting first results obtained for a flight within an outdoor scene. Thereby, we use a downsampling of the original point cloud and different neighborhood types to extract fundamental geometric features which in turn can be used for scene interpretation with respect to linear, planar or volumetric structures.

  6. Left ventricular functional parameters and geometric patterns in Korean adults on coronary CT angiography with a 320-detector-row CT scanner

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Eun Ju; Lee, Ki Nam; Cho, Won Jin; Kim, Young Dae [College of Medicine, Dong-A University, Busan (Korea, Republic of); Shin, Kyung Min; Lim, Jae Kwang; Lee, Jong Min [Dept. of Radiology, Kyungpook National University, Daegu (Korea, Republic of)

    2017-08-01

    To assess the normal reference values of left ventricle (LV) functional parameters in Korean adults on coronary CT angiography (CCTA) with a 320-detector-row CT scanner, and to analyze sex-related differences and correlations with various clinical characteristics. This study retrospectively enrolled 172 subjects (107 men and 65 women; age, 58 ± 10.9 years; body surface area [BSA], 1.75 ± 0.2 m{sup 2}) who underwent CCTA without any prior history of cardiac disease. The following parameters were measured by post-processing the CT data: LV volume, LV functional parameters (ejection fraction, stroke volume, cardiac output, etc.), LV myocardial mass, LV inner diameter, and LV myocardial thickness (including septal wall thickness [SWT], posterior wall thickness [PWT], and relative wall thickness [RWT = 2 × PWT / LV inner diameter]). All of the functional or volumetric parameters were normalized using the BSA. The general characteristics and co-morbidities for the enrolled subjects were recorded, and the correlations between these factors and the LV parameters were then evaluated. The LV myocardial thickness (SWT, 1.08 ± 0.18 cm vs. 0.90 ± 0.17 cm, p < 0.001; PWT, 0.91 ± 0.15 cm vs. 0.78 ± 0.10 cm, p < 0.001; RWT, 0.38 ± 0.08 cm vs. 0.33 ± 0.05 cm, p < 0.001), LV volume (LV end-diastolic volume, 112.9 ± 26.1 mL vs. 98.2 ± 21.0 mL, p < 0.001; LV end-systolic volume, 41.7 ± 14.7 mL vs. 33.7 ± 12.2 mL, p = 0.001) and mass (145.0 ± 29.1 g vs. 107.9 ± 20.0 g, p < 0.001) were significantly greater in men than in women. However, these differences were not significant after normalization using BSA, except for the LV mass (LV mass index, 79.6 ± 14.0 g/m{sup 2} vs. 66.2 ± 11.0 g/m{sup 2},p < 0.001). The cardiac output and ejection fraction were not significantly different between the men and women (cardiac output, 4.3 ± 1.0 L/min vs. 4.2 ± 0.9 L/min, p = 0.452; ejection fraction, 63.4 ± 7.7% vs. 66.4 ± 7.6%, p = 0.079). Most of the LV parameters were

  7. Prospective Coronary Heart Disease Screening in Asymptomatic Hodgkin Lymphoma Patients Using Coronary Computed Tomography Angiography: Results and Risk Factor Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Girinsky, Theodore, E-mail: girinsky.theodore@orange.fr [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); M’Kacher, Radhia [Laboratory of Radiobiology and Oncology, Institut de Radiobiologie Cellulaire et Moleculaire/Direction des Sciences Vivantes/Commissariat Energie Atomique, Fontenay aux Roses (France); Lessard, Nathalie [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); Koscielny, Serge [Biostatistics and Epidemiology Unit, Institut Gustave Roussy, Villejuif (France); Elfassy, Eric; Raoux, François [Department of Radiology, Marie Lannelongue, Chatenay-Malabry (France); Carde, Patrice [Department of Hematology, Institut Gustave Roussy, Villejuif (France); Santos, Marcos Dos [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); Margainaud, Jean-Pierre [Department of Head and Neck Surgery, Institut Gustave Roussy, Villejuif (France); Sabatier, Laure [Laboratory of Radiobiology and Oncology, Institut de Radiobiologie Cellulaire et Moleculaire/Direction des Sciences Vivantes/Commissariat Energie Atomique, Fontenay aux Roses (France); Ghalibafian, Mithra [Department of Radiation Oncology, Institut Gustave Roussy, Villejuif (France); Paul, Jean-François [Department of Radiology, Marie Lannelongue, Chatenay-Malabry (France)

    2014-05-01

    Purpose: To prospectively investigate the coronary artery status using coronary CT angiography (CCTA) in patients with Hodgkin lymphoma treated with combined modalities and mediastinal irradiation. Methods and Materials: All consecutive asymptomatic patients with Hodgkin lymphoma entered the study during follow-up, from August 2007 to May 2012. Coronary CT angiography was performed, and risk factors were recorded along with leukocyte telomere length (LTL) measurements. Results: One hundred seventy-nine patients entered the 5-year study. The median follow-up was 11.6 years (range, 2.1-40.2 years), and the median interval between treatment and the CCTA was 9.5 years (range, 0.5-40 years). Coronary artery abnormalities were demonstrated in 46 patients (26%). Coronary CT angiography abnormalities were detected in nearly 15% of the patients within the first 5 years after treatment. A significant increase (34%) occurred 10 years after treatment (P=.05). Stenoses were mostly nonostial. Severe stenoses were observed in 12 (6.7%) of the patients, entailing surgery with either angioplasty with stent placement or bypass grafting in 10 of them (5.5%). A multivariate analysis demonstrated that age at treatment, hypertension, and hypercholesterolemia, as well as radiation dose to the coronary artery origins, were prognostic factors. In the group of patients with LTL measurements, hypertension and LTL were the only independent risk factors. Conclusions: The findings suggest that CCTA can identify asymptomatic individuals at risk of acute coronary artery disease who might require either preventive or curative measures. Conventional risk factors and the radiation dose to coronary artery origins were independent prognostic factors. The prognostic value of LTL needs further investigation.

  8. Magnetic navigation in a coronary phantom: experimental results.

    Science.gov (United States)

    García-García, Héctor M; Tsuchida, Keiichi; Meulenbrug, Hans; Ong, Andrew T L; Van der Giessen, Willem J; Serruys, Patrick W

    2005-11-01

    The objective was to investigate the efficacy of a magnetic navigation system (MNS) in a coronary phantom. The number of coronary interventional procedures performed is steadily increasing with the availability of new devices to treat more complex lesions. Vessel tortuosity remains an important limiting factor in percutaneous coronary intervention. The MNS can orient the tip of magnetized wire. The coronary phantom is a representation of the coronary tree. Two operators using both a magnetic wire and a standard wire, measured the procedural time (PT), the fluoroscopic time (FT) and the radiation exposure/area product (DAP) required to navigate through to fourteen segments. Ten wire advancements were performed per segment. In all but two segments, the PT was significantly longer using magnetic navigation than using manual navigation. The median FT in the left main artery (LMA) - first septal segment was 7 seconds vs. 18 seconds, with magnetic and manual navigation respectively, (p=0.05); in the LMA - obtuse marginal segment the median FT was 15 seconds with magnetic navigation vs. 29.5 seconds with manual navigation, (p=0.01); in the segment from proximal right coronary artery (RCA1) to the acute marginal branch, the median FT was 8 seconds with magnetic vs. 11 seconds with manual navigation, (p=0.05); and in the RCA1 -posterior descending segment the median FT was 9.5 seconds with magnetic vs. 15 seconds with manual navigation, (p=0.006). The MNS facilitates wire access to distal segments in a coronary phantom, with a reduction in FT and radiation exposure using magnetic navigation in tortuous segments.

  9. Use of a clinical PET/MR scanner for preclinical research with first results

    Energy Technology Data Exchange (ETDEWEB)

    Chary, Karthik; Teuho, Jarmo; Virta, Jenni; Sipilä, Hannu; Saunavaara, Virva; Roivainen, Anne; Teräs, Mika [Turku PET Centre, Turku University Hospital, Turku (Finland)

    2014-07-29

    This study was performed to evaluate the feasibility of preclinical imaging in a clinical PET/MR system. Preliminary sequences were evaluated for establishing preclinical protocols for rat brain and rabbit knee. Rats were placed in a stereotactic holder, allowing a 30 minute scan time before re-administration of anesthesia. In-house developed warm-water heating system was used to maintain the body temperature at 37.5°C, monitored using an MR-compatible rectal probe. Brain imaging was performed with a dedicated 4 channel phased array receive coil (RAPID Biomedical GmbH, Germany). High resolution coronal images were acquired using conventional T1-SE (0.30x0.30x1.2mm) and T2-TSE (0.23x0.23x0.7mm) with a total scan time of 30 min. PET/MR imaging was performed on two white rabbits. The rabbits were imaged in a custom wooden holder. PET/MR protocol had a total duration of 45 minutes. No external heating was used. MR protocol consisted of anatomical T1, T2 and PDW of the knees, using a SENSE Flex-S coil. MR attenuation correction (MRAC) was acquired with 3D T1-FFE using three-class segmentation. A dynamic 30 minute PET acquisition was started on injection of 33.8MBq of Ga-68. Animal coils enabled high resolution images to be acquired in reasonable acquisition time with regards to animal handling and anesthesia. T1 and T2 images provided good differentiation of anatomy in the rat brain with high contrast. T1, T2 and PDW images of the rabbit knee had high resolution and differentiation of anatomical structures. MRAC was able to distinguish the knees and the body contour. Image fusion of PET and MR was able to localize the infection, which was confirmed by a physician. Pre-clinical imaging with the Ingenuity TF was deemed feasible, although PET imaging is limited by the resolution of the scanner. The preliminary sequences were successfully implemented for future studies on the Ingenuity TF.

  10. Use of a clinical PET/MR scanner for preclinical research with first results

    International Nuclear Information System (INIS)

    Chary, Karthik; Teuho, Jarmo; Virta, Jenni; Sipilä, Hannu; Saunavaara, Virva; Roivainen, Anne; Teräs, Mika

    2014-01-01

    This study was performed to evaluate the feasibility of preclinical imaging in a clinical PET/MR system. Preliminary sequences were evaluated for establishing preclinical protocols for rat brain and rabbit knee. Rats were placed in a stereotactic holder, allowing a 30 minute scan time before re-administration of anesthesia. In-house developed warm-water heating system was used to maintain the body temperature at 37.5°C, monitored using an MR-compatible rectal probe. Brain imaging was performed with a dedicated 4 channel phased array receive coil (RAPID Biomedical GmbH, Germany). High resolution coronal images were acquired using conventional T1-SE (0.30x0.30x1.2mm) and T2-TSE (0.23x0.23x0.7mm) with a total scan time of 30 min. PET/MR imaging was performed on two white rabbits. The rabbits were imaged in a custom wooden holder. PET/MR protocol had a total duration of 45 minutes. No external heating was used. MR protocol consisted of anatomical T1, T2 and PDW of the knees, using a SENSE Flex-S coil. MR attenuation correction (MRAC) was acquired with 3D T1-FFE using three-class segmentation. A dynamic 30 minute PET acquisition was started on injection of 33.8MBq of Ga-68. Animal coils enabled high resolution images to be acquired in reasonable acquisition time with regards to animal handling and anesthesia. T1 and T2 images provided good differentiation of anatomy in the rat brain with high contrast. T1, T2 and PDW images of the rabbit knee had high resolution and differentiation of anatomical structures. MRAC was able to distinguish the knees and the body contour. Image fusion of PET and MR was able to localize the infection, which was confirmed by a physician. Pre-clinical imaging with the Ingenuity TF was deemed feasible, although PET imaging is limited by the resolution of the scanner. The preliminary sequences were successfully implemented for future studies on the Ingenuity TF.

  11. Assessment of coronary calcification using calibrated mass score with two different multidetector computed tomography scanners in the Copenhagen General Population Study

    DEFF Research Database (Denmark)

    Fuchs, Andreas; Groen, Jaap M; Arnold, Ben A

    2017-01-01

    MS of the phantom was 32.9±0.8mg and 33.1±0.9mg (p=0.43) assessed by scanner A and B respectively - the physical calcium mass was 34.0mg. Correlation between measured MS and physical calcium mass was R2=0.99 in both scanners. In the population study the median total MS was 16.8mg (interquartile range...

  12. Reality of obesity paradox: Results of percutaneous coronary intervention in Middle Eastern patients.

    Science.gov (United States)

    Jarrah, Mohamad; Hammoudeh, Ayman J; Khader, Yousef; Tabbalat, Ramzi; Al-Mousa, Eyas; Okkeh, Osama; Alhaddad, Imad A; Tawalbeh, Loai Issa; Hweidi, Issa M

    2018-04-01

    Objective The aim of this study was to assess the baseline clinical characteristics, coronary angiographic features, and adverse cardiovascular events during hospitalization and at 1 year of follow-up in obese patients compared with overweight and normal/underweight patients. Methods A prospective, multicenter study of consecutive patients undergoing percutaneous coronary intervention was performed. Results Of 2425 enrolled patients, 699 (28.8%) were obese, 1178 (48.6%) were overweight, and 548 (22.6%) were normal/underweight. Obese patients were more likely to be female and to have a higher prevalence of diabetes, hypertension, hypercholesterolemia, or previous percutaneous coronary intervention. Acute coronary syndrome was the indication for percutaneous coronary intervention in 77.0% of obese, 76.4% of overweight, and 77.4% of normal/underweight patients. No significant differences in the prevalence of multi-vessel coronary artery disease or multi-vessel percutaneous coronary intervention were found among the three groups. Additionally, no significant differences were found in stent thrombosis, readmission bleeding rates, or cardiac mortality among the three groups during hospitalization, at 1 month, and at 1 year. Conclusion The major adverse cardiovascular event rate was the same among the three groups throughout the study period. Accordingly, body mass index is considered a weak risk factor for cardiovascular comorbidities in Arab Jordanian patients.

  13. CT coronary angiography vs. invasive coronary angiography in CHD

    Directory of Open Access Journals (Sweden)

    Anja Hagen

    2012-04-01

    Full Text Available Scientific background: Various diagnostic tests including conventional invasive coronary angiography and non-invasive computed tomography (CT coronary angiography are used in the diagnosis of coronary heart disease (CHD. Research questions: The present report aims to evaluate the clinical efficacy, diagnostic accuracy, prognostic value cost-effectiveness as well as the ethical, social and legal implications of CT coronary angiography versus invasive coronary angiography in the diagnosis of CHD. Methods: A systematic literature search was conducted in electronic data bases (MEDLINE, EMBASE etc. in October 2010 and was completed with a manual search. The literature search was restricted to articles published from 2006 in German or English. Two independent reviewers were involved in the selection of the relevant publications. The medical evaluation was based on systematic reviews of diagnostic studies with invasive coronary angiography as the reference standard and on diagnostic studies with intracoronary pressure measurement as the reference standard. Study results were combined in a meta-analysis with 95 % confidence intervals (CI. Additionally, data on radiation doses from current non-systematic reviews were taken into account. A health economic evaluation was performed by modelling from the social perspective with clinical assumptions derived from the meta-analysis and economic assumptions derived from contemporary German sources. Data on special indications (bypass or in-stent-restenosis were not included in the evaluation. Only data obtained using CT scanners with at least 64 slices were considered. Results: No studies were found regarding the clinical efficacy or prognostic value of CT coronary angiography versus conventional invasive coronary angiography in the diagnosis of CHD. Overall, 15 systematic reviews with data from 44 diagnostic studies using invasive coronary angiography as the reference standard (identification of obstructive

  14. Scintillation scanner

    International Nuclear Information System (INIS)

    Mehrbrodt, A.W.; Mog, W.F.; Brunnett, C.J.

    1977-01-01

    A scintillation scanner having a visual image producing means coupled through a lost motion connection to the boom which supports the scintillation detector is described. The lost motion connection is adjustable to compensate for such delays as may occur between sensing and recording scintillations. 13 claims, 5 figures

  15. Twisting wire scanner

    Energy Technology Data Exchange (ETDEWEB)

    Gharibyan, V.; Delfs, A.; Koruptchenkov, I.; Noelle, D.; Tiessen, H.; Werner, M.; Wittenburg, K.

    2012-11-15

    A new type of 'two-in-one' wire scanner is proposed. Recent advances in linear motors' technology make it possible to combine translational and rotational movements. This will allow to scan the beam in two perpendicular directions using a single driving motor and a special fork attached to it. Vertical or horizontal mounting will help to escape problems associated with the 45 deg scanners. Test results of the translational part with linear motors is presented.

  16. Twisting wire scanner

    International Nuclear Information System (INIS)

    Gharibyan, V.; Delfs, A.; Koruptchenkov, I.; Noelle, D.; Tiessen, H.; Werner, M.; Wittenburg, K.

    2012-11-01

    A new type of 'two-in-one' wire scanner is proposed. Recent advances in linear motors' technology make it possible to combine translational and rotational movements. This will allow to scan the beam in two perpendicular directions using a single driving motor and a special fork attached to it. Vertical or horizontal mounting will help to escape problems associated with the 45 deg scanners. Test results of the translational part with linear motors is presented.

  17. Diagnostic performance of 320-detector CT coronary angiography in patients with atrial fibrillation: preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Lei; Yang, Lin; Fan, Zhanming; Yu, Wei; Lv, Biao; Zhang, Zhaoqi [Capital Medical University, Department of Radiology, Beijing Anzhen Hospital, Beijing (China)

    2011-05-15

    To evaluate the feasibility, diagnostic accuracy, and radiation dose of CT coronary angiography (CTCA) in patients with atrial fibrillation (AF) using 320-detector CT. Thirty-seven patients with persistent AF and suspected coronary artery disease (CAD) were enrolled. All patients underwent both 320-detector CTCA and conventional coronary angiography (CCA). CT image quality and the presence of significant ({>=}50%) stenosis were evaluated by two radiologists blinded to the results of CCA. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated using CCA as the reference standard. Differences in detection of coronary artery stenosis between 320-detector CTCA and CCA were evaluated with McNemar's test. Patient radiation dose was calculated by multiplying dose length product by conversion coefficient of 0.017. In total 474 evaluated coronary segments, 459 (96.8%) segments were diagnostically evaluable. On per-segment analysis, sensitivity, specificity, PPV and NPV were 90.0% (18 of 20), 99.3% (436 of 439), 85.7% (18 of 21) and 99.5% (436 of 438). No significant difference was found between 320-detector CTCA and CCA on the detection of significant stenosis (P = 1.000). Effective doses of 320-detector CTCA was 13.0 {+-} 4.7 mSv. 320-detector CTCA is feasible and accurate in excluding CAD in patients with AF. (orig.)

  18. POINT CLOUD ANALYSIS FOR UAV-BORNE LASER SCANNING WITH HORIZONTALLY AND VERTICALLY ORIENTED LINE SCANNERS – CONCEPT AND FIRST RESULTS

    Directory of Open Access Journals (Sweden)

    M. Weinmann

    2017-08-01

    Full Text Available In this paper, we focus on UAV-borne laser scanning with the objective of densely sampling object surfaces in the local surrounding of the UAV. In this regard, using a line scanner which scans along the vertical direction and perpendicular to the flight direction results in a point cloud with low point density if the UAV moves fast. Using a line scanner which scans along the horizontal direction only delivers data corresponding to the altitude of the UAV and thus a low scene coverage. For these reasons, we present a concept and a system for UAV-borne laser scanning using multiple line scanners. Our system consists of a quadcopter equipped with horizontally and vertically oriented line scanners. We demonstrate the capabilities of our system by presenting first results obtained for a flight within an outdoor scene. Thereby, we use a downsampling of the original point cloud and different neighborhood types to extract fundamental geometric features which in turn can be used for scene interpretation with respect to linear, planar or volumetric structures.

  19. Combined use of 64-slice computed tomography angiography and gated myocardial perfusion SPECT for the detection of functionally relevant coronary artery stenoses. First results in a clinical setting concerning patients with stable angina

    International Nuclear Information System (INIS)

    Hacker, M.; Hack, N.; Tiling, R.; Jakobs, T.; Nikolaou, K.; Becker, C.; Ziegler, F. von; Knez, A.; Koenig, A.; Klauss, V.

    2007-01-01

    Aim: In patients with stable angina pectoris both morphological and functional information about the coronary artery tree should be present before revascularization therapy is performed. High accuracy was shown for spiral computed tomography (MDCT) angiography acquired with a 64-slice CT scanner compared to invasive coronary angiography (ICA) in detecting obstructive'' coronary artery disease (CAD). Gated myocardial SPECT (MPI) is an established method for the noninvasive assessment of functional significance of coronary stenoses. Aim of the study was to evaluate the combination of 64-slice CT angiography plus MPI in comparison to ICA plus MPI in the detection of hemodynamically relevant coronary artery stenoses in a clinical setting. Patients, methods: 30 patients (63 ± 10.8 years, 23 men) with stable angina (21 with suspected, 9 with known CAD) were investigated. MPI, 64-slice CT angiography and ICA were performed, reversible and fixed perfusion defects were allocated to determining lesions separately for MDCT angiography and ICA. The combination of MDCT angiography plus MPI was compared to the results of ICA plus MPI. Results: Sensitivity, specificity, negative and positive predictive value for the combination of MDCT angiography plus MPI was 85%, 97%, 98% and 79%, respectively, on a vessel-based and 93%, 87%, 93% and 88%, respectively, on a patient-based level. 19 coronary arteries with stenoses =50% in both ICA and MDCT angiography showed no ischemia in MPI. Conclusion: The combination of 64-slice CT angiography and gated myocardial SPECT enabled a comprehensive non-invasive view of the anatomical and functional status of the coronary artery tree. (orig.)

  20. Combined use of 64-slice computed tomography angiography and gated myocardial perfusion SPECT for the detection of functionally relevant coronary artery stenoses. First results in a clinical setting concerning patients with stable angina

    Energy Technology Data Exchange (ETDEWEB)

    Hacker, M.; Hack, N.; Tiling, R. [Klinikum Grosshadern (Germany). Dept. of Nuclear Medicine; Jakobs, T.; Nikolaou, K.; Becker, C. [Klinikum Grosshadern (Germany). Dept. of Clinical Radiology; Ziegler, F. von; Knez, A. [Klinikum Grosshadern (Germany). Dept. of Cardiology; Koenig, A.; Klauss, V. [Medizinische Poliklinik-Innenstadt, Univ. of Munich (Germany). Dept. of Cardiology

    2007-07-01

    Aim: In patients with stable angina pectoris both morphological and functional information about the coronary artery tree should be present before revascularization therapy is performed. High accuracy was shown for spiral computed tomography (MDCT) angiography acquired with a 64-slice CT scanner compared to invasive coronary angiography (ICA) in detecting ''obstructive'' coronary artery disease (CAD). Gated myocardial SPECT (MPI) is an established method for the noninvasive assessment of functional significance of coronary stenoses. Aim of the study was to evaluate the combination of 64-slice CT angiography plus MPI in comparison to ICA plus MPI in the detection of hemodynamically relevant coronary artery stenoses in a clinical setting. Patients, methods: 30 patients (63 {+-} 10.8 years, 23 men) with stable angina (21 with suspected, 9 with known CAD) were investigated. MPI, 64-slice CT angiography and ICA were performed, reversible and fixed perfusion defects were allocated to determining lesions separately for MDCT angiography and ICA. The combination of MDCT angiography plus MPI was compared to the results of ICA plus MPI. Results: Sensitivity, specificity, negative and positive predictive value for the combination of MDCT angiography plus MPI was 85%, 97%, 98% and 79%, respectively, on a vessel-based and 93%, 87%, 93% and 88%, respectively, on a patient-based level. 19 coronary arteries with stenoses =50% in both ICA and MDCT angiography showed no ischemia in MPI. Conclusion: The combination of 64-slice CT angiography and gated myocardial SPECT enabled a comprehensive non-invasive view of the anatomical and functional status of the coronary artery tree. (orig.)

  1. Impact of contrast agent viscosity on coronary balloon deflation times: bench testing results.

    Science.gov (United States)

    Mogabgab, Owen; Patel, Vishal G; Michael, Tesfaldet T; Kotsia, Anna; Christopoulos, George; Banerjee, Subhash; Brilakis, Emmanouil S

    2014-04-01

    To assess the impact of viscosity on angioplasty balloon deflation times. Lower contrast viscosity could result in more rapid coronary balloon deflation times. We performed a bench comparison of coronary balloon deflation times using 2 contrast agents with different viscosity (ioxaglate and iodixanol), 3 contrast dilutions, and 2 inflation syringe filling volumes. Ten identical pairs of coronary angioplasty balloons were used to conduct each comparison after balloon inflation to 12 atmospheres. Simultaneous deflations were performed under cineangiography. The time to full contrast extraction and the area of contrast remaining after 5 seconds of deflation (quantified by opaque pixel count) were compared between groups. The mean time to full contrast extraction during balloon deflation was 8.3 ± 2.5 seconds for ioxaglate (lower viscosity) versus 10.1 ± 2.9 seconds for iodixanol (higher viscosity) (17.4% decrease, P = 0.005), with a 35.6% (P = 0.004) reduction in contrast area at 5 seconds. Compared to 1:1 ioxaglate-saline mixture, 1:2 and 1:3 ioxaglate/saline mixes resulted in 26.7% (P deflation time, respectively, but at the expense of decreased balloon opacity. Filling the inflation syringe with 5 versus 15 ml of contrast/saline solution was associated with 7.5% decrease in balloon deflation time (P = 0.005), but no difference in contrast area at 5 seconds (P = 0.749). Use of a lower viscosity contrast agent and higher contrast dilution significantly reduced coronary balloon deflation times, whereas use of lower syringe filling volume had a modest effect. Rapid coronary balloon deflation could improve the safety of interventional procedures. © 2014 Wiley Periodicals, Inc.

  2. Does extubation result in haemodynamic instability in patients following coronary artery bypass grafts?

    Science.gov (United States)

    Walthall, H; Ray, S; Robson, D

    2001-10-01

    Coronary heart disease and its management continue to be at the centre of Government health policy. The present political climate demands clinical effectiveness and best practice should be established, while maintaining the philosophy of cost-effectiveness and resource management. These directives have led practitioners to question the care of patients following coronary artery bypass surgery, in particular the role of mechanical ventilation and the subsequent act of extubation. A retrospective study of 89 patients who had coronary artery bypass grafts (emergency and elective) was undertaken, to establish if extubation had a significant effect on the haemodynamic status of patients with variable degrees of left ventricular function (19% with poor left ventricular function). The study found that extubation was achieved within a mean time of 4.97 hours following return from surgery. Extubation resulted in a significant increase in heart rate (P = 0.001), as well as a respiratory acidosis (pCO2: P = 0.000; pH: P = 0.000). However, the stability of the patient was not compromised, with neither mean arterial blood pressure (P = 0.825) nor oxygenation levels (P = 0.267) being significantly altered by extubation. On multivariate analysis, the act of extubation had no significant effect on any of the dependent variables. These results suggest that it is not extubation alone that has an impact on the haemodynamic stability of patients following coronary artery bypass grafts, but that this is indeed multifactorial. Therefore extubation is 'safe' practice for patients with varying degrees of left ventricular function following coronary artery bypass grafts. Limitations of the study are acknowledged.

  3. CT coronary angiography: examination technique, clinical results, and outlook on future developments

    International Nuclear Information System (INIS)

    Dewey, M.; Hamm, B.

    2007-01-01

    Multislice computed tomography (MSCT) after intravenous contrast agent administration enables visualization of the coronary arteries with high spatial resolution (voxel sizes down to 0.5 x 0.35 x 0.35 mm3) and a short scan time. Magnetic resonance imaging (MRI) is also intensively studied with respect to the noninvasive detection of coronary artery stenosis and thus the detection of coronary artery disease (CAD) without radiation exposure but is not equal to MSCT at present. This article provides an overview of the historical development of CT coronary angiography from 4-slice CT to 16-slice CT and 64-slice CT. A crucial aspect of this development is the improvement in image quality resulting from shorter breath-hold periods and the reduced gantry rotation time. Other techniques that appear to considerably improve image quality and accuracy and make CT independent of patient heart rates are multisegment reconstruction and dual-source CT. Sublingual nitroglycerin as well as oral or intravenous betablocker administration should be considered in relation to the diagnostic question to be answered and the patient's heart rate. In the studies available CT coronary angiography with at least 12 simultaneous detector rows has a sensitivity of 96.9 % and a specificity of 75.3 % at the patient level. Especially the negative predictive value of CT (94.6 %) emphasizes the idea that this technique may reliably exclude CAD in patients with intermediate pretest likelihood. In the near future, 256-slice CT will allow examination of the entire heart during one heartbeat or even 4D CT scanning with simultaneous assessment of myocardial perfusion. Automatic or semiautomatic software tools will assume a central place in detecting and quantifying coronary artery stenoses and plaques as well as in the analysis of cardiac function in the clinical setting over the next years. Prior to its routine clinical use, the cost-effectiveness of CT coronary angiography must be determined and the

  4. Relationship between left main coronary artery plaque burden and nonleft main coronary atherosclerosis: results from the PROSPECT study.

    Science.gov (United States)

    Shimizu, Takehisa; Mintz, Gary S; De Bruyne, Bernard; Farhat, Naim Z; Inaba, Shinji; Cao, Yang; Marso, Steven P; Weisz, Giora; Serruys, Patrick W; Stone, Gregg W; Maehara, Akiko

    2018-05-17

    Whether the severity of left main coronary artery (LMCA) disease reflects LMCA and overall coronary atherosclerotic burden is not known. We aimed to assess nonculprit LMCA disease characteristics and the relationship with atherosclerosis in the rest of the coronary arteries as well as patient outcomes. In the PROSPECT study, 697 patients with acute coronary syndromes underwent three-vessel gray-scale and radiofrequency intravascular ultrasound after percutaneous coronary intervention. Overall, 552 patients with adequate LMCA imaging were compared according to LMCA plaque burden. The tertile with the highest plaque burden in the LMCA had the smallest LMCA minimum lumen area (17.4, 14.2, 10.5, lowest through highest tertiles, respectively, PPROSPECT predictors of future nonculprit major adverse cardiac events (MACE) (minimum lumen area≤4 mm, plaque burden≥70%, and virtual histology thin-cap fibroatheroma), the tertile with the highest LMCA plaque burden had the highest number of patients with at least one of three PROSPECT predictors (P=0.03). In multivariable model, though total atheroma volume (per 1%) was an independent predictor of all MACE [hazard ratio (95% confidence interval)=1.06 (1.01-1.11), P=0.02] and strong trend for non-culprit-related MACE [hazard ratio (95% confidence interval)=1.06 (1.00-1.13), P=0.06], plaque burden at LMCA was not (all MACE, P=0.90, non-culprit-related MACE, P=0.85). The severity of atherosclerosis in LMCA predicted the overall atherosclerotic plaque burden as well as the presence of high-risk plaques in the three major epicardial coronary arteries.

  5. Simultaneous acquisition of multislice PET and MR images: initial results with a MR-compatible PET scanner.

    Science.gov (United States)

    Catana, Ciprian; Wu, Yibao; Judenhofer, Martin S; Qi, Jinyi; Pichler, Bernd J; Cherry, Simon R

    2006-12-01

    PET and MRI are powerful imaging techniques that are largely complementary in the information they provide. We have designed and built a MR-compatible PET scanner based on avalanche photodiode technology that allows simultaneous acquisition of PET and MR images in small animals. The PET scanner insert uses magnetic field-insensitive, position-sensitive avalanche photodiode (PSAPD) detectors coupled, via short lengths of optical fibers, to arrays of lutetium oxyorthosilicate (LSO) scintillator crystals. The optical fibers are used to minimize electromagnetic interference between the radiofrequency and gradient coils and the PET detector system. The PET detector module components and the complete PET insert assembly are described. PET data were acquired with and without MR sequences running, and detector flood histograms were compared with the ones generated from the data acquired outside the magnet. A uniform MR phantom was also imaged to assess the effect of the PET detector on the MR data acquisition. Simultaneous PET and MRI studies of a mouse were performed ex vivo. PSAPDs can be successfully used to read out large numbers of scintillator crystals coupled through optical fibers with acceptable performance in terms of energy and timing resolution and crystal identification. The PSAPD-LSO detector performs well in the 7-T magnet, and no visible artifacts are detected in the MR images using standard pulse sequences. The first images from the complete system have been successfully acquired and reconstructed, demonstrating that simultaneous PET and MRI studies are feasible and opening up interesting possibilities for dual-modality molecular imaging studies.

  6. Population Trends in Percutaneous Coronary Intervention 20-Year Results From the SCAAR (Swedish Coronary Angiography and Angioplasty Registry)

    NARCIS (Netherlands)

    Fokkema, Marieke L.; James, Stefan K.; Albertsson, Per; Akerblom, Axel; Calais, Fredrik; Eriksson, Peter; Jensen, Jens; Nilsson, Tage; de Smet, Bart J.; Sjogren, Iwar; Thorvinger, Bjorn; Lagerqvist, Bo

    2013-01-01

    Objectives The aim of this study was to describe the characteristics and outcome of all consecutive patients treated with percutaneous coronary intervention (PCI) in an unselected nationwide cohort over the past 2 decades. Background Over the last 20 years, treatment with PCI has evolved

  7. Scanner calibration revisited

    Directory of Open Access Journals (Sweden)

    Pozhitkov Alexander E

    2010-07-01

    Full Text Available Abstract Background Calibration of a microarray scanner is critical for accurate interpretation of microarray results. Shi et al. (BMC Bioinformatics, 2005, 6, Art. No. S11 Suppl. 2. reported usage of a Full Moon BioSystems slide for calibration. Inspired by the Shi et al. work, we have calibrated microarray scanners in our previous research. We were puzzled however, that most of the signal intensities from a biological sample fell below the sensitivity threshold level determined by the calibration slide. This conundrum led us to re-investigate the quality of calibration provided by the Full Moon BioSystems slide as well as the accuracy of the analysis performed by Shi et al. Methods Signal intensities were recorded on three different microarray scanners at various photomultiplier gain levels using the same calibration slide from Full Moon BioSystems. Data analysis was conducted on raw signal intensities without normalization or transformation of any kind. Weighted least-squares method was used to fit the data. Results We found that initial analysis performed by Shi et al. did not take into account autofluorescence of the Full Moon BioSystems slide, which led to a grossly distorted microarray scanner response. Our analysis revealed that a power-law function, which is explicitly accounting for the slide autofluorescence, perfectly described a relationship between signal intensities and fluorophore quantities. Conclusions Microarray scanners respond in a much less distorted fashion than was reported by Shi et al. Full Moon BioSystems calibration slides are inadequate for performing calibration. We recommend against using these slides.

  8. Coronary Computed Tomography Angiography (CTA)

    Science.gov (United States)

    ... coronary arteries, may also be administered as a tablet or spray underneath your tongue. While lying on ... the scanner at one time such as with MRI. If an intravenous contrast material is used, you ...

  9. Cardiovascular risk factors in Middle Eastern patients undergoing percutaneous coronary intervention: Results from the first Jordanian percutaneous coronary intervention study.

    Science.gov (United States)

    Hammoudeh, Ayman J; Alhaddad, Imad A; Khader, Yousef; Tabbalat, Ramzi; Al-Mousa, Eyas; Saleh, Akram; Jarrah, Mohamad; Nammas, Assem; Izraiq, Mahmoud

    2017-07-01

    Background and aims: Cardiovascular disease (CVD) is the leading cause of death in the Middle East. We sought to study the prevalence and coexistence of 6 cardiovascular risk factors (RFs) among patients who underwent percutaneous coronary intervention (PCI), and to evaluate the impact of age and gender on the presence of multiple RFs. In this prospective, multicenter study, 2426 consecutive patients were enrolled. Mean age was 59.0 ± 10.1 years and 500 (20.6%) were women. Acute coronary syndrome and stable coronary disease were the indications for PCI in 77.1% and 22.9%, respectively. Hypertension was present in 62.3%, diabetes in 53.8%, hypercholesterolemia in 48.8%, smoking in 43.5%, family history of premature CVD 39.4% and obesity in 28.8%. Only 3.8% did not have any of these RFs. Presence of ⩾3 and ⩾4 RFS was observed in 57.4% and 29.5% of patients, respectively. Presence of ⩾3 RFs was more common in women than men (69.0% vs. 54.5%, p  Eastern population undergoing PCI. More than half and more than one-fourth of the patients had at least 3 or 4 RFs; respectively. More women than men and more middle aged patients than older or younger patients had significantly higher rates of presence of multiple RFs.

  10. The psychological impact of test results following diagnostic coronary CT angiography.

    Science.gov (United States)

    Devcich, Daniel A; Ellis, Christopher J; Broadbent, Elizabeth; Gamble, Greg; Petrie, Keith J

    2012-11-01

    Coronary computed tomography (CT) angiography is an advanced cardiac imaging test commonly used for diagnosing early signs of ischemic heart disease. Despite its importance in cardiology, little is known about its psychological effect on patients. The present study sought to examine these effects in relation to illness perceptions, cardiac health behavior intentions, and subsequent health behaviors. Forty-five nonacute cardiac patients who were referred for diagnostic coronary CT angiography completed questionnaires prior to testing and following the receipt of test results, at which point illness perceptions and intentions to take cardiac medication, as well as diet and exercise intentions were measured. Exercise and dietary behaviors were measured at follow-up 6 weeks later. Changes on these variables were then compared between patients diagnosed with normal arteries and patients diagnosed with diseased arteries. Compared to positive-testing patients, patients with normal test results reported significant changes toward more positive illness perceptions following testing, with improvements in emotional effect of illness, illness concern, consequences, and personal control of illness. The illness perception of treatment control was seen as more important among positive-testing patients, whereas both groups reported increases in illness coherence. Health behavior intentions (cardiac medication intentions and exercise intentions) increased for positive-testing patients only, as did physical activity at follow-up. Diagnosis-dependent psychological effects can be detected following coronary CT angiography. These effects have important implications for patient health and health care in diagnostic contexts, and the results from this study can be used to guide further research in this area.

  11. Radial Artery as a Coronary Artery Bypass Conduit: 20-Year Results.

    Science.gov (United States)

    Gaudino, Mario; Tondi, Paolo; Benedetto, Umberto; Milazzo, Valentina; Flore, Roberto; Glieca, Franco; Ponziani, Francesca Romana; Luciani, Nicola; Girardi, Leonard N; Crea, Filippo; Massetti, Massimo

    2016-08-09

    There is a lack of evidence for the choice of the second conduit in coronary surgery. The radial artery (RA) is a possible option, but few data on very-long-term outcomes exist. This study describes 20-year results of RA grafts used for coronary artery bypass grafting and the effects of RA removal on forearm circulation. We report the results of the prospective 20-year follow-up of the first 100 consecutive patients who received the RA as a coronary bypass conduit at our institution. Follow-up was 100% complete. There were 64 deaths, 23 (35.9%) from cardiovascular causes. Kaplan-Meier 20-year survival was 31%. Of the 36 survivors, 33 (91.6%) underwent RA graft control at a mean of 19.0 ± 2.5 years after surgery. The RA was found to be patent in 24 cases (84.8% patency). In the overall population, probability of graft failure at 20 years was 19.0 ± 0.2% for the left internal thoracic artery (ITA), 25.0 ± 0.2% for the RA, and 55.0 ± 0.2% for the saphenous vein (p = 0.002 for RA vs. saphenous vein, 0.11 for RA vs. ITA, and p 90%, but not location of distal anastomosis, significantly influenced long-term RA graft patency. No patients reported hand or forearm symptoms. The ulnar artery diameter was increased in the operated arm (2.44 ± 0.43 mm vs. 2.01 ± 0.47 mm; p 90% stenosis. RA harvesting does not lead to hand or forearm symptoms, even at a very-long-term follow-up. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  12. Survival results of postoperative coronary angiogram for treatment of perioperative myocardial ischaemia following coronary artery bypass grafting: a single-centre experience.

    Science.gov (United States)

    Preußer, Maximilian J; Landwehrt, Jan; Mastrobuoni, Stefano; Biancari, Fausto; Dakkak, Abdul R; Alshakaki, Mosab; Martens, Sven; Dell'Aquila, Angelo M

    2018-02-01

    Although perioperative myocardial ischaemia (PMI) is a well-known complication following coronary artery bypass grafting (CABG), standard strategies for its diagnosis and treatment are so far not defined. In this study, we sought to evaluate the impact on survival of postoperative coronary angiogram for management of patients with PMI after CABG. Overall, 4028 patients underwent isolated CABG in a single-centre institution between January 2006 and September 2013. A total of 168 (4.2%) patients received postoperative coronary angiogram because of diagnosis of PMI. These patients were matched on the basis of gender, age at surgery and date of surgery, with 336 (1:2 ratio) CABG patients without PMI to determine the impact of the PMI management. A total of 476 grafts were examined (263 venous grafts, 196 internal mammary artery grafts and 17 radial artery grafts). Almost three-quarters of the 168 PMI (74.4%) patients underwent postoperative coronary angiogram within 24 h of surgery. Normal postoperative coronary angiogram, graft failure and new native vessels occlusion were observed in 23.2%, 52.4% and 24.4% of patients, respectively. A total of 30 (17.9%) patients underwent surgical revision of grafts, whereas 60 (35.7%) patients were treated with percutaneous coronary intervention. Eighteen (10.7%) PMI patients died during the hospital stay compared with 6 (1.8%) patients in the non-PMI group. Survival rates at 7 years were 62.5% in the PMI group and 81.1% in non-PMI group (P PMI (P 24 h after surgery) was an independent predictor of poorer mid-term survival (P = 0.008; hazard ratio 3.62, 95% confidence interval 1.41-9.33). PMI after CABG is associated with a significantly poorer survival. A prompt postoperative management must always be considered. Further prospective studies are required to confirm our results. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights

  13. Orbital atherectomy for treating de novo, severely calcified coronary lesions: 3-year results of the pivotal ORBIT II trial.

    Science.gov (United States)

    Lee, Michael; Généreux, Philippe; Shlofmitz, Richard; Phillipson, Daniel; Anose, Bynthia M; Martinsen, Brad J; Himmelstein, Stevan I; Chambers, Jeff W

    2017-06-01

    The presence of heavy coronary artery calcification increases the complexity of percutaneous coronary intervention (PCI) and increases the incidence of major adverse cardiac events (MACE): death, myocardial infarction (MI), target vessel revascularization (TVR), and stent thrombosis. The ORBIT II (Evaluate the Safety and Efficacy of OAS in Treating Severely Calcified Coronary Lesions) trial reported low rates of procedural, 30-day, 1-year, and 2-year ischemic complications after treatment of de novo, severely calcified lesions with the Diamondback 360° Coronary Orbital Atherectomy System (OAS) (Cardiovascular Systems, Inc.). ORBIT II was a single-arm trial that enrolled 443 patients at 49U.S. sites; in this study, de novo, severely calcified coronary lesions were treated with OAS prior to stenting. The primary safety endpoint was 30-day MACE: the composite of cardiac death, MI, and TVR (inclusive of target lesion revascularization (TLR)). The primary efficacy endpoint was procedural success: stent delivery with a residual stenosis of atherectomy. There were 360 (81.3%) subjects who completed the protocol-mandated 3-year visit.The overall cumulative rate of 3-year MACE was 23.5%, including cardiac death (6.7%), MI (11.2%), and TVR (10.2%). The 3-year target lesion revascularization rate was 7.8%. In the final 3-year analysis of the ORBIT II trial, orbital atherectomy of severely calcified coronary lesions followed by stenting resulted in a low rate of adverse ischemic events compared with historical controls.Orbital atherectomy represents a safe and effective revascularization strategy for patients with severely calcified coronary lesions. The ORBIT II trial enrolled 443 subjects to study orbital atherectomy followed by stenting for de novo severely calcified coronary lesions. The overall cumulative 3-year MACE rate was 23.5%, including cardiac death (6.7%), MI (11.2%), and TVR (10.2%); the 3-year target lesion revascularization rate was 7.8%. Orbital atherectomy

  14. One-year results of total arterial revascularization vs. conventional coronary surgery: CARRPO trial

    DEFF Research Database (Denmark)

    Damgaard, Sune; Wetterslev, Jørn; Lund, Jens T

    2009-01-01

    +/- 18% in the conventional group (P = 0.52). In 72% of TAR patients and 67% of the conventional group, all grafts were patent (P = 0.45). Multiple imputation of missing angiographic data did not influence on results. Within 1 year, 37 (23%) TAR patients and 43 (25%) conventional group patients suffered...... cardiac events (HR 1.09, 95% CI 0.70-1.69, P = 0.70). One patient (0.6%) in the TAR group and two (1.2%) in the conventional group died (P = 1.00). CONCLUSION: Within 1 year post-operatively, TAR seems at least as safe and effective as CR. Prolonged follow-up will reveal whether this is sustained......AIMS: To investigate clinical and angiographic outcomes after coronary surgery using total arterial revascularization (TAR). METHODS AND RESULTS: We randomized 331 patients with multivessel or isolated left main disease to TAR [internal thoracic (ITA) and radial arteries] vs. conventional...

  15. WE-FG-207B-12: Quantitative Evaluation of a Spectral CT Scanner in a Phantom Study: Results of Spectral Reconstructions

    International Nuclear Information System (INIS)

    Duan, X; Arbique, G; Guild, J; Anderson, J; Yagil, Y

    2016-01-01

    Purpose: To evaluate the quantitative image quality of spectral reconstructions of phantom data from a spectral CT scanner. Methods: The spectral CT scanner (IQon Spectral CT, Philips Healthcare) is equipped with a dual-layer detector and generates conventional 80-140 kVp images and variety of spectral reconstructions, e.g., virtual monochromatic (VM) images, virtual non-contrast (VNC) images, iodine maps, and effective atomic number (Z) images. A cylindrical solid water phantom (Gammex 472, 33 cm diameter and 5 cm thick) with iodine (2.0-20.0 mg I/ml) and calcium (50-600 mg/ml) rod inserts was scanned at 120 kVp and 27 mGy CTDIvol. Spectral reconstructions were evaluated by comparing image measurements with theoretical values calculated from nominal rod compositions provided by the phantom manufacturer. The theoretical VNC was calculated using water and iodine basis material decomposition, and the theoretical Z was calculated using two common methods, the chemical formula method (Z1) and the dual-energy ratio method (Z2). Results: Beam-hardening-like artifacts between high-attenuation calcium rods (≥300 mg/ml, >800 HU) influenced quantitative measurements, so the quantitative analysis was only performed on iodine rods using the images from the scan with all the calcium rods removed. The CT numbers of the iodine rods in the VM images (50∼150 keV) were close to theoretical values with average difference of 2.4±6.9 HU. Compared with theoretical values, the average difference for iodine concentration, VNC CT number and effective Z of iodine rods were −0.10±0.38 mg/ml, −0.1±8.2 HU, 0.25±0.06 (Z1) and −0.23±0.07 (Z2). Conclusion: The results indicate that the spectral CT scanner generates quantitatively accurate spectral reconstructions at clinically relevant iodine concentrations. Beam-hardening-like artifacts still exist when high-attenuation objects are present and their impact on patient images needs further investigation. YY is an employee of Philips

  16. WE-FG-207B-12: Quantitative Evaluation of a Spectral CT Scanner in a Phantom Study: Results of Spectral Reconstructions

    Energy Technology Data Exchange (ETDEWEB)

    Duan, X; Arbique, G; Guild, J; Anderson, J [UT Southwestern Medical Center, Dallas, TX (United States); Yagil, Y [Philips Healthcare, Haifa (Israel)

    2016-06-15

    Purpose: To evaluate the quantitative image quality of spectral reconstructions of phantom data from a spectral CT scanner. Methods: The spectral CT scanner (IQon Spectral CT, Philips Healthcare) is equipped with a dual-layer detector and generates conventional 80-140 kVp images and variety of spectral reconstructions, e.g., virtual monochromatic (VM) images, virtual non-contrast (VNC) images, iodine maps, and effective atomic number (Z) images. A cylindrical solid water phantom (Gammex 472, 33 cm diameter and 5 cm thick) with iodine (2.0-20.0 mg I/ml) and calcium (50-600 mg/ml) rod inserts was scanned at 120 kVp and 27 mGy CTDIvol. Spectral reconstructions were evaluated by comparing image measurements with theoretical values calculated from nominal rod compositions provided by the phantom manufacturer. The theoretical VNC was calculated using water and iodine basis material decomposition, and the theoretical Z was calculated using two common methods, the chemical formula method (Z1) and the dual-energy ratio method (Z2). Results: Beam-hardening-like artifacts between high-attenuation calcium rods (≥300 mg/ml, >800 HU) influenced quantitative measurements, so the quantitative analysis was only performed on iodine rods using the images from the scan with all the calcium rods removed. The CT numbers of the iodine rods in the VM images (50∼150 keV) were close to theoretical values with average difference of 2.4±6.9 HU. Compared with theoretical values, the average difference for iodine concentration, VNC CT number and effective Z of iodine rods were −0.10±0.38 mg/ml, −0.1±8.2 HU, 0.25±0.06 (Z1) and −0.23±0.07 (Z2). Conclusion: The results indicate that the spectral CT scanner generates quantitatively accurate spectral reconstructions at clinically relevant iodine concentrations. Beam-hardening-like artifacts still exist when high-attenuation objects are present and their impact on patient images needs further investigation. YY is an employee of Philips

  17. MR coronary angiography with breath-hold targeted volumes : Preliminary clinical results

    NARCIS (Netherlands)

    van Geuns, R J; Wielopolski, P A; de Bruin, Hein G.; Rensing, B J; Hulshoff, Marc; van Ooijen, P M; de Feyter, P J; Oudkerk, M

    2000-01-01

    PURPOSE: To assess the clinical value of a magnetic resonance (MR) coronary angiography strategy involving a small targeted volume to image one coronary segment in a single breath hold for the detection of greater than 50% stenosis. MATERIALS AND METHODS: Thirty-eight patients referred for elective

  18. MR coronary angiography with breath-hold targeted volumes: preliminary clinical results

    NARCIS (Netherlands)

    R.J.M. van Geuns (Robert Jan); P.A. Wielopolski (Piotr); H.G. de Bruin (Hein); B.J.W.M. Rensing (Benno); M. Hulshoff (Maarten); P.M.A. van Ooijen (Peter); P.J. de Feyter (Pim); M. Oudkerk (Matthijs)

    2000-01-01

    textabstractPURPOSE: To assess the clinical value of a magnetic resonance (MR) coronary angiography strategy involving a small targeted volume to image one coronary segment in a single breath hold for the detection of greater than 50% stenosis. MATERIALS AND METHODS:

  19. Change in Coronary Blood Flow After Percutaneous Coronary Intervention in Relation to Baseline Lesion Physiology Results of the JUSTIFY-PCI Study

    Science.gov (United States)

    Nijjer, Sukhjinder S.; Petraco, Ricardo; van de Hoef, Tim P.; Sen, Sayan; van Lavieren, Martijn A.; Foale, Rodney A.; Meuwissen, Martijn; Broyd, Christopher; Echavarria-Pinto, Mauro; Al-Lamee, Rasha; Foin, Nicolas; Sethi, Amarjit; Malik, Iqbal S.; Mikhail, Ghada W.; Hughes, Alun D.; Mayet, Jamil; Francis, Darrel P.; Di Mario, Carlo; Escaned, Javier; Piek, Jan J.; Davies, Justin E.

    2016-01-01

    Background Percutaneous coronary intervention (PCI) aims to increase coronary blood flow by relieving epicardial obstruction. However, no study has objectively confirmed this and assessed changes in flow over different phases of the cardiac cycle. We quantified the change in resting and hyperemic flow velocity after PCI in stenoses defined physiologically by fractional flow reserve and other parameters. Methods and Results Seventy-five stenoses (67 patients) underwent paired flow velocity assessment before and after PCI. Flow velocity was measured over the whole cardiac cycle and the wave-free period. Mean fractional flow reserve was 0.68±0.02. Pre-PCI, hyperemic flow velocity is diminished in stenoses classed as physiologically significant compared with those classed nonsignificant (PPCI, resting flow velocity over the wave-free period increased little (5.6±1.6 cm/s) and significantly less than hyperemic flow velocity (21.2±3 cm/s; P0.80 had a significantly smaller gain (Δ4.6±2.3 cm/s; PPCI physiology is strongly associated with post-PCI increase in hyperemic coronary flow velocity. Hyperemic flow velocity increases 6-fold more when stenoses classed as physiologically significant undergo PCI than when nonsignificant stenoses are treated. Resting flow velocity measured over the wave-free period changes at least 4-fold less than hyperemic flow velocity after PCI. PMID:26025217

  20. Short term results of percutaneous transluminal coronary angioplasty with the monorail technique: experience in the first 1000 patients.

    Science.gov (United States)

    de Feyter, P J; Serruys, P W; van den Brand, M; Suryapranata, H; Beatt, K

    1990-04-01

    The monorail technique allows monitoring of all steps of the coronary angioplasty procedure by high quality coronary angiography; easy, rapid, and safe recrossing and redilatation of the lesion if necessary; and stepwise dilatation of a stenosis with sequential increase of size of balloons. Transstenotic pressure differences cannot, however, be measured through the narrow shaft of the standard monorail balloon catheter. The monorail technique was used in 1014 patients (820 men, 194 women; mean age 57.8 years (range 24 to 84]. The indication for coronary angioplasty was stable angina in 52%, unstable angina in 40%, and acute myocardial infarction in 8%. Single vessel coronary angioplasty was attempted in 78%, multilesion coronary angioplasty in 11%, and multivessel coronary angioplasty in 11%. Angiographic success (reduction of stenosis to less than 50% of the luminal diameter) of all attempted lesions was achieved in 93%. The technique was clinically successful--that is, angiographic success of all attempted lesions, no occurrence of a major complication (death, myocardial infarction, acute bypass surgery), and improvement of symptoms--in 92% and partially successful in 1.3%. The clinical success rates were similar for stable angina (91%) and unstable angina (94%), but were somewhat lower for acute myocardial infarction (88%). Failure without major complication occurred in 3.4% of the patients. Failure with a major complication occurred in 3.3% (death 0.3%, myocardial infarction 2.4%, and acute bypass surgery 2.3%). The total major complication rate was higher in unstable angina (4.2%) than in stable angina (3.0%). These results indicate that the monorail technique can be applied safely and effectively for coronary angioplasty of patients with stable angina, unstable angina, and acute myocardial infarction.

  1. Fractional flow reserve guided percutaneous coronary intervention results in reduced ischemic myocardium and improved outcomes.

    Science.gov (United States)

    Sawant, Abhishek C; Bhardwaj, Aishwarya; Banerjee, Kinjal; Jobanputra, Yash; Kumar, Arnav; Parikh, Parth; Kandregula, Krishna C; Poddar, Kanhaiya; Ellis, Stephen G; Nair, Ravi; Corbelli, John; Kapadia, Samir

    2018-02-06

    To determine if fractional flow reserve guided percutaneous coronary intervention (FFR-guided PCI) is associated with reduced ischemic myocardium compared with angiography-guided PCI. Although FFR-guided PCI has been shown to improve outcomes, it remains unclear if it reduces the extent of ischemic myocardium at risk compared with angiography-guided PCI. We evaluated 380 patients (190 FFR-guided PCI cases and 190 propensity-matched controls) who underwent PCI from 2009 to 2014. Clinical, laboratory, angiographic, stress testing, and major adverse cardiac events [MACE] (all-cause mortality, recurrence of MI requiring PCI, stroke) data were collected. Mean age was 63 ± 11 years; the majority of patients were males (76%) and Caucasian (77%). Median duration of follow up was 3.4 [Range: 1.9, 5.0] years. Procedural complications including coronary dissection (2% vs. 0%, P = .12) and perforation (0% vs. 0%, P = 1.00) were similar between FFR-guided and angiography-guided PCI patients. FFR-guided PCI patients had lower unadjusted (14.7% vs. 23.2%, P = .04) and adjusted [OR = 0.58 (95% CI: 0.34-0.98)] risk of repeat revascularization at one year. FFR-guided PCI patients were less likely (23% vs. 32%, P = .02) to have ischemia and had lower (5.9% vs. 21.1%, P guided PCI, FFR-guided PCI results in less repeat revascularization and a lower incidence of post PCI ischemia translating into improved survival, without an increase in complications. © 2018 Wiley Periodicals, Inc.

  2. Current discharge management of acute coronary syndromes: baseline results from a national quality improvement initiative.

    Science.gov (United States)

    Wai, A; Pulver, L K; Oliver, K; Thompson, A

    2012-05-01

    Evidence-practice gaps exist in the continuum of care for patients with acute coronary syndromes (ACS), particularly at hospital discharge. We aimed to describe the methodology and baseline results of the Discharge Management of Acute Coronary Syndromes (DMACS) project, focusing on the prescription of guideline-recommended medications, referral to cardiac rehabilitation and communication between the hospital, patient and their primary healthcare professionals. DMACS employed Drug Use Evaluation methodology involving data collection, evaluation and feedback, and targeted educational interventions. Adult patients with ACS discharged during a 4-month period were eligible to participate. Data were collected (maximum 50 patients) at each site through an inpatient medical record review, a general practitioner (GP) postal/fax survey conducted 14 days post discharge and a patient telephone survey 3 months post discharge. Forty-nine hospitals participated in the audit recruiting 1545 patients. At discharge, 57% of patients were prescribed a combination of antiplatelet agent(s), beta-blocker, statin and angiotensin-converting enzyme inhibitor and/or angiotensin II-antagonist. At 3 months post discharge, 48% of patients reported using the same combination. Some 67% of patients recalled being referred to cardiac rehabilitation; of these, 33% had completed the programme. In total, 83% of patients had a documented ACS management plan at discharge. Of these, 90% included a medication list, 56% a chest pain action plan and 54% risk factor modification advice. Overall, 65% of GPs rated the quality of information received in the discharge summary as 'very good' to 'excellent'. The findings of our baseline audit showed that despite the robust evidence base and availability of national guidelines, the management of patients with ACS can be improved. These findings will inform a multifaceted intervention strategy to improve adherence to guidelines for the discharge management of

  3. Coronary CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Dewey, Marc [Charite - Universitaetsmedizin Berlin (Germany). Inst. fuer Radiologie

    2009-07-01

    Coronary CT angiography has attained increasing scientific attention at academic institutions and has become a highly accurate diagnostic modality. Extending this knowledge into a practice setting is the purpose of 'Coronary CT Angiography'. This book will assist you in integrating cardiac CT into your daily practice, while also giving an overview of the current technical status and applications. The specific features of scanners from all four main vendors are also presented providing an objective overview of noninvasive coronary angiography using CT. (orig.)

  4. Complete-arch accuracy of intraoral scanners.

    Science.gov (United States)

    Treesh, Joshua C; Liacouras, Peter C; Taft, Robert M; Brooks, Daniel I; Raiciulescu, Sorana; Ellert, Daniel O; Grant, Gerald T; Ye, Ling

    2018-04-30

    Intraoral scanners have shown varied results in complete-arch applications. The purpose of this in vitro study was to evaluate the complete-arch accuracy of 4 intraoral scanners based on trueness and precision measurements compared with a known reference (trueness) and with each other (precision). Four intraoral scanners were evaluated: CEREC Bluecam, CEREC Omnicam, TRIOS Color, and Carestream CS 3500. A complete-arch reference cast was created and printed using a 3-dimensional dental cast printer with photopolymer resin. The reference cast was digitized using a laboratory-based white light 3-dimensional scanner. The printed reference cast was scanned 10 times with each intraoral scanner. The digital standard tessellation language (STL) files from each scanner were then registered to the reference file and compared with differences in trueness and precision using a 3-dimensional modeling software. Additionally, scanning time was recorded for each scan performed. The Wilcoxon signed rank, Kruskal-Wallis, and Dunn tests were used to detect differences for trueness, precision, and scanning time (α=.05). Carestream CS 3500 had the lowest overall trueness and precision compared with Bluecam and TRIOS Color. The fourth scanner, Omnicam, had intermediate trueness and precision. All of the scanners tended to underestimate the size of the reference file, with exception of the Carestream CS 3500, which was more variable. Based on visual inspection of the color rendering of signed differences, the greatest amount of error tended to be in the posterior aspects of the arch, with local errors exceeding 100 μm for all scans. The single capture scanner Carestream CS 3500 had the overall longest scan times and was significantly slower than the continuous capture scanners TRIOS Color and Omnicam. Significant differences in both trueness and precision were found among the scanners. Scan times of the continuous capture scanners were faster than the single capture scanners

  5. Recent Results with a segmented Hybrid Photon Detector for a novel parallax-free PET Scanner for Brain Imaging

    CERN Document Server

    Braem, André; Joram, Christian; Mathot, Serge; Séguinot, Jacques; Weilhammer, Peter; Ciocia, F; De Leo, R; Nappi, E; Vilardi, I; Argentieri, A; Corsi, F; Dragone, A; Pasqua, D

    2007-01-01

    We describe the design, fabrication and test results of a segmented Hybrid Photon Detector with integrated auto-triggering front-end electronics. Both the photodetector and its VLSI readout electronics are custom designed and have been tailored to the requirements of a recently proposed novel geometrical concept of a Positron Emission Tomograph. Emphasis is laid on the PET specific features of the device. The detector has been fabricated in the photocathode facility at CERN.

  6. Recent results and future prospects of dynamic intravenous coronary angiography using synchrotron radiation

    International Nuclear Information System (INIS)

    Ohtsuka, Sadanori

    1999-01-01

    We have developed a dynamic intravenous coronary angiography (IVCAG) by using synchrotron radiation (SR) as a less invasive and more easy examination in place of CAG. Twelve patients suspected to have angina pectoris underwent IVCAG at the clinic in the National Laboratory for High Energy Accelerator Research Organization (KEK). The patients received an intravenous injection of 40m/of contrast agent, and then irradiation was performed with a wide (130 mm x 80 mm) and monochromatic (35 KeV) X-ray beam. Images were acquired with an image intensifier and recorded with a digital fluorography system as dynamic angiography at 30 or 10 images/sec. IVCAG was repeated in 2 or 3 projections. In all patients, the dynamic images permitted clear visualization of the coronary arteries and enabled evaluation of coronary anatomy. Two patients were diagnosed to have coronary stenosis by IVCAG and were confirmed by conventional CAG. The total irradiation doses used for IVCAG were less than those for conventional angiography. Although the image definition obtained with dynamic IVCAG was somewhat less than that of conventional CAG and needs to be improved, the IVCAG can be easily used for the evaluation of coronary arteries and may be clinically used for screening and follow-up of coronary artery disease. In future, the improvement of imaging system, such as increased intensity of synchrotron radiation and high sensitivity in imaging detector, will make more advance in image quality. (author)

  7. Long-Range WindScanner System

    DEFF Research Database (Denmark)

    Vasiljevic, Nikola; Lea, Guillaume; Courtney, Michael

    2016-01-01

    The technical aspects of a multi-Doppler LiDAR instrument, the long-range WindScanner system, are presented accompanied by an overview of the results from several field campaigns. The long-range WindScanner system consists of three spatially-separated, scanning coherent Doppler LiDARs and a remote......-rangeWindScanner system measures the wind field by emitting and directing three laser beams to intersect, and then scanning the beam intersection over a region of interest. The long-range WindScanner system was developed to tackle the need for high-quality observations of wind fields on scales of modern wind turbine...

  8. Left ventricular contractile function after distal protection in primary percutaneous coronary intervention Results from the Drug Elution and Distal Protection in ST-Elevation Myocardial Infarction trial

    DEFF Research Database (Denmark)

    Kofoed, K F; Kelbæk, H; Thuesen, L

    2011-01-01

    Coronary intervention (PCI) may result in an increased infarct size. We evaluated the effect of distal protection during PCI for ST-segment elevation myocardial infarction (STEMI) on myocardial function.......Coronary intervention (PCI) may result in an increased infarct size. We evaluated the effect of distal protection during PCI for ST-segment elevation myocardial infarction (STEMI) on myocardial function....

  9. Intensive glucose regulation in hyperglycemic acute coronary syndrome: Results of the randomized BIOMarker study to identify the acute risk of a coronary syndrome-2 (BIOMArCS-2) glucose trial

    NARCIS (Netherlands)

    M. de Mulder (Maarten); V.A.W.M. Umans (Victor); J.H. Cornel (Jan); F.M. van der Zant (F.); F. Stam (Frank); R.M. Oemrawsingh (Rohit); K.M. Akkerhuis (Martijn); H. Boersma (Eric)

    2013-01-01

    textabstractIMPORTANCE: Elevated plasma glucose levels in patients with acute coronary syndrome (ACS) on hospital admission are associated with increased mortality. Clinical trials of glucose regulation have provided inconsistent results with respect to cardiovascular outcomes, perhaps because

  10. Influence of acquired obesity on coronary vessel wall late gadolinium enhancement in discordant monozygote twins

    Energy Technology Data Exchange (ETDEWEB)

    Makowski, Marcus R. [King' s College London, Division of Imaging Sciences and Biomedical Engineering, London (United Kingdom); Wellcome Trust and EPSRC Medical Engineering Centre, London (United Kingdom); King' s College London, BHF Centre of Excellence, London (United Kingdom); King' s College London, NIHR Biomedical Research Centre, London (United Kingdom); Charite-Universitaetsmedizin, Department of Radiology, Berlin (Germany); Jansen, Christian H.P. [King' s College London, Division of Imaging Sciences and Biomedical Engineering, London (United Kingdom); Ebersberger, Ullrich; Spector, Tim D. [Heart Center Munich-Bogenhausen, Department of Cardiology and Intensive Care Medicine, Munich (Germany); Schaeffter, Tobias; Razavi, Reza [King' s College London, Division of Imaging Sciences and Biomedical Engineering, London (United Kingdom); Wellcome Trust and EPSRC Medical Engineering Centre, London (United Kingdom); King' s College London, BHF Centre of Excellence, London (United Kingdom); King' s College London, NIHR Biomedical Research Centre, London (United Kingdom); Mangino, Massimo [King' s College London, Department of Twin Research and Genetic Epidemiology, London (United Kingdom); National Institute for Health Research (NIHR) Biomedical Research Centre at Guy' s and St. Thomas' Foundation Trust, London (United Kingdom); Botnar, Rene M. [King' s College London, Division of Imaging Sciences and Biomedical Engineering, London (United Kingdom); Wellcome Trust and EPSRC Medical Engineering Centre, London (United Kingdom); King' s College London, BHF Centre of Excellence, London (United Kingdom); King' s College London, NIHR Biomedical Research Centre, London (United Kingdom); Greil, Gerald F. [King' s College London, Division of Imaging Sciences and Biomedical Engineering, London (United Kingdom); Wellcome Trust and EPSRC Medical Engineering Centre, London (United Kingdom); King' s College London, BHF Centre of Excellence, London (United Kingdom); King' s College London, NIHR Biomedical Research Centre, London (United Kingdom)

    2017-11-15

    The aim of this study was to investigate the impact of BMI on late gadolinium enhancement (LGE) of the coronary artery wall in identical monozygous twins discordant for BMI. Coronary LGE represents a useful parameter for the detection and quantification of atherosclerotic coronary vessel wall disease. Thirteen monozygote female twin pairs (n = 26) with significantly different BMIs (>1.6 kg/m2) were recruited out of >10,000 twin pairs (TwinsUK Registry). A coronary 3D-T2prep-TFE MR angiogram and 3D-IR-TFE vessel wall scan were performed prior to and following the administration of 0.2 mmol/kg of Gd-DTPA on a 1.5 T MR scanner. The number of enhancing coronary segments and contrast to noise ratios (CNRs) of the coronary wall were quantified. An increase in BMI was associated with an increased number of enhancing coronary segments (5.3 ± 1.5 vs. 3.5 ± 1.6, p < 0.0001) and increased coronary wall enhancement (6.1 ± 1.1 vs. 4.8 ± 0.9, p = 0.0027) compared to matched twins with lower BMI. This study in monozygous twins indicates that acquired factors predisposing to obesity, including lifestyle and environmental factors, result in increased LGE of the coronary arteries, potentially reflecting an increase in coronary atherosclerosis in this female study population. (orig.)

  11. Influence of acquired obesity on coronary vessel wall late gadolinium enhancement in discordant monozygote twins

    International Nuclear Information System (INIS)

    Makowski, Marcus R.; Jansen, Christian H.P.; Ebersberger, Ullrich; Spector, Tim D.; Schaeffter, Tobias; Razavi, Reza; Mangino, Massimo; Botnar, Rene M.; Greil, Gerald F.

    2017-01-01

    The aim of this study was to investigate the impact of BMI on late gadolinium enhancement (LGE) of the coronary artery wall in identical monozygous twins discordant for BMI. Coronary LGE represents a useful parameter for the detection and quantification of atherosclerotic coronary vessel wall disease. Thirteen monozygote female twin pairs (n = 26) with significantly different BMIs (>1.6 kg/m2) were recruited out of >10,000 twin pairs (TwinsUK Registry). A coronary 3D-T2prep-TFE MR angiogram and 3D-IR-TFE vessel wall scan were performed prior to and following the administration of 0.2 mmol/kg of Gd-DTPA on a 1.5 T MR scanner. The number of enhancing coronary segments and contrast to noise ratios (CNRs) of the coronary wall were quantified. An increase in BMI was associated with an increased number of enhancing coronary segments (5.3 ± 1.5 vs. 3.5 ± 1.6, p < 0.0001) and increased coronary wall enhancement (6.1 ± 1.1 vs. 4.8 ± 0.9, p = 0.0027) compared to matched twins with lower BMI. This study in monozygous twins indicates that acquired factors predisposing to obesity, including lifestyle and environmental factors, result in increased LGE of the coronary arteries, potentially reflecting an increase in coronary atherosclerosis in this female study population. (orig.)

  12. Long-term outcome in patients treated with sirolimus-eluting stents in complex coronary artery lesions: 3-year results of the SCANDSTENT (Stenting Coronary Arteries in Non-Stress/Benestent Disease) trial

    DEFF Research Database (Denmark)

    Kelbaek, H.; Klovgaard, L.; Helqvist, S.

    2008-01-01

    data of the long-term outcome of patients with complex coronary artery lesions. METHODS: We randomly assigned 322 patients with total coronary occlusions or lesions located in bifurcations, ostial, or angulated segments of the coronary arteries to have SES or BMS implanted. RESULTS: At 3 years, major...... performed between 1 and 3 years after the index treatment (p = NS). According to revised definitions, stent thrombosis occurred in 5 patients (3.1%) in the SES group and in 7 patients (4.4%) in the BMS group (p = NS); very late stent thrombosis was observed in 4 versus 1 patient. CONCLUSIONS: A continued...

  13. Whole body line scanner

    International Nuclear Information System (INIS)

    Berninger, W.H.

    1975-01-01

    A bar-shaped scintillator converts incident collimated gamma rays to light pulses which are detected by a row of photoelectric tubes positioned along the output face of the scintillator wherein each tube has a convexly curved photocathode disposed in close proximity to the scintillator. Electronic circuitry connected to the output of phototubes develops the scintillation event x-axis position coordinate electrical signal with good linearity and with substantial independence of the spacing between the scintillator and photocathodes so that the phototubes can be positioned as close to the scintillator as possible to obtain reduced distortion in the field of view and improved spatial resolution. A mechanical drive of the scanner results in an image of the gamma ray source being formed by sequencing the developed scintillation position coordinate signals in the y-axis dimension

  14. Relationship between homocysteine and coronary artery disease. Results from a large prospective cohort study

    NARCIS (Netherlands)

    Schaffer, A.; Verdoia, M.; Cassetti, E.; Marino, P.; Suryapranata, H.; Luca, G. De

    2014-01-01

    BACKGROUND: Coronary artery disease (CAD) still represents the major cause of mortality in developed countries. Large research programs have been focused on the identification of new risk factors to prevent CAD, with special attention to homocysteine (Hcy), due to the known associated increased

  15. Relationship between homocysteine and coronary artery disease. Results from a large prospective cohort study.

    Science.gov (United States)

    Schaffer, Alon; Verdoia, Monica; Cassetti, Ettore; Marino, Paolo; Suryapranata, Harry; De Luca, Giuseppe

    2014-08-01

    Coronary artery disease (CAD) still represents the major cause of mortality in developed countries. Large research programs have been focused on the identification of new risk factors to prevent CAD, with special attention to homocysteine (Hcy), due to the known associated increased thrombogenicity, oxidative stress status and endothelial dysfunction. However, controversy still exists on the association between Hcy and CAD. Therefore, aim of the current study was to investigate the association of Hcy with the prevalence and extent of CAD in a large consecutive cohort of patients undergoing coronary angiography. Our population is represented by a total of 3056 consecutive patients undergoing coronary angiography between at the Azienda Ospedaliera "Maggiore della Carità", Novara, Italy. Fasting samples were collected for homocysteine levels assessment. Coronary disease was defined for at least 1 vessel stenosis>50% as evaluated by QCA. Study population was divided according to Hcy tertiles (18.2nmol/ml). High plasmatic level of homocysteine was related with age (pbenefits from vitamin administration in patients with elevated Hcy to prevent the occurrence and progression of CAD. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Systematic preoperative coronary angiography and stenting improves postoperative results of carotid endarterectomy in patients with asymptomatic coronary artery disease: a randomised controlled trial.

    Science.gov (United States)

    Illuminati, G; Ricco, J-B; Greco, C; Mangieri, E; Calio', F; Ceccanei, G; Pacilè, M A; Schiariti, M; Tanzilli, G; Barillà, F; Paravati, V; Mazzesi, G; Miraldi, F; Tritapepe, L

    2010-02-01

    To evaluate the usefulness of systematic coronary angiography followed, if needed, by coronary artery angioplasty (percutaneous coronary intervention (PCI)) on the incidence of cardiac ischaemic events after carotid endarterectomy (CEA) in patients without evidence of coronary artery disease (CAD). From January 2005 to December 2008, 426 patients, candidates for CEA, with no history of CAD and with normal cardiac ultrasound and electrocardiography (ECG), were randomised into two groups. In group A (n=216) all the patients had coronary angiography performed before CEA. In group B, all the patients had CEA without previous coronary angiography. In group A, 66 patients presenting significant coronary artery lesions at angiography received PCI before CEA. They subsequently underwent surgery under aspirin (100 mg day(-1)) and clopidogrel (75 mg day(-1)). CEA was performed within a median delay of 4 days after PCI (range: 1-8 days). Risk factors, indications for CEA and surgical techniques were comparable in both groups (p>0.05). The primary combined endpoint of the study was the incidence of postoperative myocardial ischaemic events combined with the incidence of complications of coronary angiography. Secondary endpoints were death and stroke rates after CEA and incidence of cervical haematoma. Postoperative mortality was 0% in group A and 0.9% in group B (p=0.24). One postoperative stroke (0.5%) occurred in group A, and two (0.9%) in group B (p=0.62). No postoperative myocardial event was observed in group A, whereas nine ischaemic events were observed in group B, including one fatal myocardial infarction (p=0.01). Binary logistic regression analysis demonstrated that preoperative coronary angiography was the only independent variable that predicted the occurrence of postoperative coronary ischaemia after CEA. The odds ratio for coronary angiography (group A) indicated that when holding all other variables constant, a patient having preoperative coronary angiography

  17. Randomized Comparison of Ridaforolimus- and Zotarolimus-Eluting Coronary Stents in Patients With Coronary Artery Disease: Primary Results From the BIONICS Trial (BioNIR Ridaforolimus-Eluting Coronary Stent System in Coronary Stenosis).

    Science.gov (United States)

    Kandzari, David E; Smits, Pieter C; Love, Michael P; Ben-Yehuda, Ori; Banai, Shmuel; Robinson, Simon D; Jonas, Michael; Kornowski, Ran; Bagur, Rodrigo; Iniguez, Andres; Danenberg, Haim; Feldman, Robert; Jauhar, Rajiv; Chandna, Harish; Parikh, Manish; Perlman, Gidon Y; Balcells, Mercedes; Markham, Peter; Ozan, Melek Ozgu; Genereux, Philippe; Edelman, Elazer R; Leon, Martin B; Stone, Gregg W

    2017-10-03

    The safety and efficacy of a novel cobalt alloy-based coronary stent with a durable elastomeric polymer eluting the antiproliferative agent ridaforolimus for treatment of patients with coronary artery disease is undetermined. A prospective, international 1:1 randomized trial was conducted to evaluate in a noninferiority design the relative safety and efficacy of ridaforolimus-eluting stents (RESs) and slow-release zotarolimus-eluting stents among 1919 patients undergoing percutaneous coronary intervention at 76 centers. Inclusion criteria allowed enrollment of patients with recent myocardial infarction, total occlusions, bifurcations lesions, and other complex conditions. Baseline clinical and angiographic characteristics were similar between the groups. Overall, mean age was 63.4 years, 32.5% had diabetes mellitus, and 39.7% presented with acute coronary syndromes. At 12 months, the primary end point of target lesion failure (composite of cardiac death, target vessel-related myocardial infarction, and target lesion revascularization) was 5.4% for both devices (upper bound of 1-sided 95% confidence interval 1.8%, P noninferiority =0.001). Definite/probable stent thrombosis rates were low in both groups (0.4% RES versus 0.6% zotarolimus-eluting stent, P =0.75); 13-month angiographic in-stent late lumen loss was 0.22±0.41 mm and 0.23±0.39 mm ( P noninferiority =0.004) for the RES and zotarolimus-eluting stent groups, respectively, and intravascular ultrasound percent neointimal hyperplasia was 8.10±5.81 and 8.85±7.77, respectively ( P noninferiority =0.01). In the present trial, which allowed broad inclusion criteria, the novel RESs met the prespecified criteria for noninferiority compared with zotarolimus-eluting stents for the primary end point of target lesion failure at 12 months and had similar measures of late lumen loss. These findings support the safety and efficacy of RESs in patients who are representative of clinical practice. URL: http

  18. Noninvasive testing in coronary artery disease. Selection of procedures and interpretation of results

    International Nuclear Information System (INIS)

    Sox, H.C. Jr.

    1983-01-01

    In patients with acute chest pain, selection of diagnostic tests and admission to and discharge from the coronary care unit are critical decisions for which useful empirical guidelines are now available. In hospitalized patients, the serum level of the MB fraction of creatine kinase is particularly useful when the history strongly suggests infarction but the ECG is nondiagnostic. In patients with chronic chest pain, the gender of the patient and the character of the pain are the most important guides to selecting and interpreting exercise tests. In women and in men with nonanginal chest pain, the myocardial scintiscan is preferred to the exercise ECG because of its greater diagnostic accuracy. In men with atypical angina, the two tests are nearly equivalent, and the added cost of the scintiscan is a factor in test selection. Since nearly all men with typical angina have coronary artery disease, diagnostic tests are usually not needed

  19. Mid-term results of off-pump coronary artery bypass grafting assessed by multi-slice computed tomography

    International Nuclear Information System (INIS)

    Yoshida, Seijiro; Nitta, Yoshio; Oda, Katsuhiko

    2004-01-01

    Off-pump coronary artery bypass (OPCAB) has recently increased in popularity, but the long-term results are still unknown. We evaluated the mid-term results of OPCAB surgery using multi-slice computed tomography (MSCT), which is a non-invasive postoperative evaluation method. Thirty-one consecutive patients who underwent OPCAB surgery at least 2 years prior to the study were selected. The age was 50 to 79 years (66.9±6.5) and the ratio of men to women was 26:5. Coronary angiography was performed in all patients at 2 weeks postoperatively. The follow-up was complete, and mean follow-up was 30.9 months. There were no hospital deaths and 1 non-cardiac late death. The graft patency rate in coronary angiography was left internal thoracic artery (LITA) 30/30 (100%), right internal thoracic artery (RITA) 2/2 (100%), radial artery (RA) 14/15 (93%), saphenous vein graft (SVG) 15/17 (88%). No graft became occluded on MSCT study and all patients have been angina-free during the follow-up period. We suggest that OPCAB is feasible in most patients with good patency and low mortality. MSCT is an effective follow up method for the morphological findings and noninvasive quantitative evaluation of the bypass grafts. (author)

  20. Long-Term Results After Simple Versus Complex Stenting of Coronary Artery Bifurcation Lesions Nordic Bifurcation Study 5-Year Follow-Up Results

    DEFF Research Database (Denmark)

    Maeng, M.; Holm, N. R.; Erglis, A.

    2013-01-01

    Objectives This study sought to report the 5-year follow-up results of the Nordic Bifurcation Study. Background Randomized clinical trials with short-term follow-up have indicated that coronary bifurcation lesions may be optimally treated using the optional side branch stenting strategy. Methods...... complex strategy of planned stenting of both the main vessel and the side branch. (C) 2013 by the American College of Cardiology Foundation...

  1. Quantitative angiography of the left anterior descending coronary artery: correlations with pressure gradient and results of exercise thallium scintigraphy

    International Nuclear Information System (INIS)

    Wijns, W.; Serruys, P.W.; Reiber, J.H.; van den Brand, M.; Simoons, M.L.; Kooijman, C.J.; Balakumaran, K.; Hugenholtz, P.G.

    1985-01-01

    To evaluate, during cardiac catheterization, what constitutes a physiologically significant obstruction to blood flow in the human coronary system, computer-based quantitative analysis of coronary angiograms was performed on the angiograms of 31 patients with isolated disease of the proximal left anterior descending coronary artery. The angiographic severity of stenosis was compared with the transstenotic pressure gradient measured with the dilation catheter during angioplasty and with the results of exercise thallium scintigraphy. A curvilinear relationship was found between the pressure gradient across the stenosis (normalized for the mean aortic pressure) and the residual minimal area of obstruction (after subtracting the area of the angioplasty catheter). This relationship was best fitted by the equation: normalized mean pressure gradient . a + b . log [obstruction area], r . .74. The measurements of the percent area of stenosis (cutoff 80%) and of the transstenotic pressure gradient (cutoff 0.30) obtained at rest correctly predicted the occurrence of thallium perfusion defects induced by exercise in 83% of the patients

  2. Anatomy of right superior septal artery demonstrated on the coronary CT scan

    International Nuclear Information System (INIS)

    Takeguchi, Takaya; Ibukuro, Kenji; Fukuda, Hozumi; Tobe, Kimiko; Abe, Shoko

    2012-01-01

    Background. A coronary CT scan allows for non-invasive visualization of the anatomy of a coronary artery in three dimensions compared to the two dimensions afforded by conventional angiography. The septal artery, the main blood source of the interventricular septum, is usually derived from the left anterior descending artery; however, it is occasionally derived from the right coronary artery. Purpose. To analyze the prevalence, origin, diameter, and length of the right superior septal artery (RSSA) demonstrated on a coronary CT scan. Material and Methods. The right superior septal artery was retrospectively reviewed on the reconstructed axial scan images (0.5-mm thickness, 0.25-mm interval) in 1290 consecutive patients who underwent coronary CT scans. All patients were scanned on a 320-row CT scanner. The images were transferred to a workstation to trace the vessel to analyze the origin, diameter, and length. We also compared the length of the RSSA between patients with and without coronary artery stenosis. Results. The RSSA was identified in 51 (3.9%) of 1290 patients. The origin was the proximal portion of the right coronary artery (n = 40) or the right sinus of Valsalva (n 11). The artery co-existed with the conus artery in 15 (29%) of 51 patients. The length was 16-62 mm (mean 31.2 mm ± 10.5), and the diameter was 0.8-2.0 mm (mean 1.3 mm ± 0.2). Longer RSSAs tended to be demonstrated in the patients with coronary artery stenosis rather than with normal coronary arteries (P < 0.05). Conclusion. The right superior septal artery and its anatomical variant could be analyzed with a coronary CT scan. The ability to demonstrate this artery on the coronary CT scan was the same as with coronary angiography. The recognition of this vessel is useful for physicians managing with the diagnosis and treatment of the coronary artery disease

  3. Anatomy of right superior septal artery demonstrated on the coronary CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Takeguchi, Takaya (Mitsui Memorial Hospital, Department of Diagnostic Radiology, Tokyo (Japan); Tokyo Medical and Dental University, Department of Diagnostic Radiology, Tokyo (Japan)); Ibukuro, Kenji; Fukuda, Hozumi; Tobe, Kimiko; Abe, Shoko (Mitsui Memorial Hospital, Department of Diagnostic Radiology, Tokyo (Japan)), Email: kj-ibkr@qd6.so-net.ne.jp

    2012-02-15

    Background. A coronary CT scan allows for non-invasive visualization of the anatomy of a coronary artery in three dimensions compared to the two dimensions afforded by conventional angiography. The septal artery, the main blood source of the interventricular septum, is usually derived from the left anterior descending artery; however, it is occasionally derived from the right coronary artery. Purpose. To analyze the prevalence, origin, diameter, and length of the right superior septal artery (RSSA) demonstrated on a coronary CT scan. Material and Methods. The right superior septal artery was retrospectively reviewed on the reconstructed axial scan images (0.5-mm thickness, 0.25-mm interval) in 1290 consecutive patients who underwent coronary CT scans. All patients were scanned on a 320-row CT scanner. The images were transferred to a workstation to trace the vessel to analyze the origin, diameter, and length. We also compared the length of the RSSA between patients with and without coronary artery stenosis. Results. The RSSA was identified in 51 (3.9%) of 1290 patients. The origin was the proximal portion of the right coronary artery (n = 40) or the right sinus of Valsalva (n 11). The artery co-existed with the conus artery in 15 (29%) of 51 patients. The length was 16-62 mm (mean 31.2 mm +- 10.5), and the diameter was 0.8-2.0 mm (mean 1.3 mm +- 0.2). Longer RSSAs tended to be demonstrated in the patients with coronary artery stenosis rather than with normal coronary arteries (P < 0.05). Conclusion. The right superior septal artery and its anatomical variant could be analyzed with a coronary CT scan. The ability to demonstrate this artery on the coronary CT scan was the same as with coronary angiography. The recognition of this vessel is useful for physicians managing with the diagnosis and treatment of the coronary artery disease

  4. Orbital Atherectomy for Treating De Novo Severely Calcified Coronary Narrowing (1-Year Results from the Pivotal ORBIT II Trial).

    Science.gov (United States)

    Généreux, Philippe; Lee, Arthur C; Kim, Christopher Y; Lee, Michael; Shlofmitz, Richard; Moses, Jeffrey W; Stone, Gregg W; Chambers, Jeff W

    2015-06-15

    Percutaneous coronary intervention of severely calcified lesions has historically been associated with major adverse cardiac event (MACE) rates as high as 30%. In the ORBIT II (Evaluate the Safety and Efficacy of OAS in Treating Severely Calcified Coronary Lesions) trial, treatment of de novo severely calcified lesions with the Diamondback 360° Coronary Orbital Atherectomy System (OAS) resulted in low rates of procedural and 30-day adverse ischemic events. The long-term results from this trial have not been reported. We sought to determine the 1-year outcomes after orbital atherectomy of severely calcified coronary lesions. ORBIT II was a single-arm trial enrolling 443 subjects at 49 US sites with severely calcified lesions usually excluded from randomized trials. OAS utilizes a centrifugal differential sanding mechanism of action for plaque modification prior to stent implantation. After OAS drug-eluting stents were implanted in 88.2% of the patients. The primary safety end point was 30-day MACE, the composite of cardiac death, myocardial infarction, or target vessel revascularization [TVR]. The present analysis reports the 1-year follow-up results from ORBIT II. One-year data were available in 433 of 443 patients (97.7%), with median follow-up time of 16.7 months. The 1-year MACE rate was 16.4%, including cardiac death (3.0%), myocardial infarction (9.7%), and target vessel revascularization (5.9%). The 1-year target lesion revascularization rate was 4.7%, and stent thrombosis occurred in 1 patient (0.2%). Independent predictors of 1-year MACE and target vessel revascularization were diameter stenosis at baseline and the use of bare-metal stents. In patients with severely calcified lesions who underwent percutaneous coronary intervention, the use of OAS was associated with low rates of 1-year adverse ischemic events compared with historical controls. This finding has important clinical implications for the selection of optimum treatment strategies for patients

  5. Occurrence and characteristics of mutual interference between LIDAR scanners

    Science.gov (United States)

    Kim, Gunzung; Eom, Jeongsook; Park, Seonghyeon; Park, Yongwan

    2015-05-01

    The LIDAR scanner is at the heart of object detection of the self-driving car. Mutual interference between LIDAR scanners has not been regarded as a problem because the percentage of vehicles equipped with LIDAR scanners was very rare. With the growing number of autonomous vehicle equipped with LIDAR scanner operated close to each other at the same time, the LIDAR scanner may receive laser pulses from other LIDAR scanners. In this paper, three types of experiments and their results are shown, according to the arrangement of two LIDAR scanners. We will show the probability that any LIDAR scanner will interfere mutually by considering spatial and temporal overlaps. It will present some typical mutual interference scenario and report an analysis of the interference mechanism.

  6. Comparison of immediate results and follow-up of patients with single-vessel and multivessel coronary artery disease younger than 50 years of age undergoing coronary stent implantation

    Directory of Open Access Journals (Sweden)

    Anello Alexandre L.

    2003-01-01

    Full Text Available OBJECTIVE: To assess the in-hospital results and clinical follow-up of young patients (< 50 years with multivessel coronary artery disease undergoing stent implantation in native coronary arteries and to compare their results with those of patients with single-vessel coronary artery disease. METHODS: We retrospectively studied 462 patients undergoing coronary stent implantation. Patients were divided into 2 groups: group I (G-I - 388 (84% patients with single-vessel coronary artery disease; and group II (G-II - 74 (16% patients with multivessel coronary artery disease. RESULTS: The mean age of the patients was 45±4.9 years, and the clinical findings at presentation and demographic data were similar in both groups. The rate of clinical success was 95% in G-I and 95.8% in G-II (P=0.96, with no difference in regard to in-hospital evolution between the groups. Death, acute myocardial infarction, and the need for myocardial revascularization during clinical follow-up occurred in 10.1% and 11.2% (P=0.92 in G-I and G-II, respectively. By the end of 24 months, the actuarial analysis showed an event-free survival of 84.6 % in G-I and 81.1% in G-II (P=0.57. CONCLUSION: Percutaneous treatment with coronary stent implantation in young patients with multivessel disease may be safe with a high rate of clinical success, a low incidence of in-hospital complications, and a favorable evolution in clinical follow-up.

  7. Results of completion arteriography after minimally invasive off-pump coronary artery bypass.

    Science.gov (United States)

    Hoff, Steven J; Ball, Stephen K; Leacche, Marzia; Solenkova, Natalia; Umakanthan, Ramanan; Petracek, Michael R; Ahmad, Rashid; Greelish, James P; Walker, Kristie; Byrne, John G

    2011-01-01

    The benefits of a minimally invasive approach to off-pump coronary artery bypass remain controversial. The value of completion arteriography in validating this technique has not been investigated. From April 2007 to October 2009, fifty-six patients underwent isolated minimally invasive coronary artery bypass grafting through a left thoracotomy without cardiopulmonary bypass. Forty-three of these patients underwent completion arteriography. Sixty-five grafts were performed in these 56 patients, (average, 1.2 grafts per patient; range, 1 to 3). Forty-eight grafts were studied in the 43 patients undergoing completion arteriography. There were 4 findings on arteriogram leading to further immediate intervention (8.3%). These included 3 grafts with anastomotic stenoses or spasm requiring stent placement, and 1 patient who had limited dissection in the left internal mammary artery graft and underwent placement of an additional vein graft. These findings were independent of electrocardiographic changes or hemodynamic instability. The remainder of the studies showed no significant abnormalities. There were no deaths. One patient who did not have a completion arteriogram suffered a postoperative myocardial infarction requiring stent placement for anastomotic stenosis. Patients were discharged home an average of 6.8 days postoperatively. There were no instances of renal dysfunction postoperatively attributable to catheterization. Minimally invasive coronary artery bypass is safe and effective. Findings of completion arteriography occasionally reveal previously under-recognized findings that, if corrected in a timely fashion, could potentially impact graft patency and clinical outcomes. Our experience validates this minimally invasive technique. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  8. Aspirin Desensitization in Patients With Coronary Artery Disease: Results of the Multicenter ADAPTED Registry (Aspirin Desensitization in Patients With Coronary Artery Disease).

    Science.gov (United States)

    Rossini, Roberta; Iorio, Annamaria; Pozzi, Roberto; Bianco, Matteo; Musumeci, Giuseppe; Leonardi, Sergio; Lettieri, Corrado; Bossi, Irene; Colombo, Paola; Rigattieri, Stefano; Dossena, Cinzia; Anzuini, Angelo; Capodanno, Davide; Senni, Michele; Angiolillo, Dominick J

    2017-02-01

    There are limited data on aspirin (ASA) desensitization for patients with coronary artery disease. The aim of the present study was to assess the safety and efficacy of a standard rapid desensitization protocol in patients with ASA sensitivity undergoing coronary angiography. This is a prospective, multicenter, observational study including 7 Italian centers including patients with a history of ASA sensitivity undergoing coronary angiography with intent to undergo percutaneous coronary intervention. A total of 330 patients with history of ASA sensitivity with known/suspected stable coronary artery disease or presenting with an acute coronary syndrome, including ST-segment-elevation myocardial infarction were enrolled. Adverse effects to aspirin included urticaria (n=177, 53.6%), angioedema (n=69, 20.9%), asthma (n=65, 19.7%), and anaphylactic reaction (n=19, 5.8%). Among patients with urticaria/angioedema, 13 patients (3.9%) had a history of idiopathic chronic urticaria. All patients underwent a rapid ASA (5.5 hours) desensitization procedure. The desensitization procedure was performed before cardiac catheterization in all patients, except for those (n=78, 23.6%) presenting with ST-segment-elevation myocardial infarction who underwent the desensitization after primary percutaneous coronary intervention. Percutaneous coronary intervention was performed in 235 patients (71%) of the overall study population. The desensitization procedure was successful in 315 patients (95.4%) and in all patients with a history of anaphylactic reaction. Among the 15 patients (4.6%) who did not successfully respond to the desensitization protocol, adverse reactions were minor and responded to treatment with corticosteroids and antihistamines. Among patients with successful in-hospital ASA desensitization, 253 patients (80.3%) continued ASA for at least 12 months. Discontinuation of ASA in the 62 patients (19.7%) who had responded to the desensitization protocol was because of medical

  9. Quantitative coronary plaque analysis predicts high-risk plaque morphology on coronary computed tomography angiography: results from the ROMICAT II trial.

    Science.gov (United States)

    Liu, Ting; Maurovich-Horvat, Pál; Mayrhofer, Thomas; Puchner, Stefan B; Lu, Michael T; Ghemigian, Khristine; Kitslaar, Pieter H; Broersen, Alexander; Pursnani, Amit; Hoffmann, Udo; Ferencik, Maros

    2018-02-01

    Semi-automated software can provide quantitative assessment of atherosclerotic plaques on coronary CT angiography (CTA). The relationship between established qualitative high-risk plaque features and quantitative plaque measurements has not been studied. We analyzed the association between quantitative plaque measurements and qualitative high-risk plaque features on coronary CTA. We included 260 patients with plaque who underwent coronary CTA in the Rule Out Myocardial Infarction/Ischemia Using Computer Assisted Tomography (ROMICAT) II trial. Quantitative plaque assessment and qualitative plaque characterization were performed on a per coronary segment basis. Quantitative coronary plaque measurements included plaque volume, plaque burden, remodeling index, and diameter stenosis. In qualitative analysis, high-risk plaque was present if positive remodeling, low CT attenuation plaque, napkin-ring sign or spotty calcium were detected. Univariable and multivariable logistic regression analyses were performed to assess the association between quantitative and qualitative high-risk plaque assessment. Among 888 segments with coronary plaque, high-risk plaque was present in 391 (44.0%) segments by qualitative analysis. In quantitative analysis, segments with high-risk plaque had higher total plaque volume, low CT attenuation plaque volume, plaque burden and remodeling index. Quantitatively assessed low CT attenuation plaque volume (odds ratio 1.12 per 1 mm 3 , 95% CI 1.04-1.21), positive remodeling (odds ratio 1.25 per 0.1, 95% CI 1.10-1.41) and plaque burden (odds ratio 1.53 per 0.1, 95% CI 1.08-2.16) were associated with high-risk plaque. Quantitative coronary plaque characteristics (low CT attenuation plaque volume, positive remodeling and plaque burden) measured by semi-automated software correlated with qualitative assessment of high-risk plaque features.

  10. Value of Progression of Coronary Artery Calcification for Risk Prediction of Coronary and Cardiovascular Events: Result of the HNR Study (Heinz Nixdorf Recall).

    Science.gov (United States)

    Lehmann, Nils; Erbel, Raimund; Mahabadi, Amir A; Rauwolf, Michael; Möhlenkamp, Stefan; Moebus, Susanne; Kälsch, Hagen; Budde, Thomas; Schmermund, Axel; Stang, Andreas; Führer-Sakel, Dagmar; Weimar, Christian; Roggenbuck, Ulla; Dragano, Nico; Jöckel, Karl-Heinz

    2018-02-13

    Computed tomography (CT) allows estimation of coronary artery calcium (CAC) progression. We evaluated several progression algorithms in our unselected, population-based cohort for risk prediction of coronary and cardiovascular events. In 3281 participants (45-74 years of age), free from cardiovascular disease until the second visit, risk factors, and CTs at baseline (b) and after a mean of 5.1 years (5y) were measured. Hard coronary and cardiovascular events, and total cardiovascular events including revascularization, as well, were recorded during a follow-up time of 7.8±2.2 years after the second CT. The added predictive value of 10 CAC progression algorithms on top of risk factors including baseline CAC was evaluated by using survival analysis, C-statistics, net reclassification improvement, and integrated discrimination index. A subgroup analysis of risk in CAC categories was performed. We observed 85 (2.6%) hard coronary, 161 (4.9%) hard cardiovascular, and 241 (7.3%) total cardiovascular events. Absolute CAC progression was higher with versus without subsequent coronary events (median, 115 [Q1-Q3, 23-360] versus 8 [0-83], P value of baseline CT and risk assessment in terms of C-statistic or integrated discrimination index, especially for total cardiovascular events. However, CAC progression did not improve models including CAC 5y and 5-year risk factors. An excellent prognosis was found for 921 participants with double-zero CAC b =CAC 5y =0 (10-year coronary and hard/total cardiovascular risk: 1.4%, 2.0%, and 2.8%), which was for participants with incident CAC 1.8%, 3.8%, and 6.6%, respectively. When CAC b progressed from 1 to 399 to CAC 5y ≥400, coronary and total cardiovascular risk were nearly 2-fold in comparison with subjects who remained below CAC 5y =400. Participants with CAC b ≥400 had high rates of hard coronary and hard/total cardiovascular events (10-year risk: 12.0%, 13.5%, and 30.9%, respectively). CAC progression is associated with

  11. [Endarterectomy of the coronary arteries].

    Science.gov (United States)

    Fischer, V; Simkovic, I; Holoman, M; Verchvodko, P; Janotík, P; Galbánek, J; Hulman, M; Kostelnicák, J; Jurco, R; Slezák, J

    1992-02-01

    The authors analyze 50 patients with endarterectomy of the coronary arteries during the periods of 1972-1974 and 1988-1990. The results of endarterectomy of the right and left coronary artery provide evidence of its justification in indicated cases whereby contrary to some departments the results of endarterectomy of the left coronary artery are comparable with endarterectomy of the right coronary artery.

  12. NMR-CT scanner

    International Nuclear Information System (INIS)

    Kose, Katsumi; Sato, Kozo; Sugimoto, Hiroshi; Sato, Masataka.

    1983-01-01

    A brief explanation is made on the imaging methods for a practical diagnostic NMR-CT scanner : A whole-body NMR-CT scanner utilizing a resistive magnet has been developed by Toshiba in cooperation with the Institute for Solid State Physics, the University of Tokyo. Typical NMR-CT images of volunteers and patients obtained in the clinical experiments using this device are presented. Detailed specifications are also shown about the practical NMR-CTs which are to be put on the market after obtaining the government approval. (author)

  13. Exercise electrocardiography and myocardial scintigraphy in the serial evaluation of the results of percutaneous transluminal coronary angioplasty

    International Nuclear Information System (INIS)

    Schall, J.M.; Chaitman, B.R.; David, P.R.; Dupras, G.; Brevers, G; Val, P.G.; Crepeau, J.; Lesperance, J.; Bourassa, M.G.

    1982-01-01

    The diagnostic value of exercise electrocardiography using 14 leads and thallium-201 scintigraphy were evaluated in 54 of 70 patients who underwent percutaneous transluminal coronary angioplasty (PTCA), both in the initial assessment and serial follow-up of patients after PTCA. Of the 45 patients who had successful PTCA, 36 had complete noninvasive studies performed before and 1 month after PTCA. The use of clinical symptoms in conjunction with the physiologic data, ECG and myocardial scintigram acquired during exercise provide important short-term data on the angiographic evolution of PTCA results. The noninvasive tests may be useful in determining guidelines for repeat angiography in patients who have had PTCA

  14. Results of the Croatian Primary Percutaneous Coronary Intervention Network for patients with ST-segment elevation acute myocardial infarction.

    Science.gov (United States)

    Nikolić Heitzler, Vjeran; Babic, Zdravko; Milicic, Davor; Bergovec, Mijo; Raguz, Miroslav; Mirat, Jure; Strozzi, Maja; Plazonic, Zeljko; Giunio, Lovel; Steiner, Robert; Starcevic, Boris; Vukovic, Ivica

    2010-05-01

    The Republic of Croatia, with a gross domestic product per capita of US$11,554 in 2008, is an economically less-developed Western country. The goal of the present investigation was to prove that a well-organized primary percutaneous coronary intervention network in an economically less-developed country equalizes the prospects of all patients with acute ST-segment elevation myocardial infarction at a level comparable to that of more economically developed countries. We prospectively investigated 1,190 patients with acute ST-segment elevation myocardial infarction treated with primary PCI in 8 centers across Croatia (677 nontransferred and 513 transferred). The postprocedural Thrombolysis In Myocardial Infarction flow, in-hospital mortality, and incidence of major adverse cardiovascular events (ie, mortality, pectoral angina, restenosis, reinfarction, coronary artery bypass graft, and cerebrovascular accident rate) during 6 months of follow-up were compared between the nontransferred and transferred subgroups and in the subgroups of older patients, women, and those with cardiogenic shock. In all investigated patients, the average door-to-balloon time was 108 minutes, and the total ischemic time was 265 minutes. Postprocedural Thrombolysis In Myocardial Infarction 3 flow was established in 87.1% of the patients, and the in-hospital mortality rate was 4.4%. No statistically significant difference was found in the results of treatment between the transferred and nontransferred patients overall or in the subgroups of patients >75 years, women, and those with cardiogenic shock. In conclusion, the Croatian Primary Percutaneous Coronary Intervention Network has ensured treatment results of acute ST-segment elevation myocardial infarction comparable to those of randomized studies and registries of more economically developed countries. Copyright 2010 Elsevier Inc. All rights reserved.

  15. Intraoperative coronary grafts flow measurement using the TTFM flowmeter: results from a domestic sample.

    Science.gov (United States)

    Succi, José Ernesto; Gerola, Luis Roberto; Succi, Guilherme de Menezes; Kim, Hyong Chun; Paredes, Jorge Edwin Morocho; Bufollo, Enio

    2012-01-01

    To evaluate intraoperative graft patency and identify grafts under risk of early occlusion. Fifty four patients were submitted to coronary artery bypass surgery and the graft flow was assessed by the Flowmeter (Medtronic Medistim), which utilizes the TTFM method. Three patients had left main disease and 48 had normal or mildly reduced left ventricular function. In hospital mortality was 3.7% (two patients), one for mesenteric thrombosis and one due to cardiogenic chock. Seventeen patients (34%) were submitted to off pump CABG. Arterial Graft flow measures ranged from 8 to 106 ml/min (average 31.14 ml/min), and venous grafts flow ranged from 9 to 149 ml/min (average 50.42 ml/min). Flowmeter use represents higher safety both for patients and surgeons. Even under legal aspects, the documentation provided by the device can avoid future questionings.

  16. Particle discrimination by an automatic scanner for nuclear emulsion plates

    International Nuclear Information System (INIS)

    Heinecke, W.; Fischer, B.E.

    1976-01-01

    An automatic scanner for nuclear emulsion plates has been improved by adding particle discrimination. By determination of the mean luminosity of tracks in darkfield illumination in addition to the track length a clear discrimination has been obtained, at least for lighter particles. The scanning speed of the original automatic scanner has not been reduced. The scanner works up to 200 times faster than a human scanner. Besides the particle discrimination the determination of the mean track luminosity led to a lower perturbation sensitivity with respect to a high background of accidentally developed silvergrains, scratches in emulsion etc. The reproducibility of the results obtained by the automatic scanner is better than 5%. (Auth.)

  17. Ionization beam scanner

    CERN Multimedia

    CERN PhotoLab

    1973-01-01

    Inner structure of an ionization beam scanner, a rather intricate piece of apparatus which permits one to measure the density distribution of the proton beam passing through it. On the outside of the tank wall there is the coil for the longitudinal magnetic field, on the inside, one can see the arrangement of electrodes creating a highly homogeneous transverse electric field.

  18. Product development of Indian cargo scanner

    International Nuclear Information System (INIS)

    2017-01-01

    A cargo scanner is required for nonintrusive screening of suspected cargo containers in trade, using high energy X-ray, to detect any mis-declarations, contraband goods concealment or hidden ammunition or explosives. The cargo scanners help authorities to process large number of suspected cargo with a high level of confidence with other additional benefit of faster clearance, minimised intrusive inspection and generating secured digital record of the process. BARC is in process of developing Indian Cargo Scanner with indigenous X-ray source. Proof of concept and conformance of the results to the international standards has been demonstrated in laboratory. Full scale equipment named as Portal scanner shall be demonstrated at Gamma field Trombay in year 2017. Subsequently the technology transfer may be done to a suitable Indian vendor

  19. Patient management after noninvasive cardiac imaging results from SPARC (Study of myocardial perfusion and coronary anatomy imaging roles in coronary artery disease).

    NARCIS (Netherlands)

    Hachamovitch, R.; Nutter, B.; Hlatky, M.A.; Shaw, L.J.; Ridner, M.L.; Dorbala, S.; Beanlands, R.S.; Chow, B.J.; Branscomb, E.; Chareonthaitawee, P.; Weigold, W.G.; Voros, S.; Abbara, S.; Yasuda, T.; Jacobs, J.E.; Lesser, J.; Berman, D.S.; Thomson, L.E.; Raman, S.; Heller, G.V.; Schussheim, A.; Brunken, R.; Williams, K.A.; Farkas, S.; Delbeke, D.; Schoepf, U.J.; Reichek, N.; Rabinowitz, S.; Sigman, S.R.; Patterson, R.; Corn, C.R.; White, R.; Kazerooni, E.; Corbett, J.; Bokhari, S.; Machac, J.; Guarneri, E.; Borges-Neto, S.; Millstine, J.W.; Caldwell, J.; Arrighi, J.; Hoffmann, U.; Budoff, M.; Lima, J.; Johnson, J.R.; Johnson, B.; Gaber, M.; Williams, J.A.; Foster, C.; Hainer, J.; Carli, M.F. Di

    2012-01-01

    OBJECTIVES: This study examined short-term cardiac catheterization rates and medication changes after cardiac imaging. BACKGROUND: Noninvasive cardiac imaging is widely used in coronary artery disease, but its effects on subsequent patient management are unclear. METHODS: We assessed the 90-day

  20. Heart rate at discharge and long-term prognosis following percutaneous coronary intervention in stable and acute coronary syndromes--results from the BASKET PROVE trial.

    Science.gov (United States)

    Jensen, Magnus Thorsten; Kaiser, Christoph; Sandsten, Karl Erik; Alber, Hannes; Wanitschek, Maria; Iversen, Allan; Jensen, Jan Skov; Pedersen, Sune; Soerensen, Rikke; Rickli, Hans; Zurek, Marzena; Fahrni, Gregor; Bertel, Osmund; De Servi, Stefano; Erne, Paul; Pfisterer, Matthias; Galatius, Søren

    2013-10-09

    Elevated heart rate (HR) is associated with mortality in a number of heart diseases. We examined the long-term prognostic significance of HR at discharge in a contemporary population of patients with stable angina (SAP), non-ST-segment elevation acute coronary syndromes (NSTE-ACS), and ST-segment elevation myocardial infarction (STEMI) revascularized with percutaneous coronary intervention (PCI). Patients from the BASKET-PROVE trial, an 11-center randomized all-comers trial comparing bare-metal and drug-eluting stenting in large coronary vessels, were included. Discharge HR was determined from a resting ECG. Long-term outcomes (7 days to 2 years) were evaluated for all-cause mortality and cardiovascular death and non-fatal myocardial infarction. A total of 2029 patients with sinus rhythm were included, 722 (35.6%) SAP, 647 (31.9%) NSTE-ACS, and 660 (32.5%) STEMI. Elevated discharge HR was associated significantly with all-cause mortality: when compared to a reference of 90 bpm. For cardiovascular death/myocardial infarction, a discharge HR >90 bpm was associated with a hazard ratio of 6.2 (2.5-15.5, pacute coronary syndromes an elevated discharge HR was independently associated with poor prognosis. Conversely, a HR <60 bpm at discharge was associated with a good long-term prognosis irrespective of indication for PCI. © 2013.

  1. The number and distribution of computerised tomography scanners in Turkey

    International Nuclear Information System (INIS)

    Semin, S.; Amato, Z.

    1999-01-01

    The goal of this study was to investigate the number and distribution of CT scanners in Turkey. Our results show 173 CT scanners in Turkey in 1994, which equals 2.9 scanners per million people. All of the scanners are located in 45 cities, where 81 % of the population resides. The other 31 cities in Turkey have no scanners. Of the 173 scanners, 103 (59.6 %) are owned by the private sector and the other 70 are owned by the public sector. Of Turkey's CT scanners, 49.2 % are located in private health centres, 21.9 % in university hospitals, 16.7 % in Ministry of Health (MOH) hospitals, 10.4 % in private hospitals and 1.8 % in social security hospitals. (orig.)

  2. High event rate after a first percutaneous coronary intervention in patients with diabetes mellitus: results from the Swedish coronary angiography and angioplasty registry.

    Science.gov (United States)

    Ritsinger, Viveca; Saleh, Nawsad; Lagerqvist, Bo; Norhammar, Anna

    2015-06-01

    Patients with diabetes mellitus have reduced longevity after acute coronary syndromes and revascularization. However, knowledge of the long-term complication rates and patterns from an everyday life setting is lacking. Consecutive patients undergoing percutaneous coronary intervention included in the Swedish Coronary Angiography Angioplasty Registry (SCAAR) between 2006 and 2010 and with no previous revascularization were prospectively followed up for combined cardiovascular events (first of all-cause mortality, myocardial infarction, stroke, and heart failure) until December 31, 2010. The mean follow-up period was 920 days (SD, 530 days). Differences in background and procedural characteristics were adjusted for in a multivariate Cox regression model. Of 58 891 patients, mean age 67 years, 19% had diabetes mellitus; 27% of them were on diet treatment, 33% on oral glucose lowering, and 40% on insulin treatment. At admission, cardiovascular risk factors, multiple coronary vessel, and left main stem disease were more frequent in patients with diabetes mellitus and their revascularization was less often complete. The adjusted risk for combined cardiovascular events was higher in patients on insulin (hazard ratio [95% confidence interval], 1.63 [1.55-1.72]), on oral treatment (1.23 [1.15-1.31]), and on diet alone (1.21 [1.12-1.29]) compared with patients without diabetes mellitus. Insulin-treated patients ran an increased risk of restenosis (1.54 [1.39-1.71]) and stent thrombosis (1.56 [1.25-1.96]). The prognosis after a first percutaneous coronary intervention is more severe in patients with diabetes mellitus, in particular, in patients treated with insulin, with higher rates of mortality, cardiovascular events, and stent thrombosis over the following 5 years. © 2015 American Heart Association, Inc.

  3. Prevalence of Ischemic Heart Disease and Management of Coronary Risk in Daily Clinical Practice: Results from a Mediterranean Cohort of HIV-Infected Patients

    Directory of Open Access Journals (Sweden)

    Patricia Echeverría

    2014-01-01

    Full Text Available Background. There are conflicting data on the prevalence of coronary events and the quality of the management of modifiable cardiovascular risk factors (CVRF in HIV-infected patients. Methods. We performed a retrospective descriptive study to determine the prevalence of coronary events and to evaluate the management of CVRF in a Mediterranean cohort of 3760 HIV-1-infected patients from April 1983 through June 2011. Results. We identified 81 patients with a history of a coronary event (prevalence 2.15%; 83% of them suffered an acute myocardial infarction. At the time of the coronary event, CVRF were highly prevalent (60.5% hypertension, 48% dyslipidemia, and 16% diabetes mellitus. Other CVRF, such as smoking, hypertension, lack of exercise, and body mass index, were not routinely assessed. After the coronary event, a significant decrease in total cholesterol P=0.025 and LDL-cholesterol P=0.004 was observed. However, the percentage of patients who maintained LDL-cholesterol > 100 mg/dL remained stable (from 46% to 41%, P=0.103. Patients using protease inhibitors associated with a favorable lipid profile increased over time P=0.028. Conclusions. The prevalence of coronary events in our cohort is low. CVRF prevalence is high and their management is far from optimal. More aggressive interventions should be implemented to diminish cardiovascular risk in HIV-infected patients.

  4. Cancerogenesis Risks between 64 and 320 Row Detector CT for Coronary CTA Screening

    Directory of Open Access Journals (Sweden)

    Atif N Khan

    2014-01-01

    Full Text Available Objectives: This study compares cancerogenesis risks posed by the 64 row detector and the 320 row detector computed tomography scanners used during coronary computed tomography angiography (CCTA following decennial screening guidelines. Material and Methods: Data of the radiation absorbed after CCTA by lung, thyroid, and female breast in patients between 50 and 70 years of age obtained from prior published literature for the 64 row CT scanner were compared with data from our study using 320 row detector CT scanner. Data from the 64 row and the 320 row detector CT scanners was used to determine lifetime attributable risks (LAR of cancer based on the biological effects of ionizing radiation (BEIR VII report. Results: The relative reduction of LAR (% for 50-, 60-, and 70-year-old patients undergoing scanning with the 320 row detector CT scanner was 30% lower for lung, and more than 50% lower for female breast when compared with results from 64 row detector CT scanner. The use of 320 row detector CT would result in a combined cumulative cancer incidence of less than 1/500 for breast in women and less than 1/1000 for lung in men; By comparison, this is much lower than other more common risk factors: 16-fold for lung cancer in persistent smokers, 2-fold for breast cancer with a first degree family member history of breast cancer, and 10-fold for thyroid cancer with a family member with thyroid cancer. Decennial screening would benefit at least 355,000 patients from sudden cardiac death each year, 94% of whom have significant coronary artery disease, with at least one stenosis >75%. LAR for thyroid cancer was negligible for both scanners. Conclusion: Lung and female breast LAR reductions with 320 row detector compared with 64 row detector CT are substantial, and the benefits would outweigh increased cancer risks with decennial screening in the age group of 50-70 years.

  5. MRI-Guided Intervention for Breast Lesions Using the Freehand Technique in a 3.0-T Closed-Bore MRI Scanner: Feasibility and Initial Results

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hye Young [Department of Radiology, Gyeongsang National University Hospital, Jinju 660-702 (Korea, Republic of); Kim, Sun Mi; Jang, Mijung; Yun, Bo La [Department of Radiology, Seoul National University Bundang Hospital, Seongnam 463-707 (Korea, Republic of); Kim, Sung-Won; Kang, Eunyoung [Department of Surgery, Seoul National University Bundang Hospital, Seongnam 463-707 (Korea, Republic of); Park, So Yeon [Department of Pathology, Seoul National University Bundang Hospital, Seongnam 463-707 (Korea, Republic of); Moon, Woo Kyung [Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 110-744 (Korea, Republic of); Ko, Eun Sook [Department of Radiology, Samsung Medical Center, Seoul 135-710 (Korea, Republic of)

    2013-07-01

    To report the feasibility of magnetic resonance imaging (MRI)-guided intervention for diagnosing suspicious breast lesions detectable by MRI only, using the freehand technique with a 3.0-T closed-bore MRI scanner. Five women with 5 consecutive MRI-only breast lesions underwent MRI-guided intervention: 3 underwent MRI-guided needle localization and 2, MRI-guided vacuum-assisted biopsy. The interventions were performed in a 3.0-T closed-bore MRI system using a dedicated phased-array breast coil with the patients in the prone position; the freehand technique was used. Technical success and histopathologic outcome were analyzed. MRI showed that four lesions were masses (mean size, 11.5 mm; range, 7-18 mm); and 1, a nonmass-like enhancement (maximum diameter, 21 mm). The locations of the lesions with respect to the breast with index cancer were as follows: different quadrant, same breast - 3 cases; same quadrant, same breast - 1 case; and contralateral breast - 1 case. Histopathologic evaluation of the lesions treated with needle localization disclosed perilobular hemangioma, fibrocystic change, and fibroadenomatous change. The lesions treated with vacuum-assisted biopsy demonstrated a radial scar and atypical apocrine hyperplasia. Follow-up MRI after 2-7 months (mean, 4.6 months) confirmed complete lesion removal in all cases. MRI-guided intervention for breast lesions using the freehand technique with a 3.0-T closed-bore MRI scanner is feasible and accurate for diagnosing MRI-only lesions.

  6. MRI-Guided Intervention for Breast Lesions Using the Freehand Technique in a 3.0-T Closed-Bore MRI Scanner: Feasibility and Initial Results

    International Nuclear Information System (INIS)

    Choi, Hye Young; Kim, Sun Mi; Jang, Mijung; Yun, Bo La; Kim, Sung-Won; Kang, Eunyoung; Park, So Yeon; Moon, Woo Kyung; Ko, Eun Sook

    2013-01-01

    To report the feasibility of magnetic resonance imaging (MRI)-guided intervention for diagnosing suspicious breast lesions detectable by MRI only, using the freehand technique with a 3.0-T closed-bore MRI scanner. Five women with 5 consecutive MRI-only breast lesions underwent MRI-guided intervention: 3 underwent MRI-guided needle localization and 2, MRI-guided vacuum-assisted biopsy. The interventions were performed in a 3.0-T closed-bore MRI system using a dedicated phased-array breast coil with the patients in the prone position; the freehand technique was used. Technical success and histopathologic outcome were analyzed. MRI showed that four lesions were masses (mean size, 11.5 mm; range, 7-18 mm); and 1, a nonmass-like enhancement (maximum diameter, 21 mm). The locations of the lesions with respect to the breast with index cancer were as follows: different quadrant, same breast - 3 cases; same quadrant, same breast - 1 case; and contralateral breast - 1 case. Histopathologic evaluation of the lesions treated with needle localization disclosed perilobular hemangioma, fibrocystic change, and fibroadenomatous change. The lesions treated with vacuum-assisted biopsy demonstrated a radial scar and atypical apocrine hyperplasia. Follow-up MRI after 2-7 months (mean, 4.6 months) confirmed complete lesion removal in all cases. MRI-guided intervention for breast lesions using the freehand technique with a 3.0-T closed-bore MRI scanner is feasible and accurate for diagnosing MRI-only lesions

  7. Multislice Computed Tomography Coronary Angiography at a Local Hospital: Pitfalls and Potential

    Energy Technology Data Exchange (ETDEWEB)

    Kolnes, K.; Velle, Ose H.; Hareide, S.; Hegbom, K.; Wiseth, R. [Volda Hospital (Norway). Depts. of Radiology and Internal Medicine

    2006-09-15

    Purpose: To evaluate whether the favorable results achieved with multislice computed tomography (MSCT) of coronary arteries at larger centers could be paralleled at a local hospital. Material and Methods: Fifty consecutive patients with suspected coronary artery disease scheduled for invasive investigation with quantitative coronary angiography (QCA) at a university hospital underwent MSCT with a 16-slice scanner at a local hospital. Diagnostic accuracy of MSCT for coronary artery disease was assessed using a 16-segment coronary artery model with QCA as the gold standard. Results: Segments with diameter 50% stenosis for the 416 assessable segments were 92%, 82%, 53%, and 98%, respectively. Conclusion: Our beginners' experience demonstrated favorable results regarding sensitivity and negative predictive value. The positive predictive value, however, was unsatisfactory. Calcifications were identified as the most important factor for false-positive results with MSCT. With widespread use of MSCT coronary angiography, there is a risk of recruiting patients without significant coronary artery disease to unnecessary and potentially harmful invasive procedures.

  8. Diagnostic value of multislice computed tomography angiography in coronary artery disease: A meta-analysis

    International Nuclear Information System (INIS)

    Sun Zhonghua; Jiang Wen

    2006-01-01

    Purpose: To perform a meta-analysis of the diagnostic value of multislice CT (MSCT) angiography in the detection of coronary artery disease (CAD) when compared to conventional coronary angiography. Materials and methods: A search of PubMed and MEDLINE databases for English literature was performed. Only studies with at least 10 patients comparing MSCT angiography with conventional coronary angiography in the detection of CAD were included. Diagnostic value of MSCT angiography compared to coronary angiography was compared and analyzed at segment-, vessel- and patient-based assessment. Results: 47 studies (67 comparisons) met the criteria and were included in our study. Pooled overall sensitivity, specificity and 95% confidence interval for MSCT angiography in the detection of CAD were 83% (79%, 89%), 93% (91%, 96%) at segment-based analysis; 90% (87%, 94%), 87% (80%, 93%) at vessel-based analysis; and 91% (88%, 95%), 86% (81%, 92%) at patient-based analysis, respectively. Diagnostic accuracy of MSCT angiography in evaluating assessable segments was significantly improved with 64-slice scanners when compared to that with 4- and 16-slice scanners (p < 0.05). Conclusion: Our meta-analysis showed that MSCT angiography has potential diagnostic accuracy in the detection of CAD. Diagnostic performance of MSCT angiography has been significantly improved with the latest 64-slice CT, with resultant high qualitative and quantitative diagnostic accuracy. 16-slice CT was limited in spatial resolution which makes it difficult to perform quantitative assessment of coronary artery stenoses

  9. Change in coronary blood flow after percutaneous coronary intervention in relation to baseline lesion physiology: results of the JUSTIFY-PCI study.

    Science.gov (United States)

    Nijjer, Sukhjinder S; Petraco, Ricardo; van de Hoef, Tim P; Sen, Sayan; van Lavieren, Martijn A; Foale, Rodney A; Meuwissen, Martijn; Broyd, Christopher; Echavarria-Pinto, Mauro; Al-Lamee, Rasha; Foin, Nicolas; Sethi, Amarjit; Malik, Iqbal S; Mikhail, Ghada W; Hughes, Alun D; Mayet, Jamil; Francis, Darrel P; Di Mario, Carlo; Escaned, Javier; Piek, Jan J; Davies, Justin E

    2015-06-01

    Percutaneous coronary intervention (PCI) aims to increase coronary blood flow by relieving epicardial obstruction. However, no study has objectively confirmed this and assessed changes in flow over different phases of the cardiac cycle. We quantified the change in resting and hyperemic flow velocity after PCI in stenoses defined physiologically by fractional flow reserve and other parameters. Seventy-five stenoses (67 patients) underwent paired flow velocity assessment before and after PCI. Flow velocity was measured over the whole cardiac cycle and the wave-free period. Mean fractional flow reserve was 0.68±0.02. Pre-PCI, hyperemic flow velocity is diminished in stenoses classed as physiologically significant compared with those classed nonsignificant (PPCI, resting flow velocity over the wave-free period increased little (5.6±1.6 cm/s) and significantly less than hyperemic flow velocity (21.2±3 cm/s; P0.80 had a significantly smaller gain (Δ4.6±2.3 cm/s; PPCI physiology is strongly associated with post-PCI increase in hyperemic coronary flow velocity. Hyperemic flow velocity increases 6-fold more when stenoses classed as physiologically significant undergo PCI than when nonsignificant stenoses are treated. Resting flow velocity measured over the wave-free period changes at least 4-fold less than hyperemic flow velocity after PCI. © 2015 American Heart Association, Inc.

  10. Contrast-enhanced near-infrared laser mammography with a prototype breast scanner: feasibility study with tissue phantoms and preliminary results of imaging experimental tumors.

    Science.gov (United States)

    Boehm, T; Hochmuth, A; Malich, A; Reichenbach, J R; Fleck, M; Kaiser, W A

    2001-10-01

    Near-infrared (NIR) optical mammography without contrast has a low specificity. The application of optical contrast medium may improve the performance. The concentration-dependent detectability of a new NIR contrast medium was determined with a prototype optical breast scanner. In vivo imaging of experimental tumors was performed. The NIR contrast agent NIR96010 is a newly synthesized, hydrophilic contrast agent for NIR mammography. A concentration-dependent contrast resolution was determined for tissue phantoms consisting of whole milk powder and gelatin. A central part of the phantoms measuring 2 x 2 cm2 without contrast was replaced with phantom material containing 1 micromol/L to 25 nmol/L NIR96010. The composite phantoms were measured with a prototype NIR breast scanner with lasers of lambda1 = 785 nm and lambda2 = 850 nm wavelength. Intensity profiles and standard deviations of the transmission signal in areas with and without contrast were determined by linear fit procedures. Signal-to-noise ratios and spatial resolution as a function of contrast concentration were determined. Near-infrared imaging of five tumor-bearing SCID mice (MX1 breast adenocarcinoma, tumor diameter 5-10 mm) was performed before and after intravenous application of 2 micromol/kg NIR96010. Spectrometry showed an absorption maximum of the contrast agent at 755 nm. No spectral shifts occurred in protein-containing solution. Signal-to-noise ratio in the transmission intensity profiles ranged from 1.1 at 25 nmol/L contrast to 28 at 1 micromol/L. At concentrations contrast-enhanced images, with better delineation after contrast administration. In postcontrast absorption profiles, a 44.1% +/- 11.3% greater absorption increase was seen in tumor tissue compared with normal tissue. The laser wavelength lambda1 of the prototype laser mammography device was not situated at maximum absorption of the contrast agent NIR96010 but on the descending shoulder of the absorption spectrum. This implies a 20

  11. Quantitative angiography of the left anterior descending coronary artery: correlations with pressure gradient and results of exercise thallium scintigraphy

    NARCIS (Netherlands)

    W. Wijns (William); P.W.J.C. Serruys (Patrick); J.H.C. Reiber (Johan); M.J.B.M. van den Brand (Marcel); M.L. Simoons (Maarten); C.J. Kooijman; K. Balakumaran (Kulasekaram); P.G. Hugenholtz (Paul)

    1985-01-01

    textabstractTo evaluate, during cardiac catheterization, what constitutes a physiologically significant obstruction to blood flow in the human coronary system, computer-based quantitative analysis of coronary angiograms was performed on the angiograms of 31 patients with isolated disease of the

  12. Diagnostic accuracy of non-invasive 64-slice CT coronary angiography in patients with stable angina pectoris

    Energy Technology Data Exchange (ETDEWEB)

    Pugliese, Francesca; Krestin, Gabriel P. [Erasmus Medical Center, Department of Radiology, Rotterdam (Netherlands); Mollet, Nico R.A.; deFeyter, Pim J. [Erasmus Medical Center, Department of Radiology, Rotterdam (Netherlands); Erasmus Medical Center, Department of Cardiology, Rotterdam (Netherlands); Runza, Giuseppe [University of Palermo, Department of Radiology, Palermo (Italy); Azienda Ospedaliera di Parma, Department of Radiology, Parma (Italy); Mieghem, Carlos van; Meijboom, Willem B.; Baks, Timo [Erasmus Medical Center, Department of Cardiology, Rotterdam (Netherlands); Malagutti, Patrizia [Erasmus Medical Center, Department of Cardiology, Rotterdam (Netherlands); University of Ferrara, Department of Cardiology, Ferrara (Italy); Cademartiri, Filippo [Erasmus Medical Center, Department of Radiology, Rotterdam (Netherlands); Azienda Ospedaliera di Parma, Department of Radiology, Parma (Italy)

    2006-03-15

    Multislice computed tomography (CT) is an emerging technique for the non-invasive detection of coronary stenoses. While the diagnostic accuracy of 4-slice scanners was limited, 16-slice CT imagers showed promising results due to increased temporal and spatial resolution. These technical advances prompted us to evaluate the diagnostic performance of 64-slice CT coronary angiography in the detection of significant stenoses (defined as {>=} 50% luminal diameter reduction) versus invasive quantitative coronary angiography (QCA). Thirty-five patients with stable angina pectoris underwent CT coronary angiography performed with a 64-slice scanner (gantry rotation time 330 ms, individual detector width 0.6 mm) prior to conventional coronary angiography. Patients with heart rates >70 beats/min received 100 mg metoprolol orally. One hundred millilitres of contrast agent with an iodine concentration of 400 mgl/ml were injected at a rate of 5 ml/s into the antecubital vein. The CT scan was triggered with the bolus tracking technique. The sensitivity, specificity and the positive and negative predictive values of 64-slice CT were 99%, 96%, 78% and 99%, respectively, on a per-segment basis. The values obtained on a per-patient basis were 100%, 90%, 96% and 100%, respectively. When referral to catheterisation is questionable, CT coronary angiography may identify subjects with normal angiograms and consistently decrease the number of unnecessary invasive procedures. (orig.)

  13. Diagnostic accuracy of non-invasive 64-slice CT coronary angiography in patients with stable angina pectoris

    International Nuclear Information System (INIS)

    Pugliese, Francesca; Krestin, Gabriel P.; Mollet, Nico R.A.; DeFeyter, Pim J.; Runza, Giuseppe; Mieghem, Carlos van; Meijboom, Willem B.; Baks, Timo; Malagutti, Patrizia; Cademartiri, Filippo

    2006-01-01

    Multislice computed tomography (CT) is an emerging technique for the non-invasive detection of coronary stenoses. While the diagnostic accuracy of 4-slice scanners was limited, 16-slice CT imagers showed promising results due to increased temporal and spatial resolution. These technical advances prompted us to evaluate the diagnostic performance of 64-slice CT coronary angiography in the detection of significant stenoses (defined as ≥ 50% luminal diameter reduction) versus invasive quantitative coronary angiography (QCA). Thirty-five patients with stable angina pectoris underwent CT coronary angiography performed with a 64-slice scanner (gantry rotation time 330 ms, individual detector width 0.6 mm) prior to conventional coronary angiography. Patients with heart rates >70 beats/min received 100 mg metoprolol orally. One hundred millilitres of contrast agent with an iodine concentration of 400 mgl/ml were injected at a rate of 5 ml/s into the antecubital vein. The CT scan was triggered with the bolus tracking technique. The sensitivity, specificity and the positive and negative predictive values of 64-slice CT were 99%, 96%, 78% and 99%, respectively, on a per-segment basis. The values obtained on a per-patient basis were 100%, 90%, 96% and 100%, respectively. When referral to catheterisation is questionable, CT coronary angiography may identify subjects with normal angiograms and consistently decrease the number of unnecessary invasive procedures. (orig.)

  14. Noninvasive assessment of coronary artery disease by multislice spiral computed tomography using a new retrospectively ECG-gated image reconstruction technique. Comparison with angiographic results

    Energy Technology Data Exchange (ETDEWEB)

    Sato, Yuichi; Matsumoto, Naoya; Kato, Masahiko [Nihon Univ., Tokyo (Japan). Surugadai Hospital] [and others

    2003-04-01

    The present study was designed to investigate the accuracy of multislice spiral computed tomography (MSCT) in detecting coronary artery disease, compared with coronary angiography (CAG), using a new retrospectively ECG-gated reconstruction method that reduced cardiac motion artifact. The study group comprised 54 consecutive patients undergoing MSCT and CAG. MSCT was performed using a SOMATOM Volume Zoom (4-detector-row, Siemens, Germany) with slice thickness 1.0 mm, pitch 1.5 (table feed: 1.5 mm per rotation) and gantry rotation time 500 ms. Metoprolol (20-60 mg) was administered orally prior to MSCT imaging. ECG-gated image reconstruction was performed with the reconstruction window (250 ms) positioned immediately before atrial contraction in order to reduce the cardiac motion artifact caused by the abrupt diastolic ventricular movement occurring during the rapid filling and atrial contraction periods. Following inspection of the volume rendering images, multiplanar reconstruction images and axial images of the left main coronary artery (LMCA), left anterior descending artery (LAD), left circumflex artery (LCx) and right coronary artery (RCA) were obtained and evaluated for luminal narrowing. The results were compared with those obtained by CAG. Of 216 coronary arteries, 206 (95.4%) were assessable; 10 arteries were excluded from the analysis because of severe calcification (n=4), stents (n=3) or insufficient contrast enhancement (n=3). The sensitivity to detect coronary stenoses {>=}50% was 93.5% and the specificity to define luminal narrowing <50% was 97.2%. The positive predictive value and the negative predictive value were 93.5% and 97.2%, respectively. The sensitivity was still satisfactory (80.6%) even when non-assessable arteries were included in the analysis. The new retrospectively ECG-gated reconstruction method for MSCT has excellent diagnostic accuracy in detecting significant coronary artery stenoses. (author)

  15. Gender disparities in diabetes and coronary heart disease medication among patients with type 2 diabetes: results from the DIANA study

    Directory of Open Access Journals (Sweden)

    Krämer Heike U

    2012-07-01

    Full Text Available Abstract Background Coronary heart disease (CHD is one of the most common long-term complications in people with type 2 diabetes. We analyzed whether or not gender differences exist in diabetes and CHD medication among people with type 2 diabetes. Methods The study was based on data from the baseline examination of the DIANA study, a prospective cohort study of 1,146 patients with type 2 diabetes conducted in South-West Germany. Information on diabetes and CHD medication was obtained from the physician questionnaires. Bivariate and multivariate analyses using logistic regression were employed in order to assess associations between gender and prescribed drug classes. Results In total, 624 men and 522 women with type 2 diabetes with a mean age of 67.2 and 69.7 years, respectively, were included in this analysis. Compared to women, men had more angiopathic risk factors, including smoking, alcohol consumption and worse glycemic control, and had more often a diagnosed CHD. Bivariate analyses showed higher prescription of thiazolidinediones and oral combination drugs as well as of angiotensin-converting enzyme (ACE inhibitors, calcium channel blockers and aspirin in men than in women. After full adjustment, differences between men and women remained significant only for ACE inhibitors (OR = 1.44; 95%-confidence interval (CI: 1.11 – 1.88 and calcium channel blockers (OR = 1.42, 95%-CI: 1.05 – 1.91. Conclusions These findings contribute to current discussions on gender differences in diabetes care. Men with diabetes are significantly more likely to receive oral combination drugs, ACE inhibitors and calcium channel blockers in the presence of coronary heart disease, respectively. Our results suggest, that diabetic men might be more thoroughly treated compared to women. Further research is needed to focus on reasons for these differences mainly in treatment of cardiovascular diseases to improve quality of care.

  16. Recent micro-CT scanner developments at UGCT

    Energy Technology Data Exchange (ETDEWEB)

    Dierick, Manuel, E-mail: Manuel.Dierick@UGent.be [UGCT-Department of Physics and Astronomy, Faculty of Sciences, Ghent University, Proeftuinstraat 86, 9000 Ghent (Belgium); XRE, X-Ray Engineering bvba, De Pintelaan 111, 9000 Ghent (Belgium); Van Loo, Denis, E-mail: info@XRE.be [XRE, X-Ray Engineering bvba, De Pintelaan 111, 9000 Ghent (Belgium); Masschaele, Bert [UGCT-Department of Physics and Astronomy, Faculty of Sciences, Ghent University, Proeftuinstraat 86, 9000 Ghent (Belgium); XRE, X-Ray Engineering bvba, De Pintelaan 111, 9000 Ghent (Belgium); Van den Bulcke, Jan [UGCT-Woodlab-UGent, Department of Forest and Water Management, Faculty of Bioscience Engineering, Ghent University, Coupure Links 653, 9000 Ghent (Belgium); Van Acker, Joris, E-mail: Joris.VanAcker@UGent.be [UGCT-Woodlab-UGent, Department of Forest and Water Management, Faculty of Bioscience Engineering, Ghent University, Coupure Links 653, 9000 Ghent (Belgium); Cnudde, Veerle, E-mail: Veerle.Cnudde@UGent.be [UGCT-SGIG, Department of Geology and Soil Science, Faculty of Sciences, Ghent University, Krijgslaan 281, S8, 9000 Ghent (Belgium); Van Hoorebeke, Luc, E-mail: Luc.VanHoorebeke@UGent.be [UGCT-Department of Physics and Astronomy, Faculty of Sciences, Ghent University, Proeftuinstraat 86, 9000 Ghent (Belgium)

    2014-04-01

    This paper describes two X-ray micro-CT scanners which were recently developed to extend the experimental possibilities of microtomography research at the Centre for X-ray Tomography ( (www.ugct.ugent.be)) of the Ghent University (Belgium). The first scanner, called Nanowood, is a wide-range CT scanner with two X-ray sources (160 kV{sub max}) and two detectors, resolving features down to 0.4 μm in small samples, but allowing samples up to 35 cm to be scanned. This is a sample size range of 3 orders of magnitude, making this scanner well suited for imaging multi-scale materials such as wood, stone, etc. Besides the traditional cone-beam acquisition, Nanowood supports helical acquisition, and it can generate images with significant phase-contrast contributions. The second scanner, known as the Environmental micro-CT scanner (EMCT), is a gantry based micro-CT scanner with variable magnification for scanning objects which are not easy to rotate in a standard micro-CT scanner, for example because they are physically connected to external experimental hardware such as sensor wiring, tubing or others. This scanner resolves 5 μm features, covers a field-of-view of about 12 cm wide with an 80 cm vertical travel range. Both scanners will be extensively described and characterized, and their potential will be demonstrated with some key application results.

  17. Recent micro-CT scanner developments at UGCT

    International Nuclear Information System (INIS)

    Dierick, Manuel; Van Loo, Denis; Masschaele, Bert; Van den Bulcke, Jan; Van Acker, Joris; Cnudde, Veerle; Van Hoorebeke, Luc

    2014-01-01

    This paper describes two X-ray micro-CT scanners which were recently developed to extend the experimental possibilities of microtomography research at the Centre for X-ray Tomography ( (www.ugct.ugent.be)) of the Ghent University (Belgium). The first scanner, called Nanowood, is a wide-range CT scanner with two X-ray sources (160 kV max ) and two detectors, resolving features down to 0.4 μm in small samples, but allowing samples up to 35 cm to be scanned. This is a sample size range of 3 orders of magnitude, making this scanner well suited for imaging multi-scale materials such as wood, stone, etc. Besides the traditional cone-beam acquisition, Nanowood supports helical acquisition, and it can generate images with significant phase-contrast contributions. The second scanner, known as the Environmental micro-CT scanner (EMCT), is a gantry based micro-CT scanner with variable magnification for scanning objects which are not easy to rotate in a standard micro-CT scanner, for example because they are physically connected to external experimental hardware such as sensor wiring, tubing or others. This scanner resolves 5 μm features, covers a field-of-view of about 12 cm wide with an 80 cm vertical travel range. Both scanners will be extensively described and characterized, and their potential will be demonstrated with some key application results

  18. MEMS temperature scanner: principles, advances, and applications

    Science.gov (United States)

    Otto, Thomas; Saupe, Ray; Stock, Volker; Gessner, Thomas

    2010-02-01

    Contactless measurement of temperatures has gained enormous significance in many application fields, ranging from climate protection over quality control to object recognition in public places or military objects. Thereby measurement of linear or spatially temperature distribution is often necessary. For this purposes mostly thermographic cameras or motor driven temperature scanners are used today. Both are relatively expensive and the motor drive devices are limited regarding to the scanning rate additionally. An economic alternative are temperature scanner devices based on micro mirrors. The micro mirror, attached in a simple optical setup, reflects the emitted radiation from the observed heat onto an adapted detector. A line scan of the target object is obtained by periodic deflection of the micro scanner. Planar temperature distribution will be achieved by perpendicularly moving the target object or the scanner device. Using Planck radiation law the temperature of the object is calculated. The device can be adapted to different temperature ranges and resolution by using different detectors - cooled or uncooled - and parameterized scanner parameters. With the basic configuration 40 spatially distributed measuring points can be determined with temperatures in a range from 350°C - 1000°C. The achieved miniaturization of such scanners permits the employment in complex plants with high building density or in direct proximity to the measuring point. The price advantage enables a lot of applications, especially new application in the low-price market segment This paper shows principle, setup and application of a temperature measurement system based on micro scanners working in the near infrared range. Packaging issues and measurement results will be discussed as well.

  19. Clinical application of 16-slice spiral CT in reconstruction imaging of coronary artery for diagnosing coronary disense

    International Nuclear Information System (INIS)

    Mao Xinbo; Zhu Xinjin; Zeng Huiliang; Chen Xueguang

    2005-01-01

    Objective: An evaluation of the reconstructed imaging of coronary arteries with 16-slice spiral CT in diagnosis of coronary disease. Methods: The reconstructed images of coronary arteries obtained on a 16-slice spiral CT scanner were reviewed in 60 cases, on which the following techniques were applied: retrospective ECG-gating, Segment method with 75% R-R interval, volume rendering technique (VRT), maximum intensity projection (MIP), mulfiplanar reconstruction (MPR), curved planar reconstruction (CPR) and CT virtual endoscopy (CTVE). Results: In all 60 cases, different stages of CHD were revealed in 21 cases; none abnormality was found in 33; and images were in poor quality in 2 cases, which was available for diagnosis. There were 4 stents planted in 4 cases: soft plaque suspected in lcase, patent in 2 and occlude in 1. Conclusion: The reconstructed imaging of coronary arteries with 16-slice spiral CT is superior modality in evaluation of severe coronary stenosis, plaques, and the pantency of the intra-luminal stents, which is an efficient and non-invasive imaging in diagnosis of early-stage CHD and screening in high risk population. (authors)

  20. Neuropsychological outcome after percutaneous coronary intervention or coronary artery bypass grafting: results from the Stent or Surgery (SoS) Trial.

    Science.gov (United States)

    Währborg, Peter; Booth, Jean E; Clayton, Tim; Nugara, Fiona; Pepper, John; Weintraub, William S; Sigwart, Ulrich; Stables, Rod H

    2004-11-30

    Coronary artery bypass surgery (CABG) has been associated with a range of neurological and neuropsychological complications from stroke to cognitive problems such as memory and problem solving disturbance. However, little is known about the impact of percutaneous coronary intervention (PCI) on neuropsychological outcome. In the Stent or Surgery Trial (SoS), 988 patients were randomized in equal proportions between PCI supported by stent implantation and CABG. As a substudy of this trial, we undertook an evaluation of neurological and neuropsychological outcomes after intervention. A clinical examination and neuropsychological assessment consisting of 5 tests (Digit Span Forwards and Backwards, Visual Reproduction, Bourdon, and Block Design) were performed at baseline and 6 and 12 months after the procedure. A total of 145 patients were included in the substudy analysis: 77 in the PCI group and 68 in the CABG group. One patient in the PCI arm had a stroke. There was no significant difference between treatment groups at 6 and 12 months for any of the 5 tests. The mean change from baseline was also similar in both groups. We were not able to demonstrate an important and significant difference in neuropsychological outcome in patients treated with different revascularization strategies. This important finding needs to be examined in further research.

  1. MODELS OF MAJOR ADVERSE CARDIAC EVENT RISK USING RESULTS OF EXERCISE STRESS ECHOCARDIOGRAPHY WITH NONINVASIVE CORONARY ARTERY FLOW ASSESSMENT IN PATIENTS WITH ISCHEMIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    A. V. Zagatina

    2017-01-01

    Full Text Available Ultrasound non-invasive coronary artery imaging contributes to the diagnosis of ischemic heart disease (IHD in clinical practice. However, data of the prognostic value obtained from a complex analysis of contractility disorders and coronary blood flow parameters during exercise tests in the world literature are still not available. Aim. To develop risk models for adverse outcomes in patients with probable or definite IHD based on the results of a stress test with a noninvasive coronary blood flow study. Material and methods. Medical data of 689 patients with probable or definite IHD who underwent stress echocardiography with satisfactory visualization of the anterior interventricular artery (AIVA were included in the analysis. All patients had stress echocardiography on a horizontal bicycle ergometer. Registration of coronary blood flow in the middle third of the AIVA was performed at rest and at the peak of the load with calculation of the coronary reserve value. Further patient follow-up lasted 3 years. Models of further negative outcomes were developed on the basis of the stress echocardiography results and of coronary blood flow parameters. Results. Three models that take into account the factors associated with further mortality, mortality/myocardial infarction and sum of negative outcomes were developed in the study. These models divide a cohort of patients with probable or definite IHD into groups of low, medium and very high risks. Factors associated with the risk of death include: age >56 years, load power <100 W, breach of contractility in the blood supply zone of the circumflex artery initially and during exercise, the difference in blood flow velocities in the AIVA<10 cm/s, coronary reserve of AIVA<2. The risk model of death, taking into account these factors, suggests dividing patients into low-risk group if there are ≤2 factors (mortality 0.6% for 3 years, medium risk – from 2 to 4 factors (mortality 1.8%, high risk – ≥5

  2. Comparison of multi-slice CT (MSCT) and TI-201 myocardial SPECT in detection of coronary artery disease: relation to coronary arteriography

    Energy Technology Data Exchange (ETDEWEB)

    Pai, M. S.; Kim, Y. K.; Shim, S. S. [College of Medicine, Univ. of Ewha Womens, Seoul (Korea, Republic of)

    2003-07-01

    To evaluate the diagnostic potentials of MSCT and TI-201 SPECT in the assessment of coronary artery disease. Twenty-four patients (15 men, 9 women, 42-79 years) with clinically suspected coronary artery disease were studied by TI-201 myocardial SPECT and MSCT. MSCT data were obtained with 12 x 0.75 mm, 420ms rotation, multi-slice CT scanner (SOMATOM Sensation, Siemens) using non-ionic contrast, 80ml, 4ml/sec. Multiplanar reconstruction techniques were used for evaluation of coronary arteries. TI-201 myocardial SPECT were performed at stress with adenosine and at rest. Data from MSCT and TI-201 SPECT were compared territory by territory (divided into two segments; LAD and RCA/LCx) and related to coronary arteriography, in which more than 60% stenoses are regarded as significant. MSCT and TI-201 SPECT showed agreement in 37 out of 48 segments (77.1%). Out of 11 disagreed segments (22.9), TI-201 SPECT was superior in 6 segments and MSCT was superior in 5 segments. Sensitivities and specificities of MSCT and TI-201 SPECT by coronary arteriography are 81.8%, 69.2% and 86.3%, 76.9%, respectively. Agreed 4 segments between MSCT and TI-201 SPECT exhibited results that differ from the results of coronary arteriography. Myocardial bridge in two cases were detected as significant stenoses by MSCT but showed normal perfusion in TI-201 SPECT. Agreement between MSCT and TI-201 SPECT in the assessment of coronary artery disease was good but TI-201 SPECT has higher sensitivity and specificity for the detection of jeopardized myocardium than MSCT. MSCT and TI-201 SPECT provide complementary information in the assessment of coronary artery disease and could help reduce probable mistake in the interpretation of hemo dynamically insignificant lesion in coronary arteriography.

  3. No benefit of intraoperative whole blood sequestration and autotransfusion during coronary artery bypass grafting : results of a randomized clinical trial

    NARCIS (Netherlands)

    Ramnath, A N; Naber, H R; de Boer, A; Leusink, J A

    OBJECTIVES: In a randomized clinical trial of patients undergoing elective coronary artery bypass grafting, we evaluated the effect of intraoperative whole blood sequestration and autotransfusion on postoperative blood loss and the use of allogeneic blood products. METHODS: Male patients were

  4. Magnetic resonance imaging of the coronary arteries : clinical results from three dimensional evaluation of a respiratory gated technique

    NARCIS (Netherlands)

    van Geuns, R J; de Bruin, H G; Rensing, B J; Wielopolski, P A; Hulshoff, M D; van Ooijen, P M; Oudkerk, M; de Feyter, P J

    1999-01-01

    BACKGROUND: Magnetic resonance coronary angiography is challenging because of the motion of the vessels during cardiac contraction and respiration. Additional challenges are the small calibre of the arteries and their complex three dimensional course. Respiratory gating, turboflash acquisition, and

  5. Magnetic resonance imaging of the coronary arteries: clinical results from three dimensional evaluation of a respiratory gated technique

    NARCIS (Netherlands)

    R.J.M. van Geuns (Robert Jan); H.G. de Bruin (Hein); B.J.W.M. Rensing (Benno); P.A. Wielopolski (Piotr); M.D. Hulshoff; P.M.A. van Ooijen (Peter); M. Oudkerk (Matthijs); P.J. de Feyter (Pim)

    1999-01-01

    textabstractBACKGROUND: Magnetic resonance coronary angiography is challenging because of the motion of the vessels during cardiac contraction and respiration. Additional challenges are the small calibre of the arteries and their complex three dimensional course. Respiratory

  6. [INCIDENCE OF CORONARY HEART DISEASE IN COMBINATION WITH TYPE 2 DIABETES MELLITUS ESTIMATED FROM RESULTS OF AN EPIDEMIOLOGICAL STUDY OF 20-59 YEAR OLD WOMEN].

    Science.gov (United States)

    Sultanova, S S; Kasumova, E N; Mamedova, R N

    2015-01-01

    We report evaluation of the incidence of coronary heart disease (CHD) in combination with type 2 diabetes mellitus (DM2) estimated from results of an epidemiological study of 20-59 year old women. CPD was shown to occur twice more frequently in association with DM2 especilly in the age groups of 30-39 and 50-59 years.

  7. Multimodality Registration without a Dedicated Multimodality Scanner

    Directory of Open Access Journals (Sweden)

    Bradley J. Beattie

    2007-03-01

    Full Text Available Multimodality scanners that allow the acquisition of both functional and structural image sets on a single system have recently become available for animal research use. Although the resultant registered functional/structural image sets can greatly enhance the interpretability of the functional data, the cost of multimodality systems can be prohibitive, and they are often limited to two modalities, which generally do not include magnetic resonance imaging. Using a thin plastic wrap to immobilize and fix a mouse or other small animal atop a removable bed, we are able to calculate registrations between all combinations of four different small animal imaging scanners (positron emission tomography, single-photon emission computed tomography, magnetic resonance, and computed tomography [CT] at our disposal, effectively equivalent to a quadruple-modality scanner. A comparison of serially acquired CT images, with intervening acquisitions on other scanners, demonstrates the ability of the proposed procedures to maintain the rigidity of an anesthetized mouse during transport between scanners. Movement of the bony structures of the mouse was estimated to be 0.62 mm. Soft tissue movement was predominantly the result of the filling (or emptying of the urinary bladder and thus largely constrained to this region. Phantom studies estimate the registration errors for all registration types to be less than 0.5 mm. Functional images using tracers targeted to known structures verify the accuracy of the functional to structural registrations. The procedures are easy to perform and produce robust and accurate results that rival those of dedicated multimodality scanners, but with more flexible registration combinations and while avoiding the expense and redundancy of multimodality systems.

  8. Screening results for subclinical coronary artery calcification in asymptomatic individuals in relation to a detailed parental history of premature coronary heart disease

    International Nuclear Information System (INIS)

    Wahl, Stefanie; Möhlenkamp, Stefan; Erbel, Raimund; Moebus, Susanne; Andrich, Silke; Stang, Andreas; Jöckel, Karl-Heinz; Dragano, Nico

    2013-01-01

    A parental history of premature coronary heart disease (CHD) is an established risk factor for CHD events in descendants. The study aim was to investigate whether subclinical coronary artery calcification (CAC) differs between asymptomatic individuals (a) without a parental CHD history, (b) with a parental history and (c) without knowledge of parental CHD history. The inclusion of individuals without knowledge of parental CHD history is a new approach. We also differentiated between CHD of mother and father to gain insight into their individual contributions. Data was obtained for 4,301 subjects aged 45–75 years free of overt CHD from the baseline screening of the population-based Heinz Nixdorf Recall study. CAC, measured by electron-beam computed tomography, was modeled conducting logistic regressions. Model 1 included family history, Model 2 was adjusted for age (and gender) and Model 3 added common CHD risk factors. The CAC score was dichotomized using the age and sex-specific 75th percentile. The odds ratio (OR) for CAC ≥ age and sex-specific 75th percentile was 1.33 among individuals with parental premature CHD history (95 % confidence interval [95 %CI]: 1.08, 1.63), which did not change after full adjustment (OR 1.40, 95 %CI: 1.13, 1.74). Individuals with an unknown biological father or mother had a high chance of elevated CAC scores (fully adjusted; father: OR 1.38, 95 %CI: 1.01, 1.90, mother: OR 1.86, 95 %CI: 0.90, 3.84) compared to the reference group. The current study showed an association between parental CHD history and CAC independent of common CHD risk factors. This association affirms the use of parental CHD history in cardiovascular risk assessment among asymptomatic adults in routine practice. The observation that individuals who did not know their mother or father are prone to increased CAC scores needs further confirmation in large scale studies.

  9. In-hospital management and outcome of patients on warfarin undergoing coronary stent implantation: results of the multicenter, prospective WARfarin and coronary STENTing (WAR-STENT) registry.

    Science.gov (United States)

    Rubboli, Andrea; Sciahbasi, Alessandro; Briguori, Carlo; Saia, Francesco; Palmieri, Cataldo; Moroni, Luigi Andrea; Calabrò, Paolo; Leone, Antonio Maria; Franco, Nicoletta; Valgimigli, Marco; Varani, Elisabetta; Santi, Michela; Pasqualini, Paola; Capecchi, Alessandro; Piccalò, Giacomo; Margheri, Massimo; di Pasquale, Giuseppe; Galvani, Marcello; Bolognese, Leonardo; Gonzini, Lucio; Maggioni, Aldo Pietro

    2013-04-01

    The in-hospital management of patients on warfarin undergoing coronary stent implantation (PCI-S) is variable, and the in-hospital outcome incompletely defined. To determine the adherence to the current recommendations, and the incidence of adverse events, we carried out the prospective, multicenter, observational WARfarin and coronary STENTing (WAR-STENT) registry (ClinicalTrials.gov identifier NCT00722319). All consecutive patients on warfarin undergoing PCI-S at 37 Italian centers were enrolled and followed for 12 months. Outcome measures were: major adverse cardiovascular events (MACE), including cardiovascular death, non-fatal myocardial infarction, need for urgent revascularization, stroke, and venous thromboembolism, and major and minor bleeding. In this paper, we report the in-hospital findings. Out of the 411 patients enrolled, 92% were at non-low (ie, moderate or high) thromboembolic risk. The radial approach and bare-metal stents were used in 61% and 60% of cases, respectively. Drug-eluting stents were essentially reserved to patients with diabetes, which in turn, significantly predicted the implantation of drug-eluting stents (odds ratio [OR], 2.02; 95% confidence interval [CI], 1.29-3.17; P=.002). The in-hospital MACE and major bleeding rates were 2.7% and 2.1%, respectively. At discharge, triple therapy (TT) of warfarin, aspirin, and clopidogrel was prescribed to 76% of patients. Prescription of TT was significantly more frequent in the non-low thromboembolic risk group. Non-low thromboembolic risk, in turn, was a significant predictor of TT prescription (OR, 11.2; 95% CI, 4.83-26.3; P<.0001). In conclusion, real-world warfarin patients undergoing PCI-S are largely managed according to the current recommendations. As a consequence, the risk of in-hospital MACE and major bleedings appears limited and acceptable.

  10. A flexible and wearable terahertz scanner

    Science.gov (United States)

    Suzuki, D.; Oda, S.; Kawano, Y.

    2016-12-01

    Imaging technologies based on terahertz (THz) waves have great potential for use in powerful non-invasive inspection methods. However, most real objects have various three-dimensional curvatures and existing THz technologies often encounter difficulties in imaging such configurations, which limits the useful range of THz imaging applications. Here, we report the development of a flexible and wearable THz scanner based on carbon nanotubes. We achieved room-temperature THz detection over a broad frequency band ranging from 0.14 to 39 THz and developed a portable THz scanner. Using this scanner, we performed THz imaging of samples concealed behind opaque objects, breakages and metal impurities of a bent film and multi-view scans of a syringe. We demonstrated a passive biometric THz scan of a human hand. Our results are expected to have considerable implications for non-destructive and non-contact inspections, such as medical examinations for the continuous monitoring of health conditions.

  11. Coronary artery aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Koischwitz, D.; Harder, T.; Schuppan, U.; Thurn, P.

    1982-04-01

    Seven saccular coronary artery aneurysms have been demonstrated in the course of 1452 selective coronary artery angiograms. In six patients they were arterio-sclerotic; in one patient the aneurysm must have been congenital or of mycotic-embolic origin. The differential diagnosis between true aneurysms and other causes of vascular dilatation is discussed. Coronary artery aneurysms have a poor prognosis because of the possibility of rupture with resultant cardiac tamponade, or the development of thrombo-embolic myocardial infarction. These aneurysms can only be diagnosed by means of coronary angiography and require appropriate treatment.

  12. One hundred and thirteen attempts at directional coronary atherectomy: the early and combined experience of two European centres using quantitative angiography to assess their results

    NARCIS (Netherlands)

    V.A.W.M. Umans (Victor); E. Haine; J. Renkin; P.J. de Feyter (Pim); W. Wijns (William); P.W.J.C. Serruys (Patrick)

    1992-01-01

    textabstractDirectional coronary atherectomy has been introduced as an alternative to conventional balloon angioplasty when treating coronary artery stenoses with complex lesion morphology. To determine the immediate efficacy of coronary atherectomy in patients with such lesions, the first 113

  13. Calcified Plaque of Coronary Artery: Factors Influencing Overestimation of Coronary Artery Stenosis on Coronary CT Angiography

    International Nuclear Information System (INIS)

    Kim, Mok Hee; Kim, Yun Hyeon; Choi, Song; Seon, Hyun Ju; Jeong, Gwang Woo; Park, Jin Gyoon; Kang, Heoung Keun; Ko, Joon Seok

    2010-01-01

    To assess the influence of calcified plaque characteristics on the overestimation of coronary arterial stenosis on a coronary CT angiography (CCTA). The study included 271 coronary arteries with calcified plaques identified by CCTA, and based on 928 coronary arteries from 232 patients who underwent both CCTA and invasive coronary angiography (ICA). Individual coronary arteries were classified into two groups by agreement based on the degree of stenosis from each CCTA and ICA: 1) group A includes patients with concordant CCTA and ICA results and, 2) group B includes patients with an overestimation of CCTA compared to ICA. Parameters including total calcium score, calcium score of an individual coronary artery, calcium burden number of an individual coronary artery, and the density of each calcified plaque (calcium score / number of calcium burden) for each individual coronary artery were compared between the two groups. Of the 271 coronary arteries, 164 (60.5%) were overestimated on CCTA. The left anterior descending artery (LAD) had a significantly low rate of overestimation (47.1%) compared to the other coronary arteries (p=0.001). No significant differences for total calcium score, calcium score of individual coronary artery, and the density of each calcified plaque from individual coronary arteries between two groups was observed. However, a decreasing tendency for the rate of overestimation on CCTA was observed with an increase in calcium burden of individual coronary arteries (p<0.05). The evaluation of coronary arteries suggests that the degree of coronary arterial stenosis had a tendency to be overestimated by calcified plaques on CCTA. However, the rate of overestimation for the degree of coronary arterial stenosis by calcified plaques was not significantly influenced by total calcium score, calcium score of individual coronary artery, and density of each calcified plaque

  14. Results of myocardial SPECT with fatty acids in coronary artery disease

    International Nuclear Information System (INIS)

    Reske, S.N.; Kropp, J.; Reichmann, K.; Winkler, C.; Knapp, F.F.; Nitsch, J.

    1986-01-01

    New developments in radiopharmacology of 123 I-labeled metabolic tracers and single-photon emission computerized tomography (SPECT) allow now-a-days the assessment of parameters of cardiac energy metabolism in well-defined areas of the heart muscle. This article will present a brief outline of the basic pathophysiological principles used in the application of 123 I-labeled phenyl fatty acids for the evaluation of CAD. First clinical results suggest an important application of cardiac fatty acid metabolic imaging to the detection, localisation and conceivable quantitation of myocardial ischemia, myocardial infarction and assessment of tissue viability. In addition to the diagnostic applications in CAD, cardiac fatty acid metabolic imaging may provide new perspectives to pathophysiological investigations of the coupling of local flow and substrate utilisation in vivo and the effect of therapeutic interventions. (orig.) [de

  15. Inter laboratory comparison of industrial CT scanners

    DEFF Research Database (Denmark)

    Angel, Jais Andreas Breusch; Cantatore, Angela; De Chiffre, Leonardo

    2012-01-01

    In this report results from an intercomparison of industrial CT scanners are presented. Three audit items, similar to common industrial parts, were selected for circulation: a single polymer part with complex geometry (Item 1), a simple geometry part made of two polymers (Item 2) and a miniature...

  16. Plasma cystathionine and risk of acute myocardial infarction among patients with coronary heart disease: Results from two independent cohorts.

    Science.gov (United States)

    Dhar, Indu; Svingen, Gard F T; Pedersen, Eva R; DeRatt, Barbara; Ulvik, Arve; Strand, Elin; Ueland, Per M; Bønaa, Kaare H; Gregory, Jesse F; Nygård, Ottar K

    2018-04-21

    Cystathionine is a thio-ether and a metabolite formed from homocysteine during transsulfuration. Elevated plasma cystathionine levels are reported in patients with cardiovascular disease; however prospective relationships with acute myocardial infarction (AMI) are unknown. We investigated associations between plasma cystathionine and AMI among patients with suspected and/or verified coronary heart disease (CHD). Subjects from two independent cohort studies, the Western Norway Coronary Angiography Cohort (WECAC) (3033 patients with stable angina pectoris; 263 events within 4.8 years of median follow-up) and the Norwegian Vitamin Trial (NORVIT) (3670 patients with AMI; 683 events within 3.2 years of median follow-up) were included. In both cohorts, plasma cystathionine was associated with several traditional CHD risk factors (P coronary heart disease, and is possibly related to altered redox homeostasis. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  17. Demonstration of the Safety and Feasibility of Robotically Assisted Percutaneous Coronary Intervention in Complex Coronary Lesions: Results of the CORA-PCI Study (Complex Robotically Assisted Percutaneous Coronary Intervention).

    Science.gov (United States)

    Mahmud, Ehtisham; Naghi, Jesse; Ang, Lawrence; Harrison, Jonathan; Behnamfar, Omid; Pourdjabbar, Ali; Reeves, Ryan; Patel, Mitul

    2017-07-10

    The aims of this study were to evaluate the feasibility and technical success of robotically assisted percutaneous coronary intervention (R-PCI) for the treatment of coronary artery disease (CAD) in clinical practice, especially in complex lesions, and to determine the safety and clinical success of R-PCI compared with manual percutaneous coronary intervention (M-PCI). R-PCI is safe and feasible for simple coronary lesions. The utility of R-PCI for complex coronary lesions is unknown. All consecutive PCI procedures performed robotically (study group) or manually (control group) over 18 months were included. R-PCI technical success, defined as the completion of the procedure robotically or with partial manual assistance and without a major adverse cardiovascular event, was determined. Procedures ineligible for R-PCI (i.e., atherectomy, planned 2-stent strategy for bifurcation lesion, chronic total occlusion requiring hybrid approach) were excluded for analysis from the M-PCI group. Clinical success, defined as completion of the PCI procedure without a major adverse cardiovascular event, procedure time, stent use, and fluoroscopy time were compared between groups. A total of 315 patients (mean age 67.7 ± 11.8 years; 78% men) underwent 334 PCI procedures (108 R-PCIs, 157 lesions, 78.3% type B2/C; 226 M-PCIs, 336 lesions, 68.8% type B2/C). Technical success with R-PCI was 91.7% (rate of manual assistance 11.1%, rate of manual conversion 7.4%, rate of major adverse cardiovascular events 0.93%). Clinical success (99.1% with R-PCI vs. 99.1% with M-PCI; p = 1.00), stent use (stents per procedure 1.59 ± 0.79 with R-PCI vs. 1.54 ± 0.75 with M-PCI; p = 0.73), and fluoroscopy time (18.2 ± 10.4 min with R-PCI vs. 19.2 ± 11.4 min with M-PCI; p = 0.39) were similar between the groups, although procedure time was longer in the R-PCI group (44:30 ± 26:04 min:s vs. 36:34 ± 23:03 min:s; p = 0.002). Propensity-matched analysis confirmed that procedure time was longer

  18. Five-year clinical and functional multislice computed tomography angiographic results after coronary implantation of the fully resorbable polymeric everolimus-eluting scaffold in patients with de novo coronary artery disease: the ABSORB cohort A trial.

    Science.gov (United States)

    Onuma, Yoshinobu; Dudek, Dariusz; Thuesen, Leif; Webster, Mark; Nieman, Koen; Garcia-Garcia, Hector M; Ormiston, John A; Serruys, Patrick W

    2013-10-01

    This study sought to demonstrate the 5-year clinical and functional multislice computed tomography angiographic results after implantation of the fully resorbable everolimus-eluting scaffold (Absorb BVS, Abbott Vascular, Santa Clara, California). Multimodality imaging of the first-in-humans trial using a ABSORB BVS scaffold demonstrated at 2 years the bioresorption of the device while preventing restenosis. However, the long-term safety and efficacy of this therapy remain to be documented. In the ABSORB cohort A trial (ABSORB Clinical Investigation, Cohort A [ABSORB A] Everolimus-Eluting Coronary Stent System Clinical Investigation), 30 patients with a single de novo coronary artery lesion were treated with the fully resorbable everolimus-eluting Absorb scaffold at 4 centers. As an optional investigation in 3 of the 4 centers, the patients underwent multislice computed tomography (MSCT) angiography at 18 months and 5 years. Acquired MSCT data were analyzed at an independent core laboratory (Cardialysis, Rotterdam, the Netherlands) for quantitative analysis of lumen dimensions and was further processed for calculation of fractional flow reserve (FFR) at another independent core laboratory (Heart Flow, Redwood City, California). Five-year clinical follow-up is available for 29 patients. One patient withdrew consent after 6 months, but the vital status of this patient remains available. At 46 days, 1 patient experienced a single episode of chest pain and underwent a target lesion revascularization with a slight troponin increase after the procedure. At 5 years, the ischemia-driven major adverse cardiac event rate of 3.4% remained unchanged. Clopidogrel was discontinued in all but 1 patient. Scaffold thrombosis was not observed in any patient. Two noncardiac deaths were reported, 1 caused by duodenal perforation and the other from Hodgkin's disease. At 5 years, 18 patients underwent MSCT angiography. All scaffolds were patent, with a median minimal lumen area of 3

  19. Scanner OPC signatures: automatic vendor-to-vendor OPE matching

    Science.gov (United States)

    Renwick, Stephen P.

    2009-03-01

    As 193nm lithography continues to be stretched and the k1 factor decreases, optical proximity correction (OPC) has become a vital part of the lithographer's tool kit. Unfortunately, as is now well known, the design variations of lithographic scanners from different vendors cause them to have slightly different optical-proximity effect (OPE) behavior, meaning that they print features through pitch in distinct ways. This in turn means that their response to OPC is not the same, and that an OPC solution designed for a scanner from Company 1 may or may not work properly on a scanner from Company 2. Since OPC is not inexpensive, that causes trouble for chipmakers using more than one brand of scanner. Clearly a scanner-matching procedure is needed to meet this challenge. Previously, automatic matching has only been reported for scanners of different tool generations from the same manufacturer. In contrast, scanners from different companies have been matched using expert tuning and adjustment techniques, frequently requiring laborious test exposures. Automatic matching between scanners from Company 1 and Company 2 has remained an unsettled problem. We have recently solved this problem and introduce a novel method to perform the automatic matching. The success in meeting this challenge required three enabling factors. First, we recognized the strongest drivers of OPE mismatch and are thereby able to reduce the information needed about a tool from another supplier to that information readily available from all modern scanners. Second, we developed a means of reliably identifying the scanners' optical signatures, minimizing dependence on process parameters that can cloud the issue. Third, we carefully employed standard statistical techniques, checking for robustness of the algorithms used and maximizing efficiency. The result is an automatic software system that can predict an OPC matching solution for scanners from different suppliers without requiring expert intervention.

  20. Coastal Zone Color Scanner

    Science.gov (United States)

    Johnson, B.

    1988-01-01

    The Coastal Zone Color Scanner (CZCS) spacecraft ocean color instrument is capable of measuring and mapping global ocean surface chlorophyll concentration. It is a scanning radiometer with multiband capability. With new electronics and some mechanical, and optical re-work, it probably can be made flight worthy. Some additional components of a second flight model are also available. An engineering study and further tests are necessary to determine exactly what effort is required to properly prepare the instrument for spaceflight and the nature of interfaces to prospective spacecraft. The CZCS provides operational instrument capability for monitoring of ocean productivity and currents. It could be a simple, low cost alternative to developing new instruments for ocean color imaging. Researchers have determined that with global ocean color data they can: specify quantitatively the role of oceans in the global carbon cycle and other major biogeochemical cycles; determine the magnitude and variability of annual primary production by marine phytoplankton on a global scale; understand the fate of fluvial nutrients and their possible affect on carbon budgets; elucidate the coupling mechanism between upwelling and large scale patterns in ocean basins; answer questions concerning the large scale distribution and timing of spring blooms in the global ocean; acquire a better understanding of the processes associated with mixing along the edge of eddies, coastal currents, western boundary currents, etc., and acquire global data on marine optical properties.

  1. Radiographic scanner apparatus

    International Nuclear Information System (INIS)

    Wake, R.H.

    1980-01-01

    The preferred embodiment of this invention includes a hardware system, or processing means, which operates faster than software. Moreover the computer needed is less expensive and smaller. Radiographic scanner apparatus is described for measuring the intensity of radiation after passage through a planar region and for reconstructing a representation of the attenuation of radiation by the medium. There is a source which can be rotated, and detectors, the output from which forms a data line. The detectors are disposed opposite the planar region from the source to produce a succession of data lines corresponding to the succession of angular orientations of the source. There is a convolver means for convolving each of these data lines, with a filter function, and a means of processing the convolved data lines to create the representation of the radiation attenuation in the planar region. There is also apparatus to generate a succession of data lines indicating radiation attenuation along a determinable path with convolver means. (U.K.)

  2. The cobalt-60 container scanner

    International Nuclear Information System (INIS)

    Jigang, A.; Liye, Z.; Yisi, L.; Haifeng, W.; Zhifang, W.; Liqiang, W.; Yuanshi, Z.; Xincheng, X.; Furong, L.; Baozeng, G.; Chunfa, S.

    1997-01-01

    The Institute of Nuclear Energy Technology (INET) has successfully designed and constructed a container (cargo) scanner, which uses cobalt-60 of 100-300 Ci as radiation source. The following performances of the Cobalt-60 container scanner have been achieved at INET: a) IQI (Image Quality Indicator) - 2.5% behind 100 mm of steel; b) CI (Contrast Indicator) - 0.7% behind 100 mm of steel; c) SP (Steel Penetration) - 240 mm of steel; d) Maximum Dose per Scanning - 0.02mGy; e) Throughput - twenty 40-foot containers per hour. These performances are equal or similar to those of the accelerator scanners. Besides these nice enough inspection properties, the Cobalt-60 scanner possesses many other special features which are better than accelerator scanners: a) cheap price - it will be only or two tenths of the accelerator scanner's; b) low radiation intensity - the radiation protection problem is much easier to solve and a lot of money can be saved on the radiation shielding building; c) much smaller area for installation and operation; d) simple operation and convenient maintenance; e) high reliability and stability. The Cobalt-60 container (or cargo) scanner is satisfied for boundary customs, seaports, airports and railway stations etc. Because of the nice special features said above, it is more suitable to be applied widely. Its high properties and low price will make it have much better application prospects

  3. Side scanner for supermarkets: a new scanner design standard

    Science.gov (United States)

    Cheng, Charles K.; Cheng, J. K.

    1996-09-01

    High speed UPC bar code has become a standard mode of data capture for supermarkets in the US, Europe, and Japan. The influence of the ergonomics community on the design of the scanner is evident. During the past decade the ergonomic issues of cashier in check-outs has led to occupational hand-wrist cumulative trauma disorders, in most cases causing carpal tunnel syndrome, a permanent hand injury. In this paper, the design of a side scanner to resolve the issues is discussed. The complex optical module and the sensor for aforesaid side scanner is described. The ergonomic advantages offer the old counter mounted vertical scanner has been experimentally proved by the industrial funded study at an independent university.

  4. The effect of a disease management algorithm and dedicated postacute coronary syndrome clinic on achievement of guideline compliance: results from the parkland acute coronary event treatment study.

    Science.gov (United States)

    Yorio, Jeff; Viswanathan, Sundeep; See, Raphael; Uchal, Linda; McWhorter, Jo Ann; Spencer, Nali; Murphy, Sabina; Khera, Amit; de Lemos, James A; McGuire, Darren K

    2008-01-01

    The application of disease management algorithms by physician extenders has been shown to improve therapeutic adherence in selected populations. It is unknown whether this strategy would improve adherence to secondary prevention goals after acute coronary syndromes (ACSs) in a largely indigent county hospital setting. Patients admitted for ACS were randomized at the time of discharge to usual follow-up care versus the same care with the addition of a physician extender visit. Physician extender visits were conducted according to a treatment algorithm based on contemporary practice guidelines. Groups were compared using the primary end point of achievement of low-density lipoprotein treatment goals at 3 months after discharge and achievement of additional evidence-based practice goals. One hundred forty consecutive patients were randomized. A similar proportion of patients returned for study follow-up in both groups at 3 months (54 [79%]/68 in the usual care group vs 57 [79%]/72 in the intervention group; P = 0.97). Among those completing the 3-month visit, a low-density lipoprotein cholesterol level less than 100 mg/dL was achieved in 37 (69%) of the usual care patients compared with 35 (57%) of those in the intervention group (P = 0.43). There was no statistical difference in implementation of therapeutic lifestyle changes (smoking cessation, cardiac rehabilitation, or exercise) between groups. Prescription rates of evidence-based therapeutics at 3 months were similar in both groups. The implementation of a post-ACS clinic run by a physician extender applying a disease management algorithm did not measurably improve adherence to evidence-based secondary prevention treatment goals. Despite initially high rates of evidence-based treatment at discharge, adherence with follow-up appointments and sustained implementation of evidence-based therapies remains a significant challenge in this high-risk cohort.

  5. Comparative study of coronary plaque and stenosis: CT versus MR angiography

    International Nuclear Information System (INIS)

    Liu Xin; Zhao Xihai; Cheng Liuquan; Zhao Shaohong; Cai Zulong; Cai Youquan; Yang Li

    2006-01-01

    Objective: To investigate the effect of coronary plaque composition on the extent of stenosis and compare the accuracies of coronary CTA and MRA in detecting significant stenosis (≥50%) caused by different composition plaques. Methods: Thirty patients with coronary heart disease were examined with coronary CTA, MRA and conventional coronary, angiography (CAG) within two weeks. CTA and MRA were performed with a 16-slice CT scanner and hreathhold 3D FIESTA sequence respectively. The coronary plaques were grouped as non-calcified and calcified plaque on CTA images. The accuracies and agreement of CTA and MRA in detecting significant stenosis were evaluated by two experienced radiologists independently using CAG as reference. Results: Fifty-three plaques were detected on CTA. Twenty-eight were non-calcified and the other 25 were calcified. Twenty-one of 28 non-calcified plaques caused significant stenosis on CAG. The sensitivity and specificity of CTA and MRA in detecting significant stenosis were 85.7%, 85.7% and 47.6%, 71.4%, respectively, CTA showed good agreement with CAG (K=0.65). Six of 25 calcified plaques caused significant stenosis on CAG. The sensitivity and specificity of CTA and MRA in detecting significant stenosis were 83.3%, 31.6% and 83.3%, 73.7%, respectively, MRA showed moderate agreement with CAG (K=0.46). Conclusion: CTA was accurate for detecting non-calcified plaque and stenosis, while MRA had advantage to evaluate lumen with severe calcified plaque. (authors)

  6. Primary Prevention of Coronary Artery Disease Among Middle Aged Men in Prague: Twenty-year Follow-up Results

    Czech Academy of Sciences Publication Activity Database

    Boudík, F.; Reissigová, Jindra; Hrach, Karel; Tomečková, Marie; Bultas, J.; Anger, Z.; Aschermann, M.; Zvárová, Jana

    2006-01-01

    Roč. 184, č. 1 (2006), s. 86-93 ISSN 0021-9150 R&D Projects: GA MŠk(CZ) LN00B107 Keywords : primary prevention study * atherosclerosis * cardiovascular diseases * coronary artery disease * Framingham risk function * mortality * risk factors Subject RIV: BA - General Mathematics Impact factor: 3.811, year: 2006

  7. Forward coronary flow normally seen in systole is the result of both forward and concealed back flow

    NARCIS (Netherlands)

    Spaan, J. A.; Breuls, N. P.; Laird, J. D.

    1981-01-01

    Normally systolic coronary blood flow is almost entirely forward. As perfusion pressure was lowered through the autoregulatory range in open-chest dogs, net systolic back flow appeared at approximately 70 mm Hg. Imposing a series resistance (Rs), which impedes both forward and back flow, abolished

  8. Genetic variation at the PCSK9 locus, low density lipoproteins, response to pravastatin and coronary heart disease: results from PROSPER

    Science.gov (United States)

    Caucasian carriers of the T allele at R46L in the proprotein convertase subtilisin/kexin type 9 (PCSK9) locus have been reported to have 15% lower low-density lipoprotein (LDL) cholesterol (C) levels and 47% lower coronary heart disease (CHD) risk. Our objective was to examine two PCSK9 single nucle...

  9. The specific features of the diagnosis and treatment of coronary heart disease in rheumatoid arthritis (Results of the authors’ studies

    Directory of Open Access Journals (Sweden)

    Natalya Anatolyevna Khramtsova

    2012-01-01

    Full Text Available Coronary heart disease (CHD and its complications occupy the leading place in the pattern of the causes of untimely death in rheumatoid arthritis (RA. Objective: to study the incidence, pattern, and specific features of CHD in patients with RA. Patients and methods. An analytical cross-sectional study was conducted in 257 patients with RA (ARA, 1987. The patients’ mean age was 55.4±11.6 years; RA duration was 14.7years (range 2—20 years. Results. The incidence of CHD in RA was as much as 45.9% (n = 118, including 52.5% (n = 62 for typical angina pectoris on exertion; 25.4% (n = 30 and 22.1% (n = 26 for silent ischemia and arrhythmias, respectively. A high proportion of vertebrogenic cardialgias (48.8%; n = 100 were noted in those who complained of heart pain. The authors identified traditional risk factors, such as hypertension (OR = 12.1, smoking (OR = 10.2, early menopause (OR = 3.6, decreased glomerular filtration rate (OR = 3.5, cardiovascular heredity (OR = 3.1, overweight (OR = 2.5, a heart rate of more than 70 beats/min (OR = 2.3, atherogenic dyslipidemia (OR = 2.3, hyperglycemia (OR = 2.1, and age (OR = 1.7. Along with those, the authors also ascertained CHD predictors associating with chronic inflammation consequences: use of glucocorticoids (OR = 5.0, concomitant anemia as a common complication of RA (OR = 4.7, high DAS 28 scores (OR = 3.7, visual analog scale pain scores of > 50 mm (OR = 2.6, and RA duration of >10 years (OR = 2.2. Conclusion. The specific features of CHD in RA include the frequent detection of arrhythmias and silent ischemia. The importance of the degree of inflammatory activity along with the traditional risk factors of CHD is apparent.

  10. MR respiratory navigator echo gated coronary angiography at 3 T

    International Nuclear Information System (INIS)

    Chang Shixin; Wang Yibin; Zong Genlin; Hao Nanxin; Du Yushan

    2007-01-01

    Objective: To investigate the techniques and influence factors for the respiratory navigator echo triggered whole-heart coronary MR angiography (WH-CMRA) and evaluate its application in visualizing coronary arteries and the image quality. Methods: Ninety two volunteers were acquired with WH-CMRA at 3 T MR scanner using respiratory navigator-echo gated TFE sequence. Imaging quality was visually graded as 0-IV grade according to the visual inspection, average length, diameter and sharpness of coronary arteries. The correlation between the imaging quality and respiratory pattern, heart rate and navigator efficiency was analyzed. Results: The imaging quality in 92 cases was that 28 were graded as IV, 53 were graded as III, 9 were graded as II and 2 were graded as I. The successful rate of scan was 88% (81/92). The imaging quality is mainly graded as IV when the heart rate was less than 75 beats per minute (bpm) and the sharpness of vessel was (48±11)%. When heart rate was more than 75 bpm, the image quality was mostly graded as 111 and the sharpness was (33±15)%. The correlation between heart rate and imaging quality score was negative (r= -0.726, P O.05). Conclusion: 3 T WH-CMRA technique could facilitated the visualization of whole coronary arteries at free breathing but having indications on heart rate. (authors)

  11. Evaluation of Handheld Scanners for Automotive Applications

    Directory of Open Access Journals (Sweden)

    Wadea Ameen

    2018-01-01

    Full Text Available The process of generating a computerized geometric model for an existing part is known as Reverse Engineering (RE. It is a very useful technique in product development and plays a significant role in automotive, aerospace, and medical industries. In fact, it has been getting remarkable attention in manufacturing industries owing to its advanced data acquisition technologies. The process of RE is based on two primary steps: data acquisition (also known as scanning and data processing. To facilitate point data acquisition, a variety of scanning systems is available with different capabilities and limitations. Although the optical control of 3D scanners is fully developed, still several factors can affect the quality of the scanned data. As a result, the proper selection of scanning parameters, such as resolution, laser power, shutter time, etc., becomes very crucial. This kind of investigation can be very helpful and provide its users with guidelines to identify the appropriate factors. Moreover, it is worth noting that no single system is ideal in all applications. Accordingly, this work has compared two portable (handheld systems based on laser scanning and white light optical scanning for automotive applications. A car door containing a free-form surface has been used to achieve the above-mentioned goal. The design of experiments has been employed to determine the effects of different scanning parameters and optimize them. The capabilities and limitations have been identified by comparing the two scanners in terms of accuracy, scanning time, triangle numbers, ease of use, and portability. Then, the relationships between the system capabilities and the application requirements have been established. The results revealed that the laser scanner performed better than the white light scanner in terms of accuracy, while the white light scanner performed better in terms of acquisition speed and triangle numbers.

  12. Nogle muligheder i scanner data

    DEFF Research Database (Denmark)

    Juhl, Hans Jørn

    2000-01-01

    I artiklen gives en diskussion af en række af de muligheder for effektivisering af marketingaktiviteter, der er til stede for såvel mærkevareudbyder som detaillist, ved udnyttelse af information fra scanner data......I artiklen gives en diskussion af en række af de muligheder for effektivisering af marketingaktiviteter, der er til stede for såvel mærkevareudbyder som detaillist, ved udnyttelse af information fra scanner data...

  13. Comparison of Epson scanner quality for radiochromic film evaluation.

    Science.gov (United States)

    Alnawaf, Hani; Yu, Peter K N; Butson, Martin

    2012-09-06

    Epson Desktop scanners have been quoted as devices which match the characteristics required for the evaluation of radiation dose exposure by radiochromic films. Specifically, models such as the 10000XL have been used successfully for image analysis and are recommended by ISP for dosimetry purposes. This note investigates and compares the scanner characteristics of three Epson desktop scanner models including the Epson 10000XL, V700, and V330. Both of the latter are substantially cheaper models capable of A4 scanning. As the price variation between the V330 and the 10000XL is 20-fold (based on Australian recommended retail price), cost savings by using the cheaper scanners may be warranted based on results. By a direct comparison of scanner uniformity and reproducibility we can evaluate the accuracy of these scanners for radiochromic film dosimetry. Results have shown that all three scanners can produce adequate scanner uniformity and reproducibility, with the inexpensive V330 producing a standard deviation variation across its landscape direction of 0.7% and 1.2% in the portrait direction (reflection mode). This is compared to the V700 in reflection mode of 0.25% and 0.5% for landscape and portrait directions, respectively, and 0.5% and 0.8% for the 10000XL. In transmission mode, the V700 is comparable in reproducibility to the 10000XL for portrait and landscape mode, whilst the V330 is only capable of scanning in the landscape direction and produces a standard deviation in this direction of 1.0% compared to 0.6% (V700) and 0.25% (10000XL). Results have shown that the V700 and 10000XL are comparable scanners in quality and accuracy with the 10000XL obviously capable of imaging over an A3 area as opposed to an A4 area for the V700. The V330 scanner produced slightly lower accuracy and quality with uncertainties approximately twice as much as the other scanners. However, the results show that the V330 is still an adequate scanner and could be used for radiation

  14. Computed tomography with multidetectors in the diagnosis of coronary stenosis

    International Nuclear Information System (INIS)

    Lombo, Bernardo; Carvajal, Codos A; Tafur, Monica; Gomez, Rafael

    2007-01-01

    Coronary angiography that uses multislice spiral computed tomography is a noninvasive technique for the detection of coronary stenosis that has had significant improvements in recent years. The introduction of 16 and 64 row scanners, the development of synchronized scanning electrocardiogram and better reconstruction techniques permit higher spatial and temporal resolution that allows better identification of coronary plaques and significant obstructive coronary lesions. In the next years Multislice spiral computed tomography will continue maturing and it will become a useful non invasive diagnostic imaging tool for the diagnosis of coronary disease and will be integrated to the cardiologic management protocols. Our next review will be focused on the basic and technical aspects of the scanner, diagnostic performance and clinical applications of this new technology

  15. Restoration of Hyperspectral Push-Broom Scanner Data

    DEFF Research Database (Denmark)

    Larsen, Rasmus; Nielsen, Allan Aasbjerg; Conradsen, Knut

    1997-01-01

    Several effects combine to distort the multispectral data that are obtained from push-broom scanners. We develop an algorithm for restoration of such data, illustrated on images from the ROSIS scanner. In push-broom scanners variation between elements in the detector array results in a strong...... back into the original spectral space results in noise corrected variables. The noise components will now have been removed from the entire original data set by working on a smaller set of noise contaminated transformed variables only. The application of the above techniques results in a dramatic...

  16. Bioresorbable Scaffold for Treatment of Coronary Artery Lesions: Intravascular Ultrasound Results From the ABSORB Japan Trial.

    Science.gov (United States)

    Okada, Kozo; Honda, Yasuhiro; Kitahara, Hideki; Otagiri, Kyuhachi; Tanaka, Shigemitsu; Hollak, M Brooke; Yock, Paul G; Popma, Jeffrey J; Kusano, Hajime; Cheong, Wai-Fung; Sudhir, Krishnankutty; Fitzgerald, Peter J; Kimura, Takeshi

    2018-04-09

    The aim of this study was to characterize post-procedural intravascular ultrasound (IVUS) findings in the ABSORB Japan trial, specifically stratified by the size of target coronary arteries. Despite overall noninferiority confirmed in recent randomized trials comparing bioresorbable vascular scaffolds (BVS) (Absorb BVS) and cobalt-chromium everolimus-eluting metallic stents (CoCr-EES), higher event rates of Absorb BVS have been reported with suboptimal deployment, especially in small coronary arteries. In the ABSORB Japan trial, 150 patients (2:1 randomization) were scheduled in the IVUS cohort. Small vessel was defined as mean reference lumen diameter strategy, possibly different between polymeric and metallic devices, needs to be established for bioresorbable scaffold technology. (AVJ-301 Clinical Trial: A Clinical Evaluation of AVJ-301 Absorb™ BVS) in Japanese Population [ABSORB JAPAN]; NCT01844284). Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  17. Current status of hybrid coronary revascularization.

    Science.gov (United States)

    Jaik, Nikhil P; Umakanthan, Ramanan; Leacche, Marzia; Solenkova, Natalia; Balaguer, Jorge M; Hoff, Steven J; Ball, Stephen K; Zhao, David X; Byrne, John G

    2011-10-01

    Hybrid coronary revascularization combines coronary artery bypass surgery with percutaneous coronary intervention techniques to treat coronary artery disease. The potential benefits of such a technique are to offer the patients the best available treatments for coronary artery disease while minimizing the risks of the surgery. Hybrid coronary revascularization has resulted in the establishment of new 'hybrid operating suites', which incorporate and integrate the capabilities of a cardiac surgery operating room with that of an interventional cardiology laboratory. Hybrid coronary revascularization has greatly augmented teamwork and cooperation between both fields and has demonstrated encouraging as well as good initial outcomes.

  18. Three-dimensional rectilinear scanner

    International Nuclear Information System (INIS)

    O'Neill, W.J.; Strange, D.R.; Miller, A.

    1976-01-01

    A rectilinear scanner for detecting radiation in a plurality of channels utilizing a collimator is described. Each of the channels receives information from a different portion of the collimator. Information separately received is separately messaged and later collated to present a common image. The information is processed by apparatus in a data processing system. This system has means for messaging analog signals corresponding to gamma radiation counts and converting such analog signals to digital signals. This system has means interfacing the digital signals into an address register that communicates directly via data busses to core memory of a central processing unit by cycle stealing and deriving clinically significant information by computation on the resultant digital data. This system has means for storing, retrieving, and displaying the resultant digital data and the resultant derivations therefrom collectively. This is done in such a manner as to allow time sequencing of the aforementioned operations such that the aforementioned operations can be interleaved on a real time basis. 13 claims, 44 figures

  19. Anomalous origin of right coronary artery from left coronary sinus.

    Science.gov (United States)

    Hamzeh, Gadah; Crespo, Alex; Estarán, Rafael; Rodríguez, Miguel A; Voces, Roberto; Aramendi, José I

    2008-08-01

    Anomalous aortic origin of the coronary arteries is uncommon but clinically significant. Manifestations vary from asymptomatic patients to those who present with angina pectoris, myocardial infarction, heart failure, syncope, arrhythmias, and sudden death. We describe 4 patients, aged 34 to 59 years, who were diagnosed with right coronary artery arising from the left sinus of Valsalva, confirmed by coronary angiography, which was surgically repaired. Three patients presented dyspnea and angina, and one with acute myocardial infarction. At operation, the right coronary artery was dissected at the take-off from the intramural course, and reimplanted into the right sinus of Valsalva. There was no mortality. One patient had associated coronary artery disease that required stent placement postoperatively. This reimplantation technique provides a good physiological and anatomical repair, eliminates a slit-like ostium, avoids compression of the coronary artery between the aorta and the pulmonary artery, and gives superior results to coronary artery bypass grafting or the unroofing technique.

  20. The hypertriglyceridemic-waist phenotype and the risk of coronary artery disease: results from the EPIC-Norfolk Prospective Population Study

    Science.gov (United States)

    Arsenault, Benoit J.; Lemieux, Isabelle; Després, Jean-Pierre; Wareham, Nicholas J.; Kastelein, John J.P.; Khaw, Kay-Tee; Boekholdt, S. Matthijs

    2010-01-01

    Background Screening for increased waist circumference and hypertriglyceridemia (the hypertriglyceridemic-waist phenotype) has been proposed as an inexpensive approach to identify patients with excess intra-abdominal adiposity and associated metabolic abnormalities. We examined the relationship between the hypertriglyceridemic-waist phenotype to the risk of coronary artery disease in apparently healthy individuals. Methods A total of 21 787 participants aged 45–79 years were followed for a mean of 9.8 (standard deviation 1.7) years. Coronary artery disease developed in 2109 of them during follow-up. The hypertriglyceridemic-waist phenotype was defined as a waist circumference of 90 cm or more and a triglyceride level of 2.0 mmol/L or more in men, and a waist circumference of 85 cm or more and a triglyceride level of 1.5 mmol/L or more in women. Results Compared with participants who had a waist circumference and triglyceride level below the threshold, those with the hypertriglyceridemic-waist phenotype had higher blood pressure indices, higher levels of apolipoprotein B and C-reactive protein, lower levels of high-density lipoprotein cholesterol and apolipoprotein A-I, and smaller low-density lipoprotein particles. Among men, those with the hypertriglyceridemic-waist phenotype had an unadjusted hazard ratio for future coronary artery disease of 2.40 (95% confidence interval [CI] 2.02–2.87) compared with men who did not have the phenotype. Women with the phenotype had an unadjusted hazard ratio of 3.84 (95% CI 3.20–4.62) compared with women who did not have the phenotype. Interpretation Among participants from a European cohort representative of a contemporary Western population, the hypertriglyceridemic-waist phenotype was associated with a deteriorated cardiometabolic risk profile and an increased risk for coronary artery disease. PMID:20643837

  1. Implications of normal exercise electrocardiographic results in patients with angiographically documented coronary artery disease. Correlation with left ventricular function and myocardial perfusion

    International Nuclear Information System (INIS)

    Hakki, A.H.; DePace, N.L.; Colby, J.; Iskandrian, A.S.

    1983-01-01

    The purpose of this study was to examine the incidence and implications of false-negative exercise electrocardiographic results among 216 consecutive patients with angiographically documented coronary artery disease (50 percent diameter narrowing or greater of one or more vessels). Exercise electrocardiography gave negative (false-negative) results in 23 patients and positive (true-positive) results in 102 patients, and were nondiagnostic in the rest. Exercise thallium-201 imaging was performed in 88 patients. The extent of coronary artery disease was quantitated by a scoring system that takes into consideration the degree and site of narrowing in the major vessels and their branches. The exercise heart rate was higher in patients with false-negative than in patients with true-positive exercise electrocardiographic results (161 +/- 18 versus 133 +/- 24 beats per minute, mean +/- SD; p less than 0.0001). Q-wave infarction was present in two patients (9 percent) with false-negative and 20 patients (20 percent) with true-positive exercise electrocardiographic results; left ventricular asynergy at rest was observed in 13 patients (57 percent) with false-negative and in 74 patients (74 percent) with true-positive results. Patients with false-negative results had less extensive coronary disease than did patients with true-positive results (score 5.8 +/- 3.6 versus 9.2 +/- 5.0; p . 0.0025). Angina during exercise was less frequent in patients with false-negative results (p less than 0.01). Abnormal exercise thallium-201 images were seen in 15 of 20 patients (75 percent) with false-negative results and in 56 of 68 patients (82 percent) with true-positive results

  2. [The PROPRESE trial: results of a new health care organizational model in primary care for patients with chronic coronary heart disease based on a multifactorial intervention].

    Science.gov (United States)

    Ruescas-Escolano, Esther; Orozco-Beltran, Domingo; Gaubert-Tortosa, María; Navarro-Palazón, Ana; Cordero-Fort, Alberto; Navarro-Pérez, Jorge; Carratalá-Munuera, Concepción; Pertusa-Martínez, Salvador; Soler-Bahilo, Enrique; Brotons-Muntó, Francisco; Bort-Cubero, Jose; Núñez-Martínez, Miguel A; Bertomeu-Martínez, Vicente; López-Pineda, Adriana; Gil-Guillén, Vicente F

    2014-06-01

    Comparison of the results from the EUROASPIRE I to the EUROASPIRE III, in patients with coronary heart disease, shows that the prevalence of uncontrolled risk factors remains high. The aim of the study was to evaluate the effectiveness of a new multifactorial intervention in order to improve health care for chronic coronary heart disease patients in primary care. In this randomized clinical trial with a 1-year follow-up period, we recruited patients with a diagnosis of coronary heart disease (145 for the intervention group and 1461 for the control group). An organizational intervention on the patient-professional relationship (centered on the Chronic Care Model, the Stanford Expert Patient Programme and the Kaiser Permanente model) and formative strategy for professionals were carried out. The main outcomes were smoking control, low-density lipoprotein cholesterol (LDL-C), systolic blood pressure (SBP) and diastolic blood pressure (DBP). A multivariate analysis was performed. The characteristics of patients were: age (68.4±11.8 years), male (71.6%), having diabetes mellitus (51.3%), dyslipidemia (68.5%), arterial hypertension (76.7%), non-smokers (76.1%); LDL-C cardiovascular risk factors control (smoking, LDL-C and SBP). Chronic care strategies may be an efficacy tool to help clinicians to involve the patients with a diagnosis of CHD to reach better outcomes. Copyright © 2014 Elsevier España, S.L. All rights reserved.

  3. Chinese Herbal Medicines Might Improve the Long-Term Clinical Outcomes in Patients with Acute Coronary Syndrome after Percutaneous Coronary Intervention: Results of a Decision-Analytic Markov Model

    Directory of Open Access Journals (Sweden)

    Shao-Li Wang

    2015-01-01

    Full Text Available Aims. The priority of Chinese herbal medicines (CHMs plus conventional treatment over conventional treatment alone for acute coronary syndrome (ACS after percutaneous coronary intervention (PCI was documented in the 5C trial (chictr.org number: ChiCTR-TRC-07000021. The study was designed to evaluate the 10-year effectiveness of CHMs plus conventional treatment versus conventional treatment alone with decision-analytic model for ACS after PCI. Methods and Results. We constructed a decision-analytic Markov model to compare additional CHMs for 6 months plus conventional treatment versus conventional treatment alone for ACS patients after PCI. Sources of data came from 5C trial and published reports. Outcomes were expressed in terms of quality-adjusted life years (QALYs. Sensitivity analyses were performed to test the robustness of the model. The model predicted that over the 10-year horizon the survival probability was 77.49% in patients with CHMs plus conventional treatment versus 77.29% in patients with conventional treatment alone. In combination with conventional treatment, 6-month CHMs might be associated with a gained 0.20% survival probability and 0.111 accumulated QALYs, respectively. Conclusions. The model suggested that treatment with CHMs, as an adjunctive therapy, in combination with conventional treatment for 6 months might improve the long-term clinical outcome in ACS patients after PCI.

  4. The feasibility of a scanner-independent technique to estimate organ dose from MDCT scans: Using CTDIvol to account for differences between scanners

    International Nuclear Information System (INIS)

    Turner, Adam C.; Zankl, Maria; DeMarco, John J.; Cagnon, Chris H.; Zhang Di; Angel, Erin; Cody, Dianna D.; Stevens, Donna M.; McCollough, Cynthia H.; McNitt-Gray, Michael F.

    2010-01-01

    Purpose: Monte Carlo radiation transport techniques have made it possible to accurately estimate the radiation dose to radiosensitive organs in patient models from scans performed with modern multidetector row computed tomography (MDCT) scanners. However, there is considerable variation in organ doses across scanners, even when similar acquisition conditions are used. The purpose of this study was to investigate the feasibility of a technique to estimate organ doses that would be scanner independent. This was accomplished by assessing the ability of CTDI vol measurements to account for differences in MDCT scanners that lead to organ dose differences. Methods: Monte Carlo simulations of 64-slice MDCT scanners from each of the four major manufacturers were performed. An adult female patient model from the GSF family of voxelized phantoms was used in which all ICRP Publication 103 radiosensitive organs were identified. A 120 kVp, full-body helical scan with a pitch of 1 was simulated for each scanner using similar scan protocols across scanners. From each simulated scan, the radiation dose to each organ was obtained on a per mA s basis (mGy/mA s). In addition, CTDI vol values were obtained from each scanner for the selected scan parameters. Then, to demonstrate the feasibility of generating organ dose estimates from scanner-independent coefficients, the simulated organ dose values resulting from each scanner were normalized by the CTDI vol value for those acquisition conditions. Results: CTDI vol values across scanners showed considerable variation as the coefficient of variation (CoV) across scanners was 34.1%. The simulated patient scans also demonstrated considerable differences in organ dose values, which varied by up to a factor of approximately 2 between some of the scanners. The CoV across scanners for the simulated organ doses ranged from 26.7% (for the adrenals) to 37.7% (for the thyroid), with a mean CoV of 31.5% across all organs. However, when organ doses

  5. Wire Scanner Motion Control Card

    CERN Document Server

    Forde, S E

    2006-01-01

    Scientists require a certain beam quality produced by the accelerator rings at CERN. The discovery potential of LHC is given by the reachable luminosity at its interaction points. The luminosity is maximized by minimizing the beam size. Therefore an accurate beam size measurement is required for optimizing the luminosity. The wire scanner performs very accurate profile measurements, but as it can not be used at full intensity in the LHC ring, it is used for calibrating other profile monitors. As the current wire scanner system, which is used in the present CERN accelerators, has not been made for the required specification of the LHC, a new design of a wire scanner motion control card is part of the LHC wire scanner project. The main functions of this card are to control the wire scanner motion and to acquire the position of the wire. In case of further upgrades at a later stage, it is required to allow an easy update of the firmware, hence the programmable features of FPGAs will be used for this purpose. The...

  6. Imaging Scanner Usage in Radiochemical Purity Test

    International Nuclear Information System (INIS)

    Norhafizah Othman; Yahaya Talib; Wan Hamirul Bahrin Wan Kamal

    2011-01-01

    Imaging Scanner model BIOSCAN AR-2000 has been used in the radiochemical purity test for the product of Mo-99/ Tc-99m generator. Result from this test was produced directly where the percentage of pertechnetate was calculated based on width peak area by thin layer chromatography. This paperwork will explain the function, procedure, calibration of the instrument and discussed the advantages compared to the previous method. (author)

  7. Cirsoid Aneurysm of Coronary Arteries Associated with Arterioventricular Fistula Evaluated by 64-Multidetector CT Coronary Angiography: Depiction of a Case

    International Nuclear Information System (INIS)

    Marrone, Gianluca; Mamone, Giuseppe; Milazzo, Mariapina; Caruso, Settimo; Baravoglia, Cesar Hernandez; Vitulo, Patrizio; Gridelli, Bruno; Luca, Angelo

    2009-01-01

    A female patient with severe pulmonary hypertension was admitted for lung transplant evaluation. As an incidental finding, the chest CT showed diffuse and dilated coronaries, not detected at previous echocardiography. A coronary CT angiography was then performed using a 64-multidetector computed tomography (MDCT) scanner to better evaluate the coronary tree. The images obtained after postprocessing demonstrated tremendously aneurysmatic and tortuous coronary arteries and the presence of a septal branch deepening into the myocardium and penetrating the right ventricle cavity, forming an abnormal arterioventricular fistula. A causal relation between the aneurysms and the fistula is suspected.

  8. A Cost Effective Multi-Spectral Scanner for Natural Gas Detection

    Energy Technology Data Exchange (ETDEWEB)

    Yudaya Sivathanu; Jongmook Lim; Vinoo Narayanan; Seonghyeon Park

    2005-12-07

    The objective of this project is to design, fabricate and demonstrate a cost effective, multi-spectral scanner for natural gas leak detection in transmission and distribution pipelines. During the first year of the project, a laboratory version of the multi-spectral scanner was designed, fabricated, and tested at EnUrga Inc. The multi-spectral scanner was also evaluated using a blind Department of Energy study at the Rocky Mountain Oilfield Testing Center. The performance of the scanner was inconsistent during the blind study. However, most of the leaks were outside the view of the multi-spectral scanner that was developed during the first year of the project. Therefore, a definite evaluation of the capability of the scanner was not obtained. Despite the results, sufficient number of plumes was detected fully confirming the feasibility of the multi-spectral scanner. During the second year, the optical design of the scanner was changed to improve the sensitivity of the system. Laboratory tests show that the system can reliably detect small leaks (20 SCFH) at 30 to 50 feet. A prototype scanner was built and evaluated during the second year of the project. Only laboratory evaluations were completed during the second year. The laboratory evaluations show the feasibility of using the scanner to determine natural gas pipeline leaks. Further field evaluations and optimization of the scanner are required before commercialization of the scanner can be initiated.

  9. Selective coronary scintigraphy

    International Nuclear Information System (INIS)

    Gambini, D.-J.

    1975-01-01

    Isotopic techniques occupy a leading place amongst examinations practicable on coronary patients because of their reliability and the safety and simplicity of their use. The present work reviews the possible applications of selective coronary scintigraphy in pathology. After a brief discussion on scintigraphy, isotopic techniques for myocardium research, coronarography and other methods to study local myocardium perfusion the theoretical bases for the use of the exploration are studied, the techniques and methods employed are reported and the results discussed. Coronary scintigraphy consists of selective injection in the two coronary arteries previously catheterized during a coronarography, of two different populations of microspheres labelled with two physically short-lived indicators: 15μ 99m Tc-labelled serumalbumin microspheres, 10 to 15μ In-labelled siderophiline microspheres. Various studies have shown the complete harmlessness of the exploration when certain precautions are taken regarding the size and number of the spheres. The microspheres disperse into the downstream arterial territory proportionally to the number of capillaries present in the different parts of the irrigated region, and are temporarily stopped in the precapillaries. The preparation of the different images needed to interpret the Face and OAG examination for the left coronary, then for the right coronary, is carried out at the end of the coronarography and lasts about 45 minutes. It is also possible by selective injection in the aorta-coronary bridges to judge their functional condition by observation of the regions they irrigate. 56 patients of the Necker hospital cardiological clinic have been examined [fr

  10. Generalizability of EXCEL and NOBLE results to a large registry population with unprotected left main coronary artery disease.

    Science.gov (United States)

    Lee, Pil Hyung; Kang, Se Hun; Han, Seungbong; Ahn, Jung-Min; Bae, Jae Seok; Lee, Cheol Hyun; Kang, Soo-Jin; Lee, Seung-Whan; Kim, Young-Hak; Lee, Cheol Whan; Park, Seong-Wook; Park, Duk-Woo; Park, Seung-Jung

    2017-12-01

    The aim of this study was to determine how trial-based findings of EXCEL and NOBLE might be interpreted and generalizable in 'real-world' settings with comparison of data from the large-scaled, all-comer Interventional Research Incorporation Society-Left MAIN Revascularization (IRIS-MAIN) registry. We compared baseline clinical and procedural characteristics and also determined how the relative treatment effect of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) was different in EXCEL and NOBLE, compared with those of the multicenter, IRIS-MAIN registry (n=2481). The primary outcome for between-study comparison was a composite of death, myocardial infarction (MI), or stroke. There were between-study differences in patient risk profiles (age, BMI, diabetes, and clinical presentation), lesion complexities, and procedural characteristics (stent type, the use of off-pump surgery, and radial artery); the proportion of diabetes and acute coronary syndrome was particularly lower in NOBLE than in other studies. Although there was interstudy heterogeneity for the protocol definition of MI, the risks for serious composite outcome of death, MI, or stroke were similar between PCI and CABG in EXCEL [hazard ratio (HR): 1.00; 95% confidence interval (CI): 0.79-1.26; P=0.98] and in the matched cohort of IRIS-MAIN (HR: 1.08; 95%CI: 0.85-1.38; P=0.53), whereas it was significantly higher after PCI than after CABG in NOBLE (HR: 1.47; 95%CI: 1.06-2.05; P=0.02), which was driven by more common MI and stroke after PCI. In the comparison of a large-sized, all-comer registry, the EXCEL trial might represent better generalizability with respect to baseline characteristics and observed clinical outcomes compared with the NOBLE trial.

  11. Preliminary application of 320-detector spiral CT with ECG editing for assessing coronary artery in-stent restenosis

    International Nuclear Information System (INIS)

    Li Zhiming; Tan Lilian; Li Shuxin; Fu Xi; He Weihong; Liu Ke; Huang Yong; Yu Lin

    2011-01-01

    Objective: To determine the value of 320-detector spiral CT with retrospective ECG gating and editing software for detecting coronary artery in-stent restenosis. Methods: CT scans of 14 patients with coronary artery stnets were retrospectively analyzed. The examinations were performed using a 320-detector spiral CT scanner and retrospective ECG gating combined with ECG editing software. The image quality of reconstructed coronary artery in-stents was compared before and after the editing of synchronously recorded ECG. The paired-sample t test was used for statistical analysis. Results: Before ECG editing, arrhythmia and in-stent artifact resulted in image blurring, missing arterial segments, significant stepladder artifacts or non-visualization of the interior of stents. Of 14 cases before ECG editing, in-stent restenosis was detected in 10 and patency in 3. The coronary artery stent and distal bifurcation were delineated in one patient. After ECG editing, the image quality of coronary artery stents was improved with detection of in-stent restenosis (4 cases) including the one case that not evaluable before ECG editing. The average image quality score before ECG editing (2.14±0.86) was significantly (P<0.001) lower than that after ECG editing (3.07±0.73). Conclusion: Retrospective ECG gating combined with ECG editing of 320-detector spiral CT can reduce the artifacts produced by arrhythmia or in-stent swings and improve the imaging quality of coronary artery stents. (authors)

  12. Coronary artery aneurysm after stent implantation: acute and long-term results after percutaneous treatment with a stent graft.

    Science.gov (United States)

    Rubartelli, Paolo; Terzi, Giacomo; Borgo, Lorenzo; Giachero, Corinna

    2002-03-01

    A patient with unstable angina was treated with elective Palmaz-Schatz stent implantation on a focal stenosis of the left circumflex artery. One year later, a large (13 mm in diameter) coronary artery aneurysm was diagnosed at angiography in the stented site. Intravascular ultrasound examination confirmed the presence of a true aneurysm located at the proximal end of the stent. The aneurysm was successfully treated with a Jostent Graft (Jomed Implantate) consisting of two slotted tube stainless steel stents supporting a polytetrafluoroethylene tube. The stent graft was implanted under intravascular ultrasound guidance. The 18-month angiographic follow-up showed good patency of the stent graft and complete exclusion of the aneurysm.

  13. Development of high pressure pipe scanners

    International Nuclear Information System (INIS)

    Kim, Jae H.; Lee, Jae C.; Moon, Soon S.; Eom, Heung S.; Choi, Yu R.

    1998-12-01

    This report describes an automatic ultrasonic scanning system for pressure pipe welds, which was developed in this project using recent advanced technologies on mobile robot and computer. The system consists of two modules: a robot scanner module which navigates and manipulates scanning devices, and a data acquisition module which generates ultrasonic signal and processes the data from the scanner. The robot has 4 magnetic wheels and 2 -axis manipulator on which ultrasonic transducer attached. The wheeled robot can navigate curved surface such as outer wall of circular pipes. Magnetic wheels were optimally designed through magnetic field analysis. Free surface sensing and line tracking control algorithm were developed and implemented, and the control devices and software can be used in practical inspection works. We expect our system can contribute to reduction of inspection time, performance enhancement, and effective management of inspection results

  14. Radiographic scanners and shutter mechanisms in CT scanners

    International Nuclear Information System (INIS)

    Braden, A.B.; Kuwik, J.J.; Taylor, S.K.; Covic, J.

    1981-01-01

    This patent claim relates especially to the design of a shutter mechanism in a CT scanner having a rotatable source of radiation and a series of stationary radiation detectors coplanar with the path of the source and spaced about the axis of rotation of the source, and only partially encircling the path of the source. (U.K.)

  15. Bioresorbable Polymer Coated Metallic Stents and Fully Bioresorbable Scaffolds: Benefits and limitations in different coronary lesion subsets, -clinical and intracascular imaging results-

    NARCIS (Netherlands)

    J.M. Fam (Jiang Ming)

    2018-01-01

    markdownabstractPercutaneous coronary intervention (PCI) which involves the deployment of devices such as metallic drug eluting stents (DES) in coronary artery lesions and concomitant dual antiplatelet therapy (DAPT) is one of the mainstays of management of coronary artery disease and has become one

  16. Evaluation of coronary calcifications with 64-slice CT - variability of the scores and the influence of the reconstruction interval

    International Nuclear Information System (INIS)

    Weininger, M.; Ritter, C.O.; Beer, M.; Hahn, D.; Beissert, M.

    2007-01-01

    Purpose: To evaluate the variability of coronary calcium scores depending on the image reconstruction interval using a 64-slice CT scanner. Materials and Methods: 30 patients (18 male, 12 female; mean age 57 ± 9 yrs; mean heart rate 66 ± 10 bpm) underwent coronary calcium scoring using a 64-slice CT scanner (Somatom Sensation 64, Siemens Medical Solutions, Erlangen) and a standardized scanning protocol. Oral β-blockers were administered to 12 patients with a baseline heart rate > 70 bpm. Images were reconstructed in 10 % increments from 10 - 100 % of the RR interval. Two blinded experienced observers independently calculated Agatston (AS), calcium mass (MS) and volume scores (VS) for every reconstructed image series. The results were compared to similar studies for 16-slice CT scanners. Results: The mean values and mean coefficients of variation among all patients were as follows: AS, 397 ± 829, 109 % MS, 88 ± 225, 154 % VS, 335 ± 669, 100 %. Regarding the reconstruction intervals, the mean coefficients of variation were as follows: 107 % (AS), 97 % (VS), 116 % (MS). No specific image reconstruction interval with statistically significant lower variability for each score could be identified. High inter-observer agreement was achieved (K = 0.98). With statistical significance (p < 0.05) 10/30 patients (pts) were able to be allocated to more than one risk group (RG): 6 pts = 2 RG; 3 pts 3 RG; 1 pts = 4 RG. The scores for 5/30 patients were zero for at least one reconstruction interval, but further reconstructions revealed calcifications. The number of patients assignable to different risk groups was significantly lower compared to published data using a 16-slice scanner (p < 0.05). Conclusion: Coronary calcium scores determined using a 64-slice scanner display a wide range of variability depending on the image reconstruction interval as already described for 16-slice CT scanners. However, compared to previous studies, our data indicate that this vendor

  17. Laser measuring scanners and their accuracy limits

    Science.gov (United States)

    Jablonski, Ryszard

    1993-09-01

    Scanning methods have gained the greater importance for some years now due to a short measuring time and wide range of application in flexible manufacturing processes. This paper is a summing up of the autho?s creative scientific work in the field of measuring scanners. The research conducted allowed to elaborate the optimal configurations of measuring systems based on the scanning method. An important part of the work was the analysis of a measuring scanner - as a transducer of an angle rotation into the linear displacement which resulted in obtaining its much higher accuracy and finally in working out a measuring scanner eliminating the use of an additional reference standard. The completion of the work is an attempt to determine an attainable accuracy limit of scanning measurement of both length and angle. Using a high stability deflector and a corrected scanning lens one can obtain the angle determination over 30 (or 2 mm) to an accuracy 0 (or 0 tm) when the measuring rate is 1000 Hz or the range d60 (4 mm) with accuracy 0 " (0 jim) and measurement frequency 6 Hz.

  18. A near-infrared confocal scanner

    International Nuclear Information System (INIS)

    Lee, Seungwoo; Yoo, Hongki

    2014-01-01

    In the semiconductor industry, manufacturing of three-dimensional (3D) packages or 3D integrated circuits is a high-performance technique that requires combining several functions in a small volume. Through-silicon vias, which are vertical electrical connections extending through a wafer, can be used to direct signals between stacked chips, thus increasing areal density by stacking and connecting multiple patterned chips. While defect detection is essential in the semiconductor manufacturing process, it is difficult to identify defects within a wafer or to monitor the bonding results between bonded surfaces because silicon and many other semiconductor materials are opaque to visible wavelengths. In this context, near-infrared (NIR) imaging is a promising non-destructive method to detect defects within silicon chips, to inspect bonding between chips and to monitor the chip alignment since NIR transmits through silicon. In addition, a confocal scanner provides high-contrast, optically-sectioned images of the specimen due to its ability to reject out-of-focus noise. In this study, we report an NIR confocal scanner that rapidly acquires high-resolution images with a large field of view through silicon. Two orthogonal line-scanning images can be acquired without rotating the system or the specimen by utilizing two orthogonally configured resonant scanning mirrors. This NIR confocal scanner can be efficiently used as an in-line inspection system when manufacturing semiconductor devices by rapidly detecting defects on and beneath the surface. (paper)

  19. Scanner-based macroscopic color variation estimation

    Science.gov (United States)

    Kuo, Chunghui; Lai, Di; Zeise, Eric

    2006-01-01

    Flatbed scanners have been adopted successfully in the measurement of microscopic image artifacts, such as granularity and mottle, in print samples because of their capability of providing full color, high resolution images. Accurate macroscopic color measurement relies on the use of colorimeters or spectrophotometers to provide a surrogate for human vision. The very different color response characteristics of flatbed scanners from any standard colorimetric response limits the utility of a flatbed scanner as a macroscopic color measuring device. This metamerism constraint can be significantly relaxed if our objective is mainly to quantify the color variations within a printed page or between pages where a small bias in measured colors can be tolerated as long as the color distributions relative to the individual mean values is similar. Two scenarios when converting color from the device RGB color space to a standardized color space such as CIELab are studied in this paper, blind and semi-blind color transformation, depending on the availability of the black channel information. We will show that both approaches offer satisfactory results in quantifying macroscopic color variation across pages while the semi-blind color transformation further provides fairly accurate color prediction capability.

  20. Value of 3D-Volume Rendering in the Assessment of Coronary Arteries with Retrospectively Ecg-Gated Multislice Spiral CT

    International Nuclear Information System (INIS)

    Mahnken, A.H.; Wildberger, J.E.; Dedden, K.; Schmitz-Rode, T.; Guenther, R.W.; Sinha, A.M.; Hoffmann, R.; Stanzel, S.

    2003-01-01

    Purpose: To assess the diagnostic value and measurement precision of 3D volume rendering technique (3D-VRT) from retrospectively ECG-gated multislice spiral CT (MSCT) data sets for imaging of the coronary arteries. Material and Methods: In 35 patients, retrospectively ECG-gated MSCT of the heart using a four detector row MSCT scanner with a standardized examination protocol was performed as well as quantitative X-ray coronary angiography (QCA). The MSCT data was assessed on segmental basis using 3D-VRT exclusively. The coronary artery diameters were measured at the origin of each main coronary branch and 1 cm, 3 cm and 5 cm distally. The minimum, maximum and mean diameters were determined from MSCT angiography and compared to QCA. Results: A total of 353 of 525 (67.2%) coronary artery segments were assessable by MSCT angiography. The proximal segments were more often assessable when compared to the distal segments. Stenoses were detected with a sensitivity of 82.6% and a specificity of 92.8%. According to the Bland-Altman method the mean differences between QCA and MSCT ranged from 0.55 to 1.07 mm with limits of agreement from 2.2 mm to 2.7 mm. Conclusion: When compared to QCA, the ability of 3D-VRT to quantitatively assess coronary artery diameters and coronary artery stenoses is insufficient for clinical purposes

  1. Auxetic coronary stent endoprosthesis

    DEFF Research Database (Denmark)

    Amin, Faisal; Ali, Murtaza Najabat; Ansari, Umar

    2014-01-01

    BACKGROUND: Cardiovascular heart disease is one of the leading health issues in the present era and requires considerable health care resources to prevent it. The present study was focused on the development of a new coronary stent based on novel auxetic geometry which enables the stent to exhibit...... a negative Poisson's ratio. Commercially available coronary stents have isotropic properties, whereas the vascular system of the body shows anisotropic characteristics. This results in a mismatch between anisotropic-isotropic properties of the stent and arterial wall, and this in turn is not favorable...... for mechanical adhesion of the commercially available coronary stents with the arterial wall. It is believed that an auxetic coronary stent with inherent anisotropic mechanical properties and negative Poisson's ratio will have good mechanical adhesion with the arterial wall. METHODS: The auxetic design...

  2. Detection of coronary calcification in ultrafast CT compared to coronary angiography

    International Nuclear Information System (INIS)

    Koesling, S.; Hoffmann, U.; Rother, T.; Lieberenz, S.; Heywang-Koebrunner, S.H.; Schulz, H.G.

    1994-01-01

    The angiographical findings of 24 patients with coronary artery disease were compared with qualitative and quantitative detection of coronary calcification by ultrafast CT. Doubts concerning the capabilities of the ultrafast CT for a screening of coronary artery disease arise when the results of one third false positive and fase negative findings are considered. Variations in the quantification of coronary calcification were too great to allow a realistic assessment of the degree of stenosis of the coronary arteries. (orig.) [de

  3. Physiologic assessment of coronary artery fistula

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, N.C.; Beauvais, J. (Creighton Univ., Omaha, NE (USA))

    1991-01-01

    Coronary artery fistula is an uncommon clinical entity. The most common coronary artery fistula is from the right coronary artery to the right side of the heart, and it is less frequent to the pulmonary artery. The effect of a coronary artery fistula may be physiologically significant because of the steal phenomenon resulting in coronary ischemia. Based on published reports, it is recommended that patients with congenital coronary artery fistulas be considered candidates for elective surgical correction to prevent complications including development of congestive heart failure, angina, subacute bacterial endocarditis, myocardial infarction, and coronary aneurysm formation with rupture or embolization. A patient is presented in whom treadmill-exercise thallium imaging was effective in determining the degree of coronary steal from a coronary artery fistula, leading to successful corrective surgery.

  4. Physiologic assessment of coronary artery fistula

    International Nuclear Information System (INIS)

    Gupta, N.C.; Beauvais, J.

    1991-01-01

    Coronary artery fistula is an uncommon clinical entity. The most common coronary artery fistula is from the right coronary artery to the right side of the heart, and it is less frequent to the pulmonary artery. The effect of a coronary artery fistula may be physiologically significant because of the steal phenomenon resulting in coronary ischemia. Based on published reports, it is recommended that patients with congenital coronary artery fistulas be considered candidates for elective surgical correction to prevent complications including development of congestive heart failure, angina, subacute bacterial endocarditis, myocardial infarction, and coronary aneurysm formation with rupture or embolization. A patient is presented in whom treadmill-exercise thallium imaging was effective in determining the degree of coronary steal from a coronary artery fistula, leading to successful corrective surgery

  5. Efficient system modeling for a small animal PET scanner with tapered DOI detectors

    International Nuclear Information System (INIS)

    Zhang, Mengxi; Zhou, Jian; Yang, Yongfeng; Qi, Jinyi; Rodríguez-Villafuerte, Mercedes

    2016-01-01

    A prototype small animal positron emission tomography (PET) scanner for mouse brain imaging has been developed at UC Davis. The new scanner uses tapered detector arrays with depth of interaction (DOI) measurement. In this paper, we present an efficient system model for the tapered PET scanner using matrix factorization and a virtual scanner geometry. The factored system matrix mainly consists of two components: a sinogram blurring matrix and a geometrical matrix. The geometric matrix is based on a virtual scanner geometry. The sinogram blurring matrix is estimated by matrix factorization. We investigate the performance of different virtual scanner geometries. Both simulation study and real data experiments are performed in the fully 3D mode to study the image quality under different system models. The results indicate that the proposed matrix factorization can maintain image quality while substantially reduce the image reconstruction time and system matrix storage cost. The proposed method can be also applied to other PET scanners with DOI measurement. (paper)

  6. Ventricular Fibrillation-Induced Cardiac Arrest Results in Regional Cardiac Injury Preferentially in Left Anterior Descending Coronary Artery Territory in Piglet Model

    Directory of Open Access Journals (Sweden)

    Giridhar Kaliki Venkata

    2016-01-01

    Full Text Available Objective. Decreased cardiac function after resuscitation from cardiac arrest (CA results from global ischemia of the myocardium. In the evolution of postarrest myocardial dysfunction, preferential involvement of any coronary arterial territory is not known. We hypothesized that there is no preferential involvement of any coronary artery during electrical induced ventricular fibrillation (VF in piglet model. Design. Prospective, randomized controlled study. Methods. 12 piglets were randomized to baseline and electrical induced VF. After 5 min, the animals were resuscitated according to AHA PALS guidelines. After return of spontaneous circulation (ROSC, animals were observed for an additional 4 hours prior to cardiac MRI. Data (mean ± SD was analyzed using unpaired t-test; p value ≤ 0.05 was considered statistically significant. Results. Segmental wall motion (mm; baseline versus postarrest group in segment 7 (left anterior descending (LAD was 4.68±0.54 versus 3.31±0.64, p=0.0026. In segment 13, it was 3.82±0.96 versus 2.58±0.82, p=0.02. In segment 14, it was 2.42±0.44 versus 1.29±0.99, p=0.028. Conclusion. Postarrest myocardial dysfunction resulted in segmental wall motion defects in the LAD territory. There were no perfusion defects in the involved segments.

  7. Compensation strategies for PET scanners with unconventional scanner geometry

    CERN Document Server

    Gundlich, B; Oehler, M

    2006-01-01

    The small animal PET scanner ClearPET®Neuro, developed at the Forschungszentrum Julich GmbH in cooperation with the Crystal Clear Collaboration (CERN), represents scanners with an unconventional geometry: due to axial and transaxial detector gaps ClearPet®Neuro delivers inhomogeneous sinograms with missing data. When filtered backprojection (FBP) or Fourier rebinning (FORE) are applied, strong geometrical artifacts appear in the images. In this contribution we present a method that takes the geometrical sensitivity into account and converts the measured sinograms into homogeneous and complete data. By this means artifactfree images are achieved using FBP or FORE. Besides an advantageous measurement setup that reduces inhomogeneities and data gaps in the sinograms, a modification of the measured sinograms is necessary. This modification includes two steps: a geometrical normalization and corrections for missing data. To normalize the measured sinograms, computed sinograms are used that describe the geometric...

  8. Evaluation of a LED-based flatbed document scanner for radiochromic film dosimetry in transmission mode.

    Science.gov (United States)

    Lárraga-Gutiérrez, José Manuel; García-Garduño, Olivia Amanda; Treviño-Palacios, Carlos; Herrera-González, José Alfredo

    2018-03-01

    Flatbed scanners are the most frequently used reading instrument for radiochromic film dosimetry because its low cost, high spatial resolution, among other advantages. These scanners use a fluorescent lamp and a CCD array as light source and detector, respectively. Recently, manufacturers of flatbed scanners replaced the fluorescent lamp by light emission diodes (LED) as a light source. The goal of this work is to evaluate the performance of a commercial flatbed scanner with LED based source light for radiochromic film dosimetry. Film read out consistency, response uniformity, film-scanner sensitivity, long term stability and total dose uncertainty was evaluated. In overall, the performance of the LED flatbed scanner is comparable to that of a cold cathode fluorescent lamp (CCFL). There are important spectral differences between LED and CCFL lamps that results in a higher sensitivity of the LED scanner in the green channel. Total dose uncertainty, film response reproducibility and long-term stability of LED scanner are slightly better than those of the CCFL. However, the LED based scanner has a strong non-uniform response, up to 9%, that must be adequately corrected for radiotherapy dosimetry QA. The differences in light emission spectra between LED and CCFL lamps and its potential impact on film-scanner sensitivity suggest that the design of a dedicated flat-bed scanner with LEDs may improve sensitivity and dose uncertainty in radiochromic film dosimetry. Copyright © 2018 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  9. Clinical performance of dual-source computerized tomography (DSCT) in primary diagnostics of coronary heart diseases

    International Nuclear Information System (INIS)

    Brunner, H.; Froehner, S.; Wagner, M.; Schmitt, R.; Brunn, J.; Gietzen, F.H.; Kerber, S.

    2008-01-01

    Dual-source-CT-technology (DSCT) improves temporal resolution of cardiac computed tomography to 83 ms per heart-phase. In this study, the clinical performance of this new method is evaluated. Materials and Methods: In fifty patients (33 male, 17 female; age 50±13 years) with suspected coronary heart disease, CT angiography (slice thickness 0,75 mm, contrast-agent 60-80 ml iomeprol) was performed with a Somatom Definition scanner. Based on the coronary 15-segment-model of the AHA, scores for image quality and lumen reduction were established to enable the observer, to give recommendations for further therapy. Results: Out of 750 possible AHA-segments, 655 were depicted (87,3%). 591 segments (90,2%) were assessed without any limitation of quality, 49 (7,5%) segments showed moderate, and 15 (2,3%) segments severe limitation in image quality. 508 (77,6%) segments were without pathological findings, 92 (14,0%) segments had minimal atherosclerotic lesions, 42 (6,4%) segments suffered from stenoses with lumen reduction less than 70%, and 13 (2,0%) showed significant stenoses of more than 70%. In 31 patients (62%), coronary heart disease was ruled out by CT angiography without any need for further non-invasive or invasive diagnostics. 8 patients (16%) underwent stress-testing for ischemia. In 11 (22%) patients coronary angiography was recommended, and DSCT findings were confirmed in 10 cases. Only one LCx stenosis was overestimated in DSCT. Conclusion: Contrast-enhanced DSCT is a powerful tool in diagnosis of coronary heart disease. 98% of coronary segments could be assessed in diagnostic quality, and at least 90% of haemodynamically significant coronary stenoses were detected. (orig.)

  10. Feasibility of visual aids for risk evaluation by hospitalized patients with coronary artery disease: results from face-to-face interviews

    Directory of Open Access Journals (Sweden)

    Magliano CAS

    2018-05-01

    Full Text Available Carlos Alberto da Silva Magliano,1 Andrea Liborio Monteiro,2 Bernardo Rangel Tura,1 Claudia Silvia Rocha Oliveira,1 Amanda Rebeca de Oliveira Rebelo,1 Claudia Cristina de Aguiar Pereira3 1NATS, Instituto Nacional de Cardiologia, INC, Rio de Janeiro, Rio de Janeiro, Brazil; 2Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA; 3Escola Nacional de Saúde Pública, ENSP, FIOCRUZ, Rio de Janeiro, Brazil Purpose: Communicating information about risk and probability to patients is considered a difficult task. In this study, we aim to evaluate the use of visual aids representing perioperative mortality and long-term survival in the communication process for patients diagnosed with coronary artery disease at the National Institute of Cardiology, a Brazilian public hospital specializing in cardiology. Patients and methods: One-on-one interviews were conducted between August 1 and November 20, 2017. Patients were asked to imagine that their doctor was seeking their input in the decision regarding which treatment represented the best option for them. Patients were required to choose between alternatives by considering only the different benefits and risks shown in each scenario, described as the proportion of patients who had died during the perioperative period and within 5 years. Each participant evaluated the same eight scenarios. We evaluated their answers in a qualitative and quantitative analysis. Results: The main findings were that all patients verbally expressed concern about perioperative mortality and that 25% did not express concern about long-term mortality. Twelve percent considered the probabilities irrelevant on the grounds that their prognosis would depend on “God’s will.” Ten percent of the patients disregarded the reported likelihood of perioperative mortality, deciding to focus solely on the “chance of being cured.” In the quantitative analysis, the vast

  11. Is right coronary artery chronic total vessel occlusion impacting the surgical revascularization results of patients with multivessel disease? A retrospective study

    Directory of Open Access Journals (Sweden)

    Janusz Konstanty-Kalandyk

    2018-06-01

    Full Text Available Introduction Chronic total occlusion (CTO is common in the presence of other significantly narrowed coronary arteries. The impact of total occlusion and its association with completeness of revascularization on patients with multivessel disease undergoing coronary artery bypass graft (CABG remains largely unknown. Aim The aim of our study was to compare CABG operation characteristics, as well as 30-day mortality, incidence of post-operative major adverse cardiac and cerebrovascular events (MACCE between patients with and without CTO in right coronary artery (RCA. Materials and Methods A total of 156 consecutive patients were included in the analysis. CTO of RCA or right posterior descending artery (RPD was diagnosed in 57 patients (CTO-RCA group. Coronary stenosis without CTO in RCA was diagnosed in 99 patients (nonCTO-RCA group. Baseline characteristics were comparable in both groups. Results The majority of patients had class II (49.1% vs. 46%, p = 0.86 or class III (42.1% vs. 43%, p = 1.0 Canadian Cardiovascular Society grading system symptoms. Patients in the CTO-RCA group had in average 2.2 grafts implanted, as opposed to 2.4 grafts in patients in the nonCTO-RCA group (p = 0.003. Graft to the RCA was performed in 40.3% patients in the CTO-RCA group and in 81% patients in the nonCTO-RCA group (p = 0.001. The 30-day mortality from any cause or cardiac cause did not differ between groups (7% vs. 2%, p = 0.14 and 3.5% vs. 2%, p = 0.57 respectively. In a multivariate analysis CTO in RCA or RPD and peripheral artery disease were independent predictors of post-operative MACCE (7.9 (1.434–43.045 p = 0.02; 18.8 (3.451–101.833 p < 0.01, respectively. Conclusions Chronic total occlusion of RCA was found to be associated with smaller number of grafts performed during the CABG procedure. Although mortality between patients in the CTO-RCA and nonCTO-RCA groups did not differ, patients in the CTO-RCA group had higher incidence of post-operative MACCE.

  12. Utilization pattern of whole body computed tomography scanner

    International Nuclear Information System (INIS)

    Youn, Chul Ho; Lee, Sang Suk

    1986-01-01

    Computed tomography scanner (CT scanner) is one of the most expensive and sophisticated diagnostic tool and has already been utilized in many hospitals in Korea. The price as well as operating costs of CT scanner is so expensive as to regulate its installment by government even in the United States. In order to identify the efficient utilization of the CT scanner, the utilization pattern for CT scanning was analyzed at three general hospital in seoul. The results are as follows: 1. Five out of one thousand outpatients and five out of one hundred inpatients were CT scanned. 2. Eighty percent of patients who were scanned were those of inpatients of the hospitals where the scanned are installed. 3. Head standings constitute 45.6 percent of examinations, internal medicine 63.8 percent, and 38.5 percent neurosurgery respectively. 4. The rate of indication for CT scanning showed no statistically significant difference between insured and non-insured groups. 5. Computed tomography scanner units were operated 5.5 days a week in average and full operation rate was 79.5% in average. 6. The major diagnoses mode by head scanning were: hematoma (56.7%), infarction (12.6%), tumor (8.2%), and hydrocephalus (4.4%). 7. Number of patients taken CT Scanning was 43 persons a week in average for each whole body scanner unit

  13. Long-term results of a randomized controlled trial analyzing the role of systematic pre-operative coronary angiography before elective carotid endarterectomy in patients with asymptomatic coronary artery disease.

    Science.gov (United States)

    Illuminati, G; Schneider, F; Greco, C; Mangieri, E; Schiariti, M; Tanzilli, G; Barillà, F; Paravati, V; Pizzardi, G; Calio', F; Miraldi, F; Macrina, F; Totaro, M; Greco, E; Mazzesi, G; Tritapepe, L; Toscano, M; Vietri, F; Meyer, N; Ricco, J-B

    2015-04-01

    To evaluate the potential benefit of systematic preoperative coronary-artery angiography followed by selective coronary-artery revascularization on the incidence of myocardial infarction (MI) in patients undergoing carotid endarterectomy (CEA) without a previous history of coronary artery disease (CAD). We randomised 426 patients who were candidates for CEA, with no history of CAD, a normal electrocardiogram (ECG), and a normal cardiac ultrasound. In group A (n = 216) all patients underwent coronary angiography before CEA. In group B (n = 210) CEA was performed without coronary angiography. Patients were not blinded for relevant assessments during follow-up. Primary end-point was the occurrence of MI at 3.5 years. The secondary end-point was the overall survival rate. Median length of follow-up was 6.2 years. In group A, coronary angiography revealed significant coronary artery stenosis in 68 patients (31.5%). Among them, 66 underwent percutaneous Intervention (PCI) prior to CEA and 2 received combined CEA and coronary-artery bypass grafting (CABG). Postoperatively, no MI was observed in group A, whereas 6 MI occurred in group B, one of which was fatal (p = .01). During the study period, 3 MI occurred in group A (1.4%) and 33 were observed in group B (15.7%), 6 of which were fatal. The Cox model demonstrated a reduced risk of MI for patients in group A receiving coronary angiography (HR,.078; 95% CI, 0.024-0.256; p < .001). In addition, patients with diabetes and patients <70 years presented with an increased risk of MI. Survival analysis at 6 years by Kaplan-Meier estimates was 95.6 ± 3.2% in Group A and 89.7 ± 3.7% in group B (Log Rank = 6.54, p = .01). In asymptomatic coronary-artery patients, systematic coronary angiography prior to CEA followed by selective PCI or CABG significantly reduces the incidence of late MI and increases long-term survival. (ClinicalTrials.gov number, NCT02260453). Copyright © 2015 European Society for Vascular

  14. Coronary plaque quantification and fractional flow reserve by coronary computed tomography angiography identify ischaemia-causing lesions

    DEFF Research Database (Denmark)

    Gaur, Sara; Øvrehus, Kristian Altern; Dey, Damini

    2016-01-01

    AIMS: Coronary plaque characteristics are associated with ischaemia. Differences in plaque volumes and composition may explain the discordance between coronary stenosis severity and ischaemia. We evaluated the association between coronary stenosis severity, plaque characteristics, coronary computed...... tomography angiography (CTA)-derived fractional flow reserve (FFRCT), and lesion-specific ischaemia identified by FFR in a substudy of the NXT trial (Analysis of Coronary Blood Flow Using CT Angiography: Next Steps). METHODS AND RESULTS: Coronary CTA stenosis, plaque volumes, FFRCT, and FFR were assessed...

  15. HUMAN CORONARY ARTERIES- A STUDY BASED ON GROSS ANATOMY AND CORONARY CAST

    Directory of Open Access Journals (Sweden)

    Vijayamma K. N

    2018-01-01

    Full Text Available BACKGROUND Present study is an attempt to throw light upon the coronary arterial pattern, variations in arterial distribution and extent of intercoronary anastomosis and arterial preponderance in different age groups. MATERIALS AND METHODS Total of 115 hearts were made use for this study. Ninety hearts were dissected for the gross anatomical study of coronary arteries and 25 hearts including three fetal hearts were used for the coronary cast study. The right and left coronary arteries were traced from aortic sinus along the atrioventricular groove to the area of its termination. The atrial ventricular and septal branches were traced and looked for anastomosis. Coronary casts were prepared by injecting coloured liquid latex through the coronary ostia and the branching pattern and anastomosis were studied. The coronary arterial pattern, extent of distribution of its branches, arterial preponderance and variations were observed. RESULTS It was found that 73 % cases of SA nodal branch arise from right coronary artery and 27 % from circumflex branch of left coronary artery. SA node has dual blood supply from both coronary arteries in 4% cases. Right coronary preponderance was observed in 83% of cases and left coronary preponderance in 11 % cases, and balanced supply in 6% cases. Coronary cast was helpful to understand the branching pattern of vessels, and the anastomosis of small capillaries. It was also seen that all 11 % of left preponderance were seen in male hearts and all of the 31 female hearts dissected were right preponderant. CONCLUSION Coronary arteries are called end arteries functionally. Right coronary artery originates from anterior aortic sinus in all cases except one which takes origin from posterior left aortic sinus along with left coronary artery. Right coronary preponderance is observed in 83% cases. Left coronary artery branching pattern shows variability. Left coronary preponderance was observed in 11% and all cases are male

  16. Home-based cardiac rehabilitation is as effective as centre-based cardiac rehabilitation among elderly with coronary heart disease: results from a randomised clinical trial

    DEFF Research Database (Denmark)

    Oerkild, Bodil; Frederiksen, Marianne; Hansen, Jorgen Fischer

    2011-01-01

    BACKGROUND: participation in centre-based cardiac rehabilitation (CR) is known to reduce morbidity and mortality but participation rates among the elderly are low. Establishing alternative programmes is important, and home-based CR is the predominant alternative. However, no studies have...... investigated the effect of home-based CR among a group of elderly patients with coronary heart disease with a long-term follow-up. METHODS: randomised clinical trial comparing home-based CR with comprehensive centre-based CR among patients = 65 years with coronary heart disease. RESULTS: seventy-five patients...... in the secondary outcomes of systolic blood pressure (-0.6 mmHg, 95% CI -11.3, 10.0), LDL cholesterol (0.3 mmol/l, 95% CI -0.04, 0.7), HDL cholesterol (0.2 mmol/l, 95% CI -0.01, 0.3), body composition, proportion of smokers and health-related quality of life. A group of patients who did not have an effect...

  17. Achievement of Optimal Medical Therapy Goals for US Adults with Coronary Artery Disease: Results from the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study

    Science.gov (United States)

    Brown, Todd M.; Voeks, Jenifer H.; Bittner, Vera; Brenner, David A.; Cushman, Mary; Goff, David C.; Glasser, Stephen; Muntner, Paul; Tabereaux, Paul B.; Safford, Monika M.

    2014-01-01

    Objective In a non-clinical trial setting, to determine the proportion of individuals with coronary artery disease (CAD) with optimal risk factor levels based on the Clinical Outcomes Utilizing Revascularization and Aggressive DruG Evaluation (COURAGE) trial. Background In COURAGE, the addition of percutaneous coronary intervention (PCI) to optimal medical therapy did not reduce the risk of death or myocardial infarction in stable CAD patients but resulted in more revascularization procedures. Methods REGARDS is a national prospective cohort study of 30,239 African American and White community-dwelling individuals aged >45 years enrolled in 2003-7. We calculated the proportion of 3,167 participants with self-reported CAD meeting 7 risk factor goals based on COURAGE: 1) aspirin use, 2) systolic blood pressure 40 mg/dL, and triglycerides goals met was 4. Less than a quarter met ≥5 of the 7 goals, and 16% met all 3 goals for aspirin, blood pressure, and LDL-C. Older age, white race, higher income, more education, and higher physical functioning were independently associated with meeting more goals. Conclusions There is substantial room for improvement in risk factor reduction among US individuals with CAD. PMID:24534599

  18. Does a similar procedure result in similar survival for women and men undergoing isolated coronary artery bypass grafting?

    Science.gov (United States)

    Attia, Tamer; Koch, Colleen G; Houghtaling, Penny L; Blackstone, Eugene H; Sabik, Ellen Mayer; Sabik, Joseph F

    2017-03-01

    To (1) identify sex-related differences in risk factors and revascularization strategies for patients undergoing coronary artery bypass grafting (CABG), (2) assess whether these differences influenced early and late survival, and (3) determine whether clinical effectiveness of the same revascularization strategy was influenced by sex. From January 1972 to January 2011, 57,943 adults-11,009 (19%) women-underwent primary isolated CABG. Separate models for long-term mortality were developed for men and women, followed by assessing sex-related differences in strength of risk factors (interaction terms). Incomplete revascularization was more common in men than women (26% vs 22%, P  .9) with lower survival in both sexes. Single ITA grafting was associated with equally (P = .3) better survival in women and men. Although bilateral ITA grafting was associated with better survival than single ITA grafting, it was less effective in women-11% lower late mortality (hazard ratio, 0.89 [0.77-1.022]) versus 27% lower in men (hazard ratio, 0.73 [0.69-0.77]; P = .01). Women on average have longer life expectancies than men but not after CABG. Every attempt should be made to use arterial grafting and complete revascularization, but for unexplained reasons, sex-related differences in effectiveness of bilateral arterial grafting were identified. Copyright © 2016. Published by Elsevier Inc.

  19. Monte Carlo dose calibration in CT scanner

    International Nuclear Information System (INIS)

    Yadav, Poonam; Ramasubramanian, V.; Subbaiah, K.V.; Thayalan, K.

    2008-01-01

    Computed Tomography (CT) scanner is a high radiation imaging modality compared to radiography. The dose from a CT examination can vary greatly depending on the particular CT scanner used, the area of the body examined, and the operating parameters of the scan. CT is a major contributor to collective effective dose in diagnostic radiology. Apart from the clinical benefits, the widespread use of multislice scanner is increasing radiation level to patient in comparison with conventional CT scanner. So, it becomes necessary to increase awareness about the CT scanner. (author)

  20. The minimum coronary artery diameter in which coronary spasm can be identified by synchrotron radiation coronary angiography

    International Nuclear Information System (INIS)

    Matsushita, Shonosuke; Hyodo, Kazuyuki; Imazuru, Tomohiro; Tokunaga, Chiho; Sato, Fujio; Enomoto, Yoshiharu; Hiramatsu, Yuji; Sakakibara, Yuzuru

    2008-01-01

    Background: Coronary vasospasm is defined as a temporary, intense narrowing of the coronary conduit artery. It brings about ischemic chest pain and becomes one of the causes of myocardial infarction. Coronary spasms are divided into two categories. One is the coronary spasm of the conduit artery and the other is the coronary microvascular spasm. Although coronary spasms are diagnosed with the images of coronary angiography, microvascular spasms cannot be diagnosed because of the limitations of conventional angiographic systems. However, synchrotron radiation coronary angiography (SRCA) can identify coronary arteries down to 100 μm in diameter in the beating heart and 50 μm in arrested heart. Aim: The purpose of this study was to confirm whether microvascular spasms could be identified or not using SRCA, and then down that size identification was possible. Methods: The Langendorff perfusion system with isolated rat hearts was employed. Krebs-Henseleit solution (KH solution) was used as a perfusate. 10 mM of 4-aminopyridine (4-AP: a voltage-gated potassium channel blocker; spasm inducer) was added to the KH solution and maintained for 5 min. SRCA was performed at pre-, during and 10 min after cessation of the KH solution with 4-AP. Coronary spasms were defined as a temporal 75% reduction of coronary arterial diameter. Results and conclusion: Multiple sizes of coronary arteries showed coronary spasms. The minimum stenosed coronary artery size was 100 μm. Since coronary microvascular spasms are seen in the arterioles (50-400 μm), coronary microvascular spasms may be diagnosed with the use of synchrotron radiation coronary angiography

  1. Coffee consumption and coronary calcification - The Rotterdam Coronary Calcification Study

    NARCIS (Netherlands)

    van Woudenbergh, Geertruida J.; Vliegenthart, Rozemarijn; van Rooij, Frank J. A.; Hofman, Albert; Oudkerk, Matthijs; Witteman, Jacqueline C. M.; Geleijnse, Johanna M.

    Background-The role of coffee in the cardiovascular system is not yet clear. We examined the relation of coffee intake with coronary calcification in a population-based cohort. Methods and Results-The study involved 1570 older men and women without coronary heart disease who participated in the

  2. Coffee consumption and coronary calcification: The Rotterdam coronary calcification study

    NARCIS (Netherlands)

    G.J. van Woudenbergh (Geertruida); R. Vliegenthart (Rozemarijn); F.J.A. van Rooij (Frank); A. Hofman (Albert); M. Oudkerk (Matthijs); J.C.M. Witteman (Jacqueline); J.M. Geleijnse (Marianne)

    2008-01-01

    textabstractBACKGROUND - The role of coffee in the cardiovascular system is not yet clear. We examined the relation of coffee intake with coronary calcification in a population-based cohort. METHODS AND RESULTS - The study involved 1570 older men and women without coronary heart disease who

  3. Coffee Consumption and Coronary Calcification: The Rotterdam Coronary Calcification Study

    NARCIS (Netherlands)

    Woudenbergh, van G.J.; Vliegenthart, R.; Rooij, van F.J.A.; Hofman, A.; Oudkerk, M.; Witteman, J.C.M.; Geleijnse, J.M.

    2008-01-01

    Background¿ The role of coffee in the cardiovascular system is not yet clear. We examined the relation of coffee intake with coronary calcification in a population-based cohort. Methods and Results¿ The study involved 1570 older men and women without coronary heart disease who participated in the

  4. Multislice CT coronary angiography: evaluation of an automatic vessel detection tool

    International Nuclear Information System (INIS)

    Dewey, M.; Schnapauff, D.; Lembcke, A.; Hamm, B.; Rogalla, P.; Laule, M.; Borges, A.C.; Rutsch, W.

    2004-01-01

    Purpose: To investigate the potential of a new detection tool for multisliceCT (MSCT) coronary angiography with automatic display of curved multiplanar reformations and orthogonal cross-sections. Materials and Methods: Thirty-five patients were consecutively enrolled in a prospective intention-to-diagnose study and examined using a MSCT scanner with 16 x 0.5 mm detector collimation and 400 ms gantry rotation time (Aquilion, Toshiba). A multisegment algorithm using up to four segments was applied for ECG-gated reconstruction. Automatic and manual detection of coronary arteries was conducted using the coronary artery CT protocol of a workstation (Vitrea 2, Version 3.3, Vital Images) to detect significant stenoses (≥50%) in all segments of ≥1.5 mm in diameter. Each detection tool was used by one reader who was blinded to the results of the other detection method and the results of conventional coronary angiography. Results: The overall sensitivity, specificity, nondiagnostic rate, and accuracy of the automatic and manual approach were 90 vs. 94%, 89 vs. 84%, 6 vs. 6%, and 89 vs. 88%, respectively (p=n.s.). The vessel length detected with the automatic and manual approach were highly correlated for the left main/left anterior descending (143±30 vs. 146±24 mm, r=0.923, p [de

  5. Recent advances in segmented gamma scanner analysis

    International Nuclear Information System (INIS)

    Sprinkle, J.K. Jr.; Hsue, S.T.

    1987-01-01

    The segmented gamma scanner (SGS) is used in many facilities to assay low-density scrap and waste generated in the facilities. The procedures for using the SGS can cause a negative bias if the sample does not satisfy the assumptions made in the method. Some process samples do not comply with the assumptions. This paper discusses the effect of the presence of lumps on the SGS assay results, describes a method to detect the presence of lumps, and describes an approach to correct for the lumps. Other recent advances in SGS analysis are also discussed

  6. Fast wire scanner for intense electron beams

    Directory of Open Access Journals (Sweden)

    T. Moore

    2014-02-01

    Full Text Available We have developed a cost-effective, fast rotating wire scanner for use in accelerators where high beam currents would otherwise melt even carbon wires. This new design uses a simple planetary gear setup to rotate a carbon wire, fixed at one end, through the beam at speeds in excess of 20  m/s. We present results from bench tests, as well as transverse beam profile measurements taken at Cornell’s high-brightness energy recovery linac photoinjector, for beam currents up to 35 mA.

  7. SU-E-P-11: Comparison of Image Quality and Radiation Dose Between Different Scanner System in Routine Abdomen CT

    Energy Technology Data Exchange (ETDEWEB)

    Liao, S; Wang, Y; Weng, H [Chiayi Chang Gung Memorial Hospital of The C.G.M.F, Puzi City, Chiayi County, Taiwan (China)

    2015-06-15

    Purpose To evaluate image quality and radiation dose of routine abdomen computed tomography exam with the automatic current modulation technique (ATCM) performed in two different brand 64-slice CT scanners in our site. Materials and Methods A retrospective review of routine abdomen CT exam performed with two scanners; scanner A and scanner B in our site. To calculate standard deviation of the portal hepatic level with a region of interest of 12.5 mm x 12.5mm represented to the image noise. The radiation dose was obtained from CT DICOM image information. Using Computed tomography dose index volume (CTDIv) to represented CT radiation dose. The patient data in this study were with normal weight (about 65–75 Kg). Results The standard deviation of Scanner A was smaller than scanner B, the scanner A might with better image quality than scanner B. On the other hand, the radiation dose of scanner A was higher than scanner B(about higher 50–60%) with ATCM. Both of them, the radiation dose was under diagnostic reference level. Conclusion The ATCM systems in modern CT scanners can contribute a significant reduction in radiation dose to the patient. But the reduction by ATCM systems from different CT scanner manufacturers has slightly variation. Whatever CT scanner we use, it is necessary to find the acceptable threshold of image quality with the minimum possible radiation exposure to the patient in agreement with the ALARA principle.

  8. SU-E-P-11: Comparison of Image Quality and Radiation Dose Between Different Scanner System in Routine Abdomen CT

    International Nuclear Information System (INIS)

    Liao, S; Wang, Y; Weng, H

    2015-01-01

    Purpose To evaluate image quality and radiation dose of routine abdomen computed tomography exam with the automatic current modulation technique (ATCM) performed in two different brand 64-slice CT scanners in our site. Materials and Methods A retrospective review of routine abdomen CT exam performed with two scanners; scanner A and scanner B in our site. To calculate standard deviation of the portal hepatic level with a region of interest of 12.5 mm x 12.5mm represented to the image noise. The radiation dose was obtained from CT DICOM image information. Using Computed tomography dose index volume (CTDIv) to represented CT radiation dose. The patient data in this study were with normal weight (about 65–75 Kg). Results The standard deviation of Scanner A was smaller than scanner B, the scanner A might with better image quality than scanner B. On the other hand, the radiation dose of scanner A was higher than scanner B(about higher 50–60%) with ATCM. Both of them, the radiation dose was under diagnostic reference level. Conclusion The ATCM systems in modern CT scanners can contribute a significant reduction in radiation dose to the patient. But the reduction by ATCM systems from different CT scanner manufacturers has slightly variation. Whatever CT scanner we use, it is necessary to find the acceptable threshold of image quality with the minimum possible radiation exposure to the patient in agreement with the ALARA principle

  9. Geometric calibration between PET scanner and structured light scanner

    DEFF Research Database (Denmark)

    Kjer, Hans Martin; Olesen, Oline Vinter; Paulsen, Rasmus Reinhold

    2011-01-01

    Head movements degrade the image quality of high resolution Positron Emission Tomography (PET) brain studies through blurring and artifacts. Manny image reconstruction methods allows for motion correction if the head position is tracked continuously during the study. Our method for motion tracking...... is a structured light scanner placed just above the patient tunnel on the High Resolution Research Tomograph (HRRT, Siemens). It continuously registers point clouds of a part of the patient's face. The relative motion is estimated as the rigid transformation between frames. A geometric calibration between...

  10. Predictors of depressive disorder following acute coronary syndrome: Results from K-DEPACS and EsDEPACS.

    Science.gov (United States)

    Kang, Hee-Ju; Stewart, Robert; Bae, Kyung-Yeol; Kim, Sung-Wan; Shin, Il-Seon; Hong, Young Joon; Ahn, Youngkeun; Jeong, Myung Ho; Yoon, Jin-Sang; Kim, Jae-Min

    2015-08-01

    Depression is common and associated with poor prognosis in acute coronary syndrome (ACS). There are few reports on the predictors of incident and persistent post-discharge depressive disorders in ACS. This study aimed to investigate the incidence and persistence of depressive disorder over a one year follow-up, and predictors of these outcomes. 1152 patients with recently developed ACS were recruited at baseline, and 828 were followed one year thereafter. Depressive disorder (major and minor) was diagnosed according to DSM-IV criteria, and analyzed according to baseline prevalence, and follow up incidence and persistence. Of 446 baseline participants with depressive disorders, 300 were randomized to a 24-week double blind trial of escitalopram or placebo, while the remaining 146 received medical treatment as usual. Associations of baseline socio-demographic and clinical characteristics with depressive disorder were investigated using logistic regression models. Two-week prevalence, and one-year incidence and persistence of depressive disorder were 38.7%, 13.1%, and 46.3%, respectively. Baseline depressive disorder was independently associated with female, lower educational level, previous ACS and higher heart rate. Incident depressive disorder was independently predicted by current unemployment, family history of depression, higher baseline Hamilton Depression Rating Scale(HAMD) score and lower left ventricular ejection fraction, and persistent depressive disorder by higher baseline HAMD score and the placebo or medical treatment as usual group in the 24-week trial. The generalizability should be considered since this study conducted in a single center. Depressive disorder in ACS patients is common and often persistent, and is associated with baseline characteristics and insufficient treatment. Appropriate detection and treatment of depressive disorder are clearly important in ACS patients. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. Less Is More: Results of a Statewide Analysis of the Impact of Blood Transfusion on Coronary Artery Bypass Grafting Outcomes.

    Science.gov (United States)

    Crawford, Todd C; Magruder, J Trent; Fraser, Charles; Suarez-Pierre, Alejandro; Alejo, Diane; Bobbitt, Jennifer; Fonner, Clifford E; Canner, Joseph K; Horvath, Keith; Wehberg, Kurt; Taylor, Bradley; Kwon, Christopher; Whitman, Glenn J; Conte, John V; Salenger, Rawn

    2018-01-01

    Debate persists over the association between blood transfusions, especially those considered discretionary, and outcomes after cardiac operations. Using data from the Maryland Cardiac Surgery Quality Initiative, we sought to determine whether outcomes differed among coronary artery bypass grafting (CABG) patients receiving 1 U of red blood cells (RBCs) vs none. We used a statewide database to review patients who underwent isolated CABG from July 1, 2011, to June 30, 2016, across 10 Maryland cardiac surgery centers. We included patients who received 1 U or fewer of RBCs from the time of the operation through discharge. Propensity scoring, using 20 variables to control for treatment effect, was performed among patients who did and did not receive a transfusion. These two groups were matched 1:1 to assess for differences in our primary outcomes: operative death, prolonged postoperative length of stay (>14 days), and a composite postoperative respiratory complication of pneumonia or reintubation, or both. Of 10,877 patients who underwent CABG, 6,124 (56%) received no RBCs (group 1) during their operative hospitalization, and 981 (9.0%) received 1 U of RBCs (group 2), including 345 of 981 patients (35%) who received a transfusion intraoperatively. Propensity score matching generated 937 well-matched pairs. Compared with group 2, propensity-matched analysis revealed significantly greater 30-day survival in group 1 (99% vs 98%, p = 0.02) and reduced incidence of prolonged length of stay (3.7% vs 4.0%, p < 0.01). Our collaborative statewide analysis demonstrated that even 1 unit of blood was associated with significantly worse survival and longer length of stay after CABG. Multiinstitutional quality initiatives may seek to address discretionary transfusions and possess the potential to improve patient outcomes. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  12. Family perception of unmet support needs following a diagnosis of congenital coronary anomaly in children: Results of a survey.

    Science.gov (United States)

    Agrawal, Hitesh; Wright, Oriana K; Carberry, Kathleen E; Sexson Tejtel, S Kristen; Mery, Carlos M; Molossi, Silvana

    2017-12-01

    Long-term outcome data on patients with anomalous aortic origin of coronary arteries (AAOCA) is sparse and they are often managed in a nonuniform manner. There is subjective perception of anxiety and unmet needs in these patients and families. An online survey of 13 questions was sent to 74 families of patients with AAOCA between May and October 2015. Descriptive statistics were performed. A total of 31 (47%) families responded. Of these, 27 expressed the need to interact with other patients/families with AAOCA. The majority were interested in either face-to-face meetings (77%) or online support groups (71%). Regarding content of the meeting, 74% were interested in brief talks by medical personnel/families, 58% suggested informal interactions with families, 55% proposed a structured discussion with a moderator and 39% mentioned fun activities/games. Regarding participants in these meetings, 90% would like to include healthcare providers, 61% suggested including family friends, 58% wished to include psychologists and 16% mentioned including social workers. The families currently use various social media including Facebook (87%), YouTube (39%), Google+ (36%), and LinkedIn (32%). For future online resources, 77% of families would like a Facebook site, an informative website (58%), a blog (52%), or an open forum (29%). The majority of the families (77%) were interested in attending a dedicated AAOCA meeting. There appears to be an unmet need for family support in those affected by AAOCA, a substantial life changing diagnosis for patients and families. Further research is needed to assess quality of life in this population. © 2017 Wiley Periodicals, Inc.

  13. Accuracy of multidetector row computed tomography for the detection of transplant vasculopathy: comparison with invasive coronary angiography and intravascular ultrasound

    International Nuclear Information System (INIS)

    Carrascosa, P.; Capunay, C.; Carrascosa, J.; Perrone, S.; Deviggiano, A.; Lopez, E.M.; Lev, G.; Garcia, M.J.

    2009-01-01

    Objective: To evaluate the diagnostic accuracy of multidetector computed tomography (MDCT) for detection of luminal stenosis and cardiac allograft vasculopathy in comparison with coronary angiography (CA) and intravascular ultrasound (IVUS) respectively. Material and methods: Nineteen cardiac transplant patients scheduled for follow-up CA were included. MDCT coronary angiography was performed using a 16-row CT scanner within 7-14 days after CA and IVUS. Studies were analyzed by independent readers; two observers evaluated the CT datasets for the presence of coronary artery stenosis > 50% and allograft vasculopathy. Results: The sensitivity for detecting > 50% luminal stenosis was 80-88% and specificity, 98-99% and for detection of cardiac allograft vasculopathy, the sensitivity was 91-96% and specificity, 88-91%. Conclusion: In this preliminary series, our results indicate that MDCT coronary angiography was capable of detecting both significant coronary stenosis as well as diffuse intimal proliferation. This non-invasive procedure could be an alternative to CA and IVUS in the surveillance of heart transplant patients. (authors) [es

  14. Prospective, multi-center evaluation of a silicon carbide coated cobalt chromium bare metal stent for percutaneous coronary interventions: Two-year results of the ENERGY Registry

    International Nuclear Information System (INIS)

    Erbel, Raimund; Eggebrecht, Holger; Roguin, Ariel; Schroeder, Erwin; Philipp, Sebastian; Heitzer, Thomas; Schwacke, Harald; Ayzenberg, Oded; Serra, Antonio; Delarche, Nicolas; Luchner, Andreas; Slagboom, Ton

    2014-01-01

    Background: Novel bare metal stents with improved stent design may become a viable alternative to drug-eluting stents in certain patient groups, particularly, when long-term dual antiplatelet therapy should be avoided. Purpose: The ENERGY registry aimed to assess the safety and benefits of a cobalt–chromium thin strut bare metal stent with a passive coating in a large series of patients under real-world conditions. Methods and materials: This prospective registry recruited 1016 patients with 1074 lesions in 48 centers from April to November 2010. The primary endpoint was the rate of major adverse cardiac events (MACEs), a composite of cardiac death, myocardial infarction and clinically driven target lesion revascularization. Results: More than half of the lesions (61.0%) were type A/B1 lesions, mean lesion length was 14.5 ± 6.5 mm and mean reference vessel diameter 3.2 ± 0.5 mm. MACE rates at 6, 12 and 24 months were 4.9%, 8.1% and 9.4%, target lesion revascularization rates 2.8%, 4.9% and 5.4% and definite stent thrombosis rates 0.5%, 0.6% and 0.6%. Subgroups showed significant differences in baseline and procedural characteristics which did not translate into significantly different clinical outcomes. Specifically, MACE rates at 24 months were 13.5% in diabetics, 8.6% in small stents and 9.6% in acute coronary syndrome patients. Conclusion: The population of ENERGY reflects real-world conditions with bare metal stents being mainly used in simple lesions. In this setting, percutaneous coronary intervention using a cobalt–chromium thin strut bare metal stent with a passive coating showed very good results up to 24 months. (ClinicalTrials.gov:NCT01056120) Summary for annotated table of contents: The ENERGY international registry evaluated the safety and benefits of a cobalt–chromium thin strut bare metal stent with passive coating in 1016 patients under real-world conditions until 2 years. Results were encouraging with a low composite rate of cardiac death

  15. Prospective, multi-center evaluation of a silicon carbide coated cobalt chromium bare metal stent for percutaneous coronary interventions: Two-year results of the ENERGY Registry

    Energy Technology Data Exchange (ETDEWEB)

    Erbel, Raimund, E-mail: erbel@uk-essen.de [Department of Cardiology, University of Duisburg-Essen, Essen (Germany); Eggebrecht, Holger [Cardioangiological Center Bethanien (CCB), Frankfurt (Germany); Roguin, Ariel [Department of Cardiology, Rambam Medical Center, Haifa (Israel); Schroeder, Erwin [Division of Cardiovascular Medicine, Cliniques Universitaires de Mont-Godinne, Yvoir (Belgium); Philipp, Sebastian [Department Internal Medicine/Cardiology, Elbe Klinikum Stade, Stade (Germany); Heitzer, Thomas [Department of Cardiology, Heart Center Dortmund, Dortmund (Germany); Schwacke, Harald [Department of Internal Medicine, Diakonissen-Stiftungs- Krankenhaus Speyer (Germany); Ayzenberg, Oded [The Heart Institute, Kaplan Medical Center, Rehovot (Israel); Serra, Antonio [Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, España (Spain); Delarche, Nicolas [Cardiology unit, Pau General Hospital, Pau (France); Luchner, Andreas [Department of Internal Medicine/Cardiology, Universitätsklinikum Regensburg (Germany); Slagboom, Ton [Department of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam (Netherlands)

    2014-11-15

    Background: Novel bare metal stents with improved stent design may become a viable alternative to drug-eluting stents in certain patient groups, particularly, when long-term dual antiplatelet therapy should be avoided. Purpose: The ENERGY registry aimed to assess the safety and benefits of a cobalt–chromium thin strut bare metal stent with a passive coating in a large series of patients under real-world conditions. Methods and materials: This prospective registry recruited 1016 patients with 1074 lesions in 48 centers from April to November 2010. The primary endpoint was the rate of major adverse cardiac events (MACEs), a composite of cardiac death, myocardial infarction and clinically driven target lesion revascularization. Results: More than half of the lesions (61.0%) were type A/B1 lesions, mean lesion length was 14.5 ± 6.5 mm and mean reference vessel diameter 3.2 ± 0.5 mm. MACE rates at 6, 12 and 24 months were 4.9%, 8.1% and 9.4%, target lesion revascularization rates 2.8%, 4.9% and 5.4% and definite stent thrombosis rates 0.5%, 0.6% and 0.6%. Subgroups showed significant differences in baseline and procedural characteristics which did not translate into significantly different clinical outcomes. Specifically, MACE rates at 24 months were 13.5% in diabetics, 8.6% in small stents and 9.6% in acute coronary syndrome patients. Conclusion: The population of ENERGY reflects real-world conditions with bare metal stents being mainly used in simple lesions. In this setting, percutaneous coronary intervention using a cobalt–chromium thin strut bare metal stent with a passive coating showed very good results up to 24 months. (ClinicalTrials.gov:NCT01056120) Summary for annotated table of contents: The ENERGY international registry evaluated the safety and benefits of a cobalt–chromium thin strut bare metal stent with passive coating in 1016 patients under real-world conditions until 2 years. Results were encouraging with a low composite rate of cardiac death

  16. Evaluation of the restenosis of coronary artery after percutaneous transluminal coronary angioplasty by three-dimensional coronary magnetic resonance angiography

    International Nuclear Information System (INIS)

    Arisaka, Hiraku

    2000-01-01

    Coronary magnetic resonance angiography (MRA) has been recently brought into clinical use, however, there has not been reports on the comparison with MRA and conventional contrast coronary angiography (CAG) in the detection of the localization and characteristics of coronary restenosis after percutaneous transluminal coronary angioplasty (PTCA). To assess the restenosis of coronary artery after PTCA, this study compared three-dimensional (3D) coronary MRA and CAG. One hundred three patients (76 males and 27 females, average age of 64.6±9.3 years old) were performed coronary MRA at 3-6 months after PTCA. The right coronary artery (RCA) group consist of 21 patients, the left anterior descending branch (LAD) 63 patients and the left circumflex branch (LCX) 19 patients. Coronary MRA was performed with the patients in supine position on a 1.5 T whole body scanner (MAGNETOM VISION, Siemens AG, Germany) using body array coil. The imaging technique used a 3-D gradient echo sequence with respiratory gating and fat suppression. The slice thickness was 2 mm, slab thickness 32 mm, a field of view of 300 mm and a matrix of 128 x 256. Other parameters were an echo time of 2.7 ms and a repetition time of 600 to 1100 msec. The measurement time of 1 imaging slab took 15 to 20 minutes depending on the patient's heart rate. The coronary arteries were reconstructed from the 3-D data set using a multiplanar reconstruction (MPR) technique. According to previous coronary MRA studies, a significant stenosis with a luminal reduction of ≥50% was assumed if a marked signal reduction or signal loss of a vessel segment was visible. In CAG, 57 of 103 patients showed restenosis. In coronary MRA, 37 of 103 patients demonstrated restenosis. The sensitivity, specificity, positive and negative predictive values were 64.9%, 100%, 100% and 69.6%, respectively. Predictive accuracy was 79.6%. Three-dimensional coronary MRA is useful in a noninvasive diagnostic method to evaluate the coronary

  17. COVERED STENTS IN IATROGENIC CORONARY ARTERY FISTULA; A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Masoud Poormoghaddas

    2010-11-01

    Full Text Available Abstract    BACKGROUND: Coronary artery fistula is an abnormal communication between a coronary artery and a cardiac chamber or major cardiac vessels, mostly congenital but some of them are acquired as a consequence of coronary artery perforation.    CASE PRESENTATION: We report a case of cavity spilling coronary artery perforation during percutaneous coronary intervention 7 years ago. Because of continuing symptoms and risk of developing heart failure and pulmonary hypertension we were ought to treat this iatrogenically formed coronary artery fistula. We used stent graft implantation to treat it with acceptable results.    CONCLUSION: Beside their application as a rescue for acute coronary artery perforations, stent grafts can be used with acceptable results in iatrogenically acquired coronary artery coronary artery fistula      Keywords: Coronary artery perforation, Coronary artery fistula, Stent graft.

  18. Progress in genetics of coronary artery disease

    African Journals Online (AJOL)

    Radwa Gamal

    To the Editor. Coronary Heart Disease (CHD) is the leading cause of mortality and morbidity worldwide [1] and it is a result of coronary artery disease (CAD). Coronary artery disease refers to the build-up of atherosclerotic plaque in the blood vessels that supply oxygen and nutrients to the heart. Progressive infiltration of the ...

  19. A Stepwise Psychotherapy Intervention for Reducing Risk in Coronary Artery Disease (SPIRR-CAD): Results of an Observer-Blinded, Multicenter, Randomized Trial in Depressed Patients With Coronary Artery Disease.

    Science.gov (United States)

    Herrmann-Lingen, Christoph; Beutel, Manfred E; Bosbach, Alexandra; Deter, Hans-Christian; Fritzsche, Kurt; Hellmich, Martin; Jordan, Jochen; Jünger, Jana; Ladwig, Karl-Heinz; Michal, Matthias; Petrowski, Katja; Pieske, Burkert; Ronel, Joram; Söllner, Wolfgang; Stöhr, Andreas; Weber, Cora; de Zwaan, Martina; Albus, Christian

    2016-01-01

    Depression predicts adverse prognosis in patients with coronary artery disease (CAD), but previous treatment trials yielded mixed results. We tested the hypothesis that stepwise psychotherapy improves depressive symptoms more than simple information. In a multicenter trial, we randomized 570 CAD patients scoring higher than 7 on the Hospital Anxiety and Depression Scale-depression subscale to usual care plus either one information session (UC-IS) or stepwise psychotherapy (UC-PT). UC-PT patients received three individual psychotherapy sessions. Those still depressed were offered group psychotherapy (25 sessions). The primary outcome was changed in the Hospital Anxiety and Depression Scale-depression scores from baseline to 18 months. Preplanned subgroup analyses examined whether treatment responses differed by patients' sex and personality factors (Type D). The mean (standard deviation) depression scores declined from 10.4 (2.5) to 8.7 (4.1) at 18 months in UC-PT and from 10.4 (2.5) to 8.9 (3.9) in UC-IS (both p psychotherapy failed to improve depressive symptoms in CAD patients more than UC-IS. The intervention might be beneficial for depressed CAD patients with Type D personality. However, this finding requires further study. www.clinicaltrials.gov NCT00705965; www.isrctn.com ISRCTN76240576.

  20. Clinical presentation and management of stable coronary artery disease: insights from the international prospective CLARIFY registry - results from the Greek national cohort.

    Science.gov (United States)

    Sbarouni, Eftihia; Voudris, Vassilis; Georgiadou, Panagiota; Hamilos, Michalis; Steg, P Gabriel; Fox, Kim M; Greenlaw, Nicola; Ferrari, Roberto; Vardas, Panos E

    2014-01-01

    Coronary artery disease (CAD) is highly prevalent worldwide, yet there is a paucity of data regarding the clinical characteristics and management of outpatients with stable CAD. In this paper, we report the baseline data of the Greek cohort and we compare our national data with the global results of the entire registry, as well as the results from the western European countries. CLARIFY is an international, prospective, observational, longitudinal registry of outpatients with stable CAD, defined as prior myocardial infarction or revascularization procedure, evidence of coronary stenosis >50%, or chest pain associated with proven myocardial ischemia. A total of 33,283 patients from 45 countries in 4 continents were enrolled between November 2009 and July 2010; of these, 14,726 were from western European countries (Austria, Belgium, Denmark, France, Germany, Greece, Ireland, Italy, Netherlands, Portugal, Spain, Switzerland and the United Kingdom) and 559 patients were enrolled in Greece. Compared to their counterparts in western Europe and the entire cohort, Greeks were younger (p<0.0001, p<0.0001, respectively), more predominantly male (p<0.0039, p<0.0001), with a higher body mass index (p<0.0002, p<0.0001) and a larger waist circumference (p<0.0001, p<0.0001), as well as a higher prevalence of family history of CAD (p<0.0008, 0.0005), hyperlipidemia (p<0.0001, p<0.0001) and smoking (p<0.0001, p<0.0001). Noninvasive testing (p<0.0001, p<0.0001, respectively) and coronary angiography (p<0.0001, 0.0013) along with surgical revascularization (CABG) (p<0.0001, 0.0088) were performed more often in Greece. Antiplatelets, b-blockers and lipid lowering medications were used to an equal extent in Greece as in the other two cohorts. There are substantial differences in demographics, clinical profiles and treatment in patients with stable CAD within the data set, which are also observed for Greek data. Interestingly, these differences are consistent in relation to the global

  1. Coronary artery with aberrant origin malignant right

    International Nuclear Information System (INIS)

    Ozcan, E.; Bozlar, U.; Demirkol, S.; Saglam, M.

    2012-01-01

    Full text: Introduction: Congenital anomalies of the coronary arteries is a major cause of sudden death, especially in young patients. Objectives and tasks: In this study we aim to present a young patient with chest pain who had malignant right coronary artery (RCA) with aberrant origin. Materials and methods: 24-year-old man who applied cardiology clinic for chest pain and palpitations especially after exercise, was referred to our clinic for coronary computed tomography (CT) angiography to evaluate coronary artery anomalies. Results: In CT angiography; we detected aberrant RCA with origin of tubularly part of ascendant aorta with a malignant course between aorta and pulmonary artery. Left main coronary artery, left anterior descending and circumflex artery had normal origin and course. Conclusion: Coronary artery with malignant course may cause sudden death especially after exercise. Coronary CT angiography has an important role in diagnosis of congenital coronary artery anomalies, with high resolution multiplanner reformatted images

  2. Coronary fluorine-18-sodium fluoride uptake is increased in healthy adults with an unfavorable cardiovascular risk profile: results from the CAMONA study.

    Science.gov (United States)

    Blomberg, Björn A; Thomassen, Anders; de Jong, Pim A; Lam, Marnix G E; Diederichsen, Axel C P; Olsen, Michael H; Mickley, Hans; Mali, Willem P T M; Alavi, Abass; Høilund-Carlsen, Poul F

    2017-11-01

    Coronary artery fluorine-18-sodium fluoride (F-NaF) uptake reflects coronary artery calcification metabolism and is considered to be an early prognostic marker of coronary heart disease. This study evaluated the relationship between coronary artery F-NaF uptake and cardiovascular risk in healthy adults at low cardiovascular risk. Study participants underwent blood pressure measurements, blood analyses, and coronary artery F-NaF PET/CT imaging. In addition, the 10-year risk for the development of cardiovascular disease, on the basis of the Framingham Risk Score, was estimated. Multivariable linear regression evaluated the dependence of coronary artery F-NaF uptake on cardiovascular risk factors. We recruited 89 (47 men, 42 women) healthy adults aged 21-75 years. Female sex (0.34 kBq/ml; P=0.009), age (0.16 kBq/ml per SD; P=0.002), and BMI (0.42 kBq/ml per SD; Prisk factors present (Prisk for the development of cardiovascular disease was on average 2.4 times higher in adults with coronary artery F-NaF uptake in the highest quartile compared with those in the lowest quartile of the distribution (8.0 vs. 3.3%, Prisk and that an unfavorable cardiovascular risk profile is associated with a marked increase in coronary artery F-NaF uptake.

  3. Comparison of neurocognitive results after coronary artery bypass grafting and thoracic aortic surgery using retrograde cerebral perfusion.

    Science.gov (United States)

    Miyairi, Takeshi; Takamoto, Shinichi; Kotsuka, Yutaka; Takeuchi, Atsuko; Yamanaka, Katsuo; Sato, Hajime

    2005-07-01

    Retrograde cerebral perfusion (RCP) is used as an adjunctive method to hypothermic circulatory arrest to enhance cerebral protection in patients undergoing thoracic aortic surgery. It remains unclear whether RCP provides improved neurological and neuropsychological outcome. Forty-six patients undergoing thoracic aortic surgery using RCP, and 28 undergoing coronary artery bypass grafting (CABG; n = 28) with CPB, were enrolled in the study. Patients receiving RCP were subdivided into two groups, those with less than 60 min of RCP (S-RCP; n = 27) and with 60 min or more (L-RCP; n = 19). The patients' neurocognitive state was assessed by the revised Wechsler Adult Intelligence Scale a few days before operation, at 2-3 weeks and 4-6 months after operation. There were no stroke, seizure, and hospital mortality in either group. Significant decline between baseline and early scores were seen in three subtests (digit span, arithmetic, and picture completion) for S-RCP and four (digit span, arithmetic, picture completion, and picture arrangement) for L-RCP. Significant decline between baseline and late scores were seen in one subtest (arithmetic) for S-RCP, four (digit span, arithmetic, picture completion, and picture arrangement) for L-RCP, and one (object assembly) for CABG. The mean change of scores for one late test (digit symbol) was significantly lower in S-RCP than in CABG. The mean change of scores for three early tests (digit span, vocabulary, and picture arrangement) and four late tests (information, digit span, picture completion, and picture arrangement) were significantly lower in L-RCP than in CABG. Stepwise logistic regression analysis disclosed that, after considering the other variables, significant difference in test score changes were observed between CABG and L-RCP for two early tests (picture completion and digit symbol) as well as for three late tests (digit span, similarities, and picture completion). None of test score changes showed significant

  4. Cost implications of intraprocedural thrombotic events and bleeding in percutaneous coronary intervention: Results from the CHAMPION PHOENIX ECONOMICS Study.

    Science.gov (United States)

    Tamez, Hector; Généreux, Philip; Yeh, Robert W; Amin, Amit P; Fan, Weihong; White, Harvey D; Kirtane, Ajay J; Stone, Gregg W; Gibson, C Michael; Harrington, Robert A; Bhatt, Deepak L; Pinto, Duane S

    2018-05-04

    Despite improvements in percutaneous coronary intervention (PCI), intraprocedural thrombotic events (IPTE) and bleeding complications occur and are prognostically important. These have not been included in prior economic studies. PHOENIX ECONOMICS was a substudy of the CHAMPION PHOENIX trial, evaluating cangrelor during PCI. Hospital bills were reviewed from 1,171 patients enrolled at 22 of 63 US sites. Costs were estimated using standard methods including resource-based accounting, hospital billing data, and the Medicare fee schedule. Bleeding and IPTE, defined as abrupt vessel closure (transient or sustained), new/suspected thrombus, new clot on wire/catheter, no reflow, side-branch occlusion, procedural stent thrombosis or urgent need for CABG were identified. Costs were calculated according to whether a complication occurred and type of event. Multivariate analyses were used to estimate the incremental costs of IPTE and postprocedural events. IPTE occurred in 4.3% and were associated with higher catheterization laboratory and overall index hospitalization costs by $2,734 (95%CI $1,117, $4,351; P = 0.001) and $6,354 (95% CI $4,122, $8,586; P < 0.001), respectively. IPTE were associated with MI (35.4% vs. 3.6%; P < 0.001), out-of-laboratory stent thrombosis (4.2% vs. 0.1%; 0 = 0.005), ischemia driven revascularization (12.5% vs. 0.3%; P < 0.001), but not mortality (2.1% vs. 0.2%; P = 0.12) vs. no procedural thrombotic complication. By comparison, ACUITY minor bleeding increased hospitalization cost by $1,416 (95%CI = 312, $2,519; P = 0.012). ACUITY major bleeding increased cost of hospitalization by $7,894 (95%CI $4,154, $11,635; P < 0.001). IPTE and bleeding complications, though infrequent, are associated with substantial increased cost. These complications should be collected in economic assessments of PCI. © 2018 Wiley Periodicals, Inc.

  5. Scanner qualification with IntenCD based reticle error correction

    Science.gov (United States)

    Elblinger, Yair; Finders, Jo; Demarteau, Marcel; Wismans, Onno; Minnaert Janssen, Ingrid; Duray, Frank; Ben Yishai, Michael; Mangan, Shmoolik; Cohen, Yaron; Parizat, Ziv; Attal, Shay; Polonsky, Netanel; Englard, Ilan

    2010-03-01

    Scanner introduction into the fab production environment is a challenging task. An efficient evaluation of scanner performance matrices during factory acceptance test (FAT) and later on during site acceptance test (SAT) is crucial for minimizing the cycle time for pre and post production-start activities. If done effectively, the matrices of base line performance established during the SAT are used as a reference for scanner performance and fleet matching monitoring and maintenance in the fab environment. Key elements which can influence the cycle time of the SAT, FAT and maintenance cycles are the imaging, process and mask characterizations involved with those cycles. Discrete mask measurement techniques are currently in use to create across-mask CDU maps. By subtracting these maps from their final wafer measurement CDU map counterparts, it is possible to assess the real scanner induced printed errors within certain limitations. The current discrete measurement methods are time consuming and some techniques also overlook mask based effects other than line width variations, such as transmission and phase variations, all of which influence the final printed CD variability. Applied Materials Aera2TM mask inspection tool with IntenCDTM technology can scan the mask at high speed, offer full mask coverage and accurate assessment of all masks induced source of errors simultaneously, making it beneficial for scanner qualifications and performance monitoring. In this paper we report on a study that was done to improve a scanner introduction and qualification process using the IntenCD application to map the mask induced CD non uniformity. We will present the results of six scanners in production and discuss the benefits of the new method.

  6. Coastal Zone Color Scanner studies

    Science.gov (United States)

    Elrod, J.

    1988-01-01

    Activities over the past year have included cooperative work with a summer faculty fellow using the Coastal Zone Color Scanner (CZCS) imagery to study the effects of gradients in trophic resources on coral reefs in the Caribbean. Other research included characterization of ocean radiances specific to an acid-waste plume. Other activities include involvement in the quality control of imagery produced in the processing of the global CZCS data set, the collection of various other data global sets, and the subsequent data comparison and analysis.

  7. Optimal medical therapy for secondary prevention after an acute coronary syndrome: 18-month follow-up results at a tertiary teaching hospital in South Korea

    Directory of Open Access Journals (Sweden)

    Byeon HJ

    2016-02-01

    Full Text Available Hee Ja Byeon,1,* Young-Mo Yang,2,* Eun Joo Choi21Department of Pharmacy, Chosun University Hospital, 2Department of Pharmacy, College of Pharmacy, Chosun University, Gwangju, South Korea*These authors contributed equally to this workBackground: Acute coronary syndrome (ACS is a fatal cardiovascular disease caused by atherosclerotic plaque erosion or rupture and formation of coronary thrombus. The latest guidelines for ACS recommend the combined drug regimen, comprising aspirin, P2Y12 inhibitor, angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker, β-blocker, and statin, at discharge after ACS treatment to reduce recurrent ischemic cardiovascular events. This study aimed to examine prescription patterns of secondary prevention drugs in Korean patients with ACS after hospital discharge, to access the appropriateness of secondary prevention drug therapy for ACS, and to evaluate whether to persistently use discharge medications for 18 months.Methods: This study was retrospectively conducted with the patients who were discharged from the tertiary hospital, located in South Korea, after ACS treatment between September 2009 and August 2013. Data were collected through electronic medical record.Results: Among 3,676 patients during the study period, 494 were selected based on inclusion and exclusion criteria. The regimen of aspirin + clopidogrel + β-blocker + angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker + statin was prescribed to 374 (75.71% patients with ACS at discharge. Specifically, this regimen was used in 177 (69.69% unstable angina patients, 44 (70.97% non-ST-segment elevation myocardial infarction patients, and 153 (85.96% ST-segment elevation myocardial infarction patients. Compared with the number of ACS patients with all five guideline-recommended drugs at discharge, the number of ACS patients using them 12 (n=169, 34.21% and 18 (n=105, 21.26% months after discharge tended to be gradually

  8. The value of coronary artery calcium score assessed by dual-source computed tomography coronary angiography for predicting presence and severity of coronary artery disease

    International Nuclear Information System (INIS)

    Almasi, Alireza; Pouraliakbar, Hamidreza; Sedghian, Ahmad; Karimi, Mohammad Ali; Firouzi, Ata; Tehrai, Mahmood

    2014-01-01

    Measuring coronary artery calcium score (CACS) using a dual-source CT scanner is recognized as a major indicator for assessing coronary artery disease. The present study aimed to validate the clinical significance of CACS in predicting coronary artery stenosis and its severity. This prospective study was conducted on 202 consecutive patients who underwent both conventional coronary angiography and dual-source (256-slice) computed tomography coronary angiography (CTA) for any reason in our cardiac imaging center from March to September 2013. CACS was measured by Agatston algorithm on non-enhanced CT. The severity of coronary artery disease was assessed by Gensini score on conventional angiography. There was a significant relationship between the number of diseased coronary vessels and mean calcium score, i.e. the mean calcium score was 202.25±450.06 in normal coronary status, 427.50±607.24 in single-vessel disease, 590.03±511.34 in two-vessel disease, and 953.35±1023.45 in three-vessel disease (p<0.001). There was a positive association between calcium score and Gensini score (r=0.636, p<0.001). In a linear regression model, calcium score was a strong determinant of the severity of coronary artery disease. Calcium scoring had an acceptable value for discriminating coronary disease from normal condition with optimal cutoff point of 350, yielding a sensitivity and specificity of 83% and 70%, respectively. Our study confirmed the strong relationship between the coronary artery calcium score and the presence and severity of stenosis in coronary arteries assessed by both the number of diseased coronary vessels and also by the Gnesini score

  9. Comportamento da síndrome coronariana aguda: resultados de um registro brasileiro Acute coronary syndrome behavior: results of a Brazilian registry

    Directory of Open Access Journals (Sweden)

    Leopoldo Soares Piegas

    2013-01-01

    ão ajudar a promover um melhor planejamento e manejo do atendimento da síndrome coronariana aguda a nível público e privado.BACKGROUND: Brazil lacks published multicenter registries of acute coronary syndrome. OBJECTIVE: The Brazilian Registry of Acute Coronary Syndrome is a multicenter national study aiming at providing data on clinical aspects, management and hospital outcomes of acute coronary syndrome in our country. METHODS: A total of 23 hospitals from 14 cities, participated in this study. Eligible patients were those who came to the emergency wards with suspected acute coronary syndrome within the first 24 hours of symptom onset, associated with compatible electrocardiographic alterations and/or altered necrosis biomarkers. Follow-up lasted until hospital discharge or death, whichever occurred first. RESULTS: Between 2003 and 2008, 2,693 ACS patients were enrolled, of which 864 (32.1% were females. T he final diagnosis was unstable angina in 1,141 patients, (42.4%, with a mortality rate of 3.06%, non-ST elevation acute myocardial infarction (AMI in 529 (19.6%, with mortality of 6.8%, ST-elevation AMI 950 (35.3%, with mortality of 8.1% and non-confirmed diagnosis 73 (2.7%, with mortality of 1.36%. The overall mortality was 5.53%. The multiple logistic regression model identified the following as risk factors for death regarding demographic factors and interventions: female gender (OR=1.45, diabetes mellitus (OR=1.59, body mass index (OR=1.27 and percutaneous coronary intervention (OR=0.70. A second model for death due to major complications identified: cardiogenic shock/acute pulmonary edema (OR=4.57, reinfarction (OR=3.48, stroke (OR=21.56, major bleeding (OR=3.33, cardiopulmonary arrest (OR=40.27 and Killip functional class (OR=3.37. CONCLUSION: The Brazilian Registry of Acute Coronary Syndrome data do not differ from other data collected abroad. The understanding of their findings may help promote better planning and management of acute coronary syndrome care

  10. Non-invasive prediction of hemodynamically significant coronary artery stenoses by contrast density difference in coronary CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Hell, Michaela M., E-mail: michaela.hell@uk-erlangen.de [Department of Cardiology, University of Erlangen (Germany); Dey, Damini [Department of Biomedical Sciences, Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Taper Building, Room A238, 8700 Beverly Boulevard, Los Angeles, CA 90048 (United States); Marwan, Mohamed; Achenbach, Stephan; Schmid, Jasmin; Schuhbaeck, Annika [Department of Cardiology, University of Erlangen (Germany)

    2015-08-15

    Highlights: • Overestimation of coronary lesions by coronary computed tomography angiography and subsequent unnecessary invasive coronary angiography and revascularization is a concern. • Differences in plaque characteristics and contrast density difference between hemodynamically significant and non-significant stenoses, as defined by invasive fractional flow reserve, were assessed. • At a threshold of ≥24%, contrast density difference predicted hemodynamically significant lesions with a specificity of 75%, sensitivity of 33%, PPV of 35% and NPV of 73%. • The determination of contrast density difference required less time than transluminal attenuation gradient measurement. - Abstract: Objectives: Coronary computed tomography angiography (CTA) allows the detection of obstructive coronary artery disease. However, its ability to predict the hemodynamic significance of stenoses is limited. We assessed differences in plaque characteristics and contrast density difference between hemodynamically significant and non-significant stenoses, as defined by invasive fractional flow reserve (FFR). Methods: Lesion characteristics of 59 consecutive patients (72 lesions) in whom invasive FFR was performed in at least one coronary artery with moderate to high-grade stenoses in coronary CTA were evaluated by two experienced readers. Coronary CTA data sets were acquired on a second-generation dual-source CT scanner using retrospectively ECG-gated spiral acquisition or prospectively ECG-triggered axial acquisition mode. Plaque volume and composition (non-calcified, calcified), remodeling index as well as contrast density difference (defined as the percentage decline in luminal CT attenuation/cross-sectional area over the lesion) were assessed using a semi-automatic software tool (Autoplaq). Additionally, the transluminal attenuation gradient (defined as the linear regression coefficient between intraluminal CT attenuation and length from the ostium) was determined

  11. Coronary artery wall imaging in mice using osmium tetroxide and micro-computed tomography (micro-CT)

    International Nuclear Information System (INIS)

    Pai, Vinay M.; Kozlowski, Megan; Donahue, Danielle; Miller, Elishiah; Xiao, Xianghui; Chen, Marcus Y.; Yu, Zu-Xi; Connelly, Patricia; Jeffries, Kenneth; Wen, Han

    2012-01-01

    The high spatial resolution of micro-computed tomography (micro-CT) is ideal for 3D imaging of coronary arteries in intact mouse heart specimens. Previously, micro-CT of mouse heart specimens utilized intravascular contrast agents that hardened within the vessel lumen and allowed a vascular cast to be made. However, for mouse coronary artery disease models, it is highly desirable to image coronary artery walls and highlight plaques. For this purpose, we describe an ex vivo contrast-enhanced micro-CT imaging technique based on tissue staining with osmium tetroxide (OsO 4 ) solution. As a tissue-staining contrast agent, OsO 4 is retained in the vessel wall and surrounding tissue during the fixation process and cleared from the vessel lumens. Its high X-ray attenuation makes the artery wall visible in CT. Additionally, since OsO 4 preferentially binds to lipids, it highlights lipid deposition in the artery wall. We performed micro-CT of heart specimens of 5- to 25-week-old C57BL/6 wild-type mice and 5- to 13-week-old apolipoprotein E knockout (apoE -/- ) mice at 10 μm resolution. The results show that walls of coronary arteries as small as 45 μm in diameter are visible using a table-top micro-CT scanner. Similar image clarity was achieved with 1/2000th the scan time using a synchrotron CT scanner. In 13-week-old apoE mice, lipid-rich plaques are visible in the aorta. Our study shows that the combination of OsO 4 and micro-CT permits the visualization of the coronary artery wall in intact mouse hearts.

  12. Multislice computed tomography: angiographic emulation versus standard assessment for detection of coronary stenoses

    Energy Technology Data Exchange (ETDEWEB)

    Schnapauff, Dirk; Hamm, Bernd; Dewey, Marc [Humboldt-Universitaet zu Berlin, Department of Radiology, Charite - Universitaetsmedizin Berlin, Chariteplatz 1, P.O. Box 10098, Berlin (Germany); Duebel, Hans-Peter; Baumann, Gert [Charite - Universitaetsmedizin Berlin, Department of Cardiology, Berlin (Germany); Scholze, Juergen [Charite - Universitaetsmedizin Berlin, Charite Outpatient Centre, Berlin (Germany)

    2007-07-15

    The present study investigated angiographic emulation of multislice computed tomography (MSCT) (catheter-like visualization) as an alternative approach of analyzing and visualizing findings in comparison with standard assessment. Thirty patients (120 coronary arteries) were randomly selected from 90 prospectively investigated patients with suspected coronary artery disease who underwent MSCT (16-slice scanner, 0.5 mm collimation, 400 ms rotation time) prior to conventional coronary angiography for comparison of both approaches. Sensitivity and specificity of angiographic emulation [81% (26/32) and 93% (82/88)] were not significantly different from those of standard assessment [88% (28/32) and 99% (87/88)], while the per-case analysis time was significantly shorter for angiographic emulation than for standard assessment (3.4 {+-} 1.5 vs 7.0 {+-} 2.5 min, P < 0.001). Both interventional and referring cardiologists preferred angiographic emulation over standard curved multiplanar reformations of MSCT coronary angiography for illustration, mainly because of improved overall lucidity and depiction of sidebranches (P < 0.001). In conclusion, angiographic emulation of MSCT reduces analysis time, yields a diagnostic accuracy comparable to that of standard assessment, and is preferred by cardiologists for visualization of results. (orig.)

  13. Detection of coronary artery calcification with non triggered computed tomography of the chest

    Energy Technology Data Exchange (ETDEWEB)

    Pelandré, Gustavo Lemos; Sanches, Nathália Martins Pereira, E-mail: gustavo.pelandre@ufsc.br [Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC (Brazil); Nacif, Marcelo Souto [Universidade Federal Fluminense (UFF), Niterói, RJ (Brazil); Marchiori, Edson [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil)

    2018-01-15

    Objective: To evaluate the accuracy of visual analysis and of the coronary artery calcium (CAC) score in non triggered computed tomography (CT), in comparison with that of the CAC score in electrocardiogram-triggered CT, in identifying coronary calcification. Materials and methods: A total of 174 patients for whom CT was indicated for CAC scoring underwent non triggered and triggered CT in a 64-channel multislice scanner, in a single session without a change in position. The images were interpreted by a radiologist with seven years of experience in thoracic and cardiovascular radiology. The measurement of coronary calcium was carried out by three methods: CAC score with dedicated software in non triggered CT, CAC score with dedicated software in triggered CT, and visual analysis without dedicated software in non triggered CT. Results: In non triggered CT, the CAC score presented an accuracy of 95.98% (95% CI: 91.93 - 98.04). The visual analysis showed an accuracy of 97.13% (95% CI: 93.45 - 98.77). Conclusion: Non triggered CT showed excellent accuracy in the identification and exclusion of coronary calcification, either the CAC score was determined with dedicated software or through visual analysis. (author)

  14. Gamma scanner conceptual design report

    International Nuclear Information System (INIS)

    Swinth, K.L.

    1979-11-01

    The Fuels and Materials Examination Facility (FMEF) will include several stations for the nondestructive examination of irradiated fuels. One of these stations will be the gamma scanner which will be employed to detect gamma radiation from the irradiated fuel pins. The conceptual design of the gamma scan station is described. The gamma scanner will use a Standard Exam Stage (SES) as a positioner and transport mechanism for the fuel pins which it will obtain from a magazine. A pin guide mechanism mounted on the face of the collimator will assure that the fuel pins remain in front of the collimator during scanning. The collimator has remotely adjustable tungsten slits and can be manually rotated to align the slit at various angles. A shielded detector cart located in the operating corridor holds an intrinsic germanium detector and associated sodium-iodide anticoincidence detector. The electronics associated with the counting system consist of standard NIM modules to process the detector signals and a stand-alone multichannel analyzer (MCA) for counting data accumulation. Data from the MCA are bussed to the station computer for analysis and storage on magnetic tape. The station computer controls the collimator, the MCA, a source positioner and the SES through CAMAC-based interface hardware. Most of the electronic hardware is commercially available but some interfaces will require development. Conceptual drawings are included for mechanical hardware that must be designed and fabricated

  15. Achievement of optimal medical therapy goals for U.S. adults with coronary artery disease: results from the REGARDS Study (REasons for Geographic And Racial Differences in Stroke).

    Science.gov (United States)

    Brown, Todd M; Voeks, Jenifer H; Bittner, Vera; Brenner, David A; Cushman, Mary; Goff, David C; Glasser, Stephen; Muntner, Paul; Tabereaux, Paul B; Safford, Monika M

    2014-04-29

    In a nonclinical trial setting, we sought to determine the proportion of individuals with coronary artery disease (CAD) with optimal risk factor levels based on the COURAGE (Clinical Outcomes Utilizing Revascularization and Aggressive DruG Evaluation) trial. In the COURAGE trial, the addition of percutaneous coronary intervention (PCI) to optimal medical therapy did not reduce the risk of death or myocardial infarction in stable CAD patients but resulted in more revascularization procedures. The REGARDS (REasons for Geographic And Racial Differences in Stroke) study is a national prospective cohort study of 30,239 African-American and white community-dwelling individuals older than 45 years of age who enrolled in 2003 through 2007. We calculated the proportion of 3,167 participants with self-reported CAD meeting 7 risk factor goals based on the COURAGE trial: 1) aspirin use; 2) systolic blood pressure 40 mg/dl, and triglycerides exercise ≥4 days per week. The mean age of participants was 69 ± 9 years; 33% were African American and 35% were female. Overall, the median number of goals met was 4. Less than one-fourth met ≥5 of the 7 goals, and 16% met all 3 goals for aspirin, blood pressure, and low-density lipoprotein cholesterol. Older age, white race, higher income, more education, and higher physical functioning were independently associated with meeting more goals. There is substantial room for improvement in risk factor reduction among U.S. individuals with CAD. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  16. Sub-xyphoid pleural drain as a determinant of functional capacity and clinical results after off-pump coronary artery bypass surgery: a randomized clinical trial.

    Science.gov (United States)

    Guizilini, Solange; Alves, Daniel F; Bolzan, Douglas W; Cancio, Andreia S A; Regenga, Marisa M; Moreira, Rita S L; Trimer, Renata; Gomes, Walter J

    2014-09-01

    The aim of this trial was to compare functional capacity, pulmonary shunt fraction and clinical outcomes between patients undergoing pleurotomy with a pleural drain inserted in the sub-xyphoid position and patients with a pleural drain placed in the intercostal position after off-pump coronary artery bypass surgery. Patients were randomized into two groups according to the pleural drain site: Group II (n = 33 intercostal pleural drain); and Group SI (n = 35 sub-xyphoid pleural drain). Functional capacity was assessed by the distance covered on the 6-min walking test performed preoperatively and on postoperative day (POD) 5; in addition, pulmonary function test was determined preoperatively and on POD 1 and 5. Pulmonary shunt fraction was evaluated preoperatively and on POD 1, and clinical outcomes were recorded throughout the study. Group SI had better preservation of lung volumes and capacities in POD compared with Group II (P Pulmonary shunt fraction increased in both groups postoperatively; however, Group SI showed a smaller pulmonary shunt fraction (0.26 ± 0.04 vs 0.21 ± 0.04%; P = 0.0014). Functional capacity was significantly reduced in both groups on POD 5; however, Group SI showed better preservation of functional capacity (P = 0.0001). Group SI had better postoperative clinical results, with lower incidence of atelectasis and pleural effusion (P capacity and exercise tolerance with a smaller pulmonary shunt fraction and improved clinical outcomes compared with intercostal pleural drainage after off-pump coronary artery bypass surgery. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  17. A multicenter post-marketing evaluation of the Elixir DESolve® Novolimus-eluting bioresorbable coronary scaffold system: First results from the DESolve PMCF study.

    Science.gov (United States)

    Nef, Holger; Wiebe, Jens; Boeder, Niklas; Dörr, Oliver; Bauer, Timm; Hauptmann, Karl-Eugen; Latib, Azeem; Colombo, Antonio; Fischer, Dieter; Rudolph, Tanja; Foin, Nicolas; Richardt, Gert; Hamm, Christian

    2018-03-06

    To date, experience with bioresorbable scaffolds (BRS) that elute agents other than everolimus is limited. Thus, a post-marketing clinical follow-up study was conducted to evaluate the continued safety and effectiveness of the DESolve® NOVOLIMUS™ Eluting BRS as treatment for patients with stable coronary artery disease. The DESolve BRS combines a poly-l-lactide-based backbone with a biodegradable polylactide-based polymer and Novolimus, a macrocyclic lactone mTOR inhibitor. One hundred and two patients (mean age 62 years, 77.5% male) were enrolled at 10 European sites. Comparison of baseline and post-procedural angiographic assessment was performed, and a device-oriented composite endpoint (comprising cardiac death, target vessel myocardial infarction, and clinically driven target lesion revascularization) and rate of scaffold thrombosis at 12 months were examined. The device was successfully delivered and deployed in 98.2% (107/109) of the lesions, with two failures to cross the lesion. A total of 100 patients (109 lesions) were treated with a DESolve BRS. Post-procedural angiographic assessment indicated an in-scaffold acute gain of 1.54 ± 0.44 mm, with a reduction in % diameter stenosis from 61.00 ± 11.29 to 12.69 ± 0.44. At 12 months, the device-oriented composite endpoint had occurred in 3.0% (3/100) of patients, with 1.0% (1/100) experiencing scaffold thrombosis and myocardial infarction and 3.0% (3/100) undergoing target lesion revascularization. There were no cardiac deaths. Results through 12 months indicate that the DESolve BRS is a safe and effective treatment for coronary lesions, though larger, long-term prospective studies are needed. © 2018 Wiley Periodicals, Inc.

  18. Radiation exposure and contrast agent use related to radial versus femoral arterial access during percutaneous coronary intervention (PCI)—Results of the FERARI study

    Energy Technology Data Exchange (ETDEWEB)

    Becher, Tobias, E-mail: Tobias.Becher@umm.de [First Department of Medicine, University Medical Centre Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany); DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany); Behnes, Michael; Ünsal, Melike; Baumann, Stefan; El-Battrawy, Ibrahim; Fastner, Christian; Kuschyk, Jürgen; Papavassiliu, Theano; Hoffmann, Ursula [First Department of Medicine, University Medical Centre Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany); DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany); Mashayekhi, Kambis [Division of Cardiology and Angiology II, University Heart Center Freiburg Bad Krozingen, Bad Krozingen (Germany); Borggrefe, Martin; Akin, Ibrahim [First Department of Medicine, University Medical Centre Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany); DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim (Germany)

    2016-12-15

    Summary: Background: Data regarding radiation exposure related to radial versus femoral arterial access in patients undergoing percutaneous coronary intervention (PCI) remain controversial. This study aims to evaluate patients enrolled in the FERARI study regarding radiation exposure, fluoroscopy time and contrast agent use. Methods: The Femoral Closure versus Radial Compression Devices Related to Percutaneous Coronary Interventions (FERARI) study evaluated prospectively 400 patients between February 2014 and May 2015 undergoing PCI either using the radial or femoral access. In these 400 patients, baseline characteristics, procedural data such as procedural duration, fluoroscopy time, dose–area product (DAP) as well as the amount of contrast agent used were documented and analyzed. Results: Median fluoroscopy time was not significantly different in patients undergoing radial versus femoral access (12.2 vs. 9.8 min, p = 0.507). Furthermore, median DAP (54.5 vs. 52.0 Gycm2, p = 0.826), procedural duration (46.0 vs. 45.0 min, p = 0.363) and contrast agent use (185.5 vs. 199.5 ml, p = 0.742) were also similar in radial and femoral PCI. Conclusion: There was no difference regarding median fluoroscopy time, procedural duration, radiation dose or contrast agent use between radial versus femoral arterial access in PCI. - Highlights: • Data comparing radiation exposure in radial versus femoral PCI remain controversial. • 400 enrolled in the FERARI study were prospectively evaluated. • There was no difference regarding radiation exposure in radial versus femoral access. • Furthermore, there was no significant difference regarding contrast agent use.

  19. Radiation exposure and contrast agent use related to radial versus femoral arterial access during percutaneous coronary intervention (PCI)—Results of the FERARI study

    International Nuclear Information System (INIS)

    Becher, Tobias; Behnes, Michael; Ünsal, Melike; Baumann, Stefan; El-Battrawy, Ibrahim; Fastner, Christian; Kuschyk, Jürgen; Papavassiliu, Theano; Hoffmann, Ursula; Mashayekhi, Kambis; Borggrefe, Martin; Akin, Ibrahim

    2016-01-01

    Summary: Background: Data regarding radiation exposure related to radial versus femoral arterial access in patients undergoing percutaneous coronary intervention (PCI) remain controversial. This study aims to evaluate patients enrolled in the FERARI study regarding radiation exposure, fluoroscopy time and contrast agent use. Methods: The Femoral Closure versus Radial Compression Devices Related to Percutaneous Coronary Interventions (FERARI) study evaluated prospectively 400 patients between February 2014 and May 2015 undergoing PCI either using the radial or femoral access. In these 400 patients, baseline characteristics, procedural data such as procedural duration, fluoroscopy time, dose–area product (DAP) as well as the amount of contrast agent used were documented and analyzed. Results: Median fluoroscopy time was not significantly different in patients undergoing radial versus femoral access (12.2 vs. 9.8 min, p = 0.507). Furthermore, median DAP (54.5 vs. 52.0 Gycm2, p = 0.826), procedural duration (46.0 vs. 45.0 min, p = 0.363) and contrast agent use (185.5 vs. 199.5 ml, p = 0.742) were also similar in radial and femoral PCI. Conclusion: There was no difference regarding median fluoroscopy time, procedural duration, radiation dose or contrast agent use between radial versus femoral arterial access in PCI. - Highlights: • Data comparing radiation exposure in radial versus femoral PCI remain controversial. • 400 enrolled in the FERARI study were prospectively evaluated. • There was no difference regarding radiation exposure in radial versus femoral access. • Furthermore, there was no significant difference regarding contrast agent use

  20. Experience with a fuel rod enrichment scanner

    International Nuclear Information System (INIS)

    Kubik, R.N.; Pettus, W.G.

    1975-01-01

    This enrichment scanner views all fuel rods produced at B and W's Commercial Nuclear Fuel Plant. The scanner design is derived from the PAPAS System reported by R. A. Forster, H. D. Menlove, and their associates at Los Alamos. The spatial resolution of the system and smoothing of the data are discussed in detail. The cost-effectiveness of multi-detector versus single detector scanners of this general design is also discussed

  1. High-picture quality industrial CT scanner

    International Nuclear Information System (INIS)

    Shoji, Takao; Nishide, Akihiko; Fujii, Masashi.

    1989-01-01

    Industrial X-ray-CT-scanners, which provide cross-sectional images of a tested sample without destroying it, are attracting attention as a new nondestructive inspection device. In 1982, Toshiba commenced the development of industrial CT scanners, and introduced the 'TOSCANER' -3000 and-4000 series. Now, the state of the art 'TOSCANER'-20000 series of CT systems has been developed incorporating the latest computer tomography and image processing technology, such as the T9506 image processor. One of the advantages of this system is its applicability to a wide range of X-ray energy . The 'TOSCANER'-20000 series can be utilized for inspecting castings and other materials with relatively low-transparency to X-rays, as well as ceramics, composite materials and other materials with high X-ray transparency. A further feature of the new system is its high-picture quality, with a high-spatial resolution resulting from a pixel size of 0.2x0.2(mm). (author)

  2. Miniaturized Fourier-plane fiber scanner for OCT endoscopy

    International Nuclear Information System (INIS)

    Vilches, Sergio; Kretschmer, Simon; Ataman, Çağlar; Zappe, Hans

    2017-01-01

    A forward-looking endoscopic optical coherence tomography (OCT) probe featuring a Fourier-plane fiber scanner is designed, manufactured and characterized. In contrast to common image-plane fiber scanners, the Fourier-plane scanner is a telecentric arrangement that eliminates vignetting and spatial resolution variations across the image plane. To scan the OCT beam in a spiral pattern, a tubular piezoelectric actuator is used to resonate an optical fiber bearing a collimating GRIN lens at its tip. The free-end of the GRIN lens sits at the back focal plane of an objective lens, such that its rotation replicates the beam angles in the collimated region of a classical telecentric 4f optical system. Such an optical arrangement inherently has a low numerical aperture combined with a relatively large field-of-view, rendering it particularly useful for endoscopic OCT imaging. Furthermore, the optical train of the Fourier-plane scanner is shorter than that of a comparable image-plane scanner by one focal length of the objective lens, significantly shortening the final arrangement. As a result, enclosed within a 3D printed housing of 2.5 mm outer diameter and 15 mm total length, the developed probe is the most compact forward-looking endoscopic OCT imager to date. Due to its compact form factor and compatibility with real-time OCT imaging, the developed probe is also ideal for use in the working channel of flexible endoscopes as a potential optical biopsy tool. (paper)

  3. Miniaturized Fourier-plane fiber scanner for OCT endoscopy

    Science.gov (United States)

    Vilches, Sergio; Kretschmer, Simon; Ataman, Çağlar; Zappe, Hans

    2017-10-01

    A forward-looking endoscopic optical coherence tomography (OCT) probe featuring a Fourier-plane fiber scanner is designed, manufactured and characterized. In contrast to common image-plane fiber scanners, the Fourier-plane scanner is a telecentric arrangement that eliminates vignetting and spatial resolution variations across the image plane. To scan the OCT beam in a spiral pattern, a tubular piezoelectric actuator is used to resonate an optical fiber bearing a collimating GRIN lens at its tip. The free-end of the GRIN lens sits at the back focal plane of an objective lens, such that its rotation replicates the beam angles in the collimated region of a classical telecentric 4f optical system. Such an optical arrangement inherently has a low numerical aperture combined with a relatively large field-of-view, rendering it particularly useful for endoscopic OCT imaging. Furthermore, the optical train of the Fourier-plane scanner is shorter than that of a comparable image-plane scanner by one focal length of the objective lens, significantly shortening the final arrangement. As a result, enclosed within a 3D printed housing of 2.5 mm outer diameter and 15 mm total length, the developed probe is the most compact forward-looking endoscopic OCT imager to date. Due to its compact form factor and compatibility with real-time OCT imaging, the developed probe is also ideal for use in the working channel of flexible endoscopes as a potential optical biopsy tool.

  4. Optimization of coronary attenuation in coronary computed tomography angiography using diluted contrast material.

    Science.gov (United States)

    Kawaguchi, Naoto; Kurata, Akira; Kido, Teruhito; Nishiyama, Yoshiko; Kido, Tomoyuki; Miyagawa, Masao; Ogimoto, Akiyoshi; Mochizuki, Teruhito

    2014-01-01

    The purpose of this study was to evaluate a personalized protocol with diluted contrast material (CM) for coronary computed tomography angiography (CTA). One hundred patients with suspected coronary artery disease underwent retrospective electrocardiogram-gated coronary CTA on a 256-slice multidetector-row CT scanner. In the diluted CM protocol (n=50), the optimal scan timing and CM dilution rate were determined by the timing bolus scan, with 20% CM dilution (5ml/s during 10s) being considered suitable to achieve the target arterial attenuation of 350 Hounsfield units (HU). In the body weight (BW)-adjusted protocol (n=50, 222mg iodine/kg), only the optimal scan timing was determined by the timing bolus scan. The injection rate and volume in the timing bolus scan and real scan were identical between the 2 protocols. We compared the means and variations in coronary attenuation between the 2 protocols. Coronary attenuation (mean±SD) in the diluted CM and BW-adjusted protocols was 346.1±23.9 HU and 298.8±45.2 HU, respectively. The diluted CM protocol provided significantly higher coronary attenuation and lower variance than did the BW-adjusted protocol (P<0.05, in each). The diluted CM protocol facilitates more uniform attenuation on coronary CTA in comparison with the BW-adjusted protocol.  

  5. Is metabolic syndrome predictive of prevalence, extent, and risk of coronary artery disease beyond its components? results from the multinational coronary ct angiography evaluation for clinical outcome: An international multicenter registry (confirm) : An international multicenter registry (confirm)

    NARCIS (Netherlands)

    A. Ahmadi (Amir); J. Leipsic (Jonathon); G.M. Feuchtner (Gudrun); H. Gransar (Heidi); Kalra, D. (Dan); R. Heo (Ran); S. Achenbach (Stephan); D. Andreini (Daniele); M. Al-Mallah (Mouaz); D.S. Berman (Daniel S.); M.J. Budoff (Matthew); F. Cademartiri (Filippo); T.Q. Callister (Tracy); H.-J. Chang (Hyuk-Jae); K. Chinnaiyan (Kavitha); B.J.W. Chow (Benjamin); R.C. Cury (Ricardo); A. Delago (Augustin); M. Gomez (Millie); M. Hadamitzky (Martin); J. Hausleiter (Jörg); N. Hindoyan (Niree); P.A. Kaufmann (Philipp); Y.-J. Kim (Yong-Jin); F.Y. Lin (Fay); E. Maffei (Erica); G. Pontone (Gianluca); G.L. Raff (Gilbert); L.J. Shaw (Leslee); T.C. Villines (Todd); A.M. Dunning (Allison M.); J.K. Min (James)

    2015-01-01

    textabstractAlthough metabolic syndrome is associated with increased risk of cardiovascular disease and events, its added prognostic value beyond its components remains unknown. This study compared the prevalence, severity of coronary artery disease (CAD), and prognosis of patients with metabolic

  6. Robotic Prostate Biopsy in Closed MRI Scanner

    National Research Council Canada - National Science Library

    Fischer, Gregory

    2008-01-01

    .... This work enables prostate brachytherapy and biopsy procedures in standard high-field diagnostic MRI scanners through the development of a robotic needle placement device specifically designed...

  7. Heparin monotherapy or bivalirudin during percutaneous coronary intervention in patients with non-ST-segment-elevation acute coronary syndromes or stable ischemic heart disease: results from the Evaluation of Drug-Eluting Stents and Ischemic Events registry.

    Science.gov (United States)

    Bangalore, Sripal; Pencina, Michael J; Kleiman, Neal S; Cohen, David J

    2014-06-01

    The use of bivalirudin versus unfractionated heparin monotherapy in patients without ST-segment-elevation myocardial infarction is not well defined. The study population consisted of patients enrolled in the Evaluation of Drug-Eluting Stents and Ischemic Events (EVENT) registry with either non-ST-segment-elevation acute coronary syndromes or stable ischemic heart disease, who underwent percutaneous coronary intervention with either unfractionated heparin or bivalirudin monotherapy. Propensity score matching was used to adjust for baseline characteristics. The primary bleeding (in-hospital composite bleeding-access site bleeding, thrombolysis in myocardial infarction major/minor bleeding, or transfusion) and primary (in-hospital death/myocardial infarction) and secondary ischemic outcomes (death/myocardial infarction/unplanned repeat revascularization at 12 months) were evaluated. Propensity score matching yielded 1036 patients with non-ST-segment-elevation acute coronary syndromes and 2062 patients with stable ischemic heart disease. For the non-ST-segment-elevation acute coronary syndrome cohort, bivalirudin use was associated with lower bleeding (difference, -3.3% [-0.8% to -5.8%]; P=0.01; number need to treat=30) without increase in either primary (difference, 1.2% [4.1% to -1.8%]; P=0.45) or secondary ischemic outcomes, including stent thrombosis (difference, 0.0% [1.3% to -1.3%]; P=1.00). Similarly, in the stable ischemic heart disease cohort, bivalirudin use was associated with lower bleeding (difference, -1.8% [-0.4% to -3.3%]; P=0.01; number need to treat=53) without increase in either primary (difference, 0.4% [2.3% to -1.5%]; P=0.70) or secondary ischemic outcomes, including stent thrombosis (difference, 0.0% [0.7% to -0.7%]; P=1.00) when compared with unfractionated heparin monotherapy. Among patients with non-ST-segment-elevation acute coronary syndromes or stable ischemic heart disease undergoing percutaneous coronary intervention, bivalirudin use

  8. Optimal timing of coronary invasive strategy in non-ST-segment elevation acute coronary syndromes

    DEFF Research Database (Denmark)

    Navarese, Eliano P; Gurbel, Paul A; Andreotti, Felicita

    2013-01-01

    The optimal timing of coronary intervention in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACSs) is a matter of debate. Conflicting results among published studies partly relate to different risk profiles of the studied populations.......The optimal timing of coronary intervention in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACSs) is a matter of debate. Conflicting results among published studies partly relate to different risk profiles of the studied populations....

  9. Epicardial fat volume is correlated with coronary lesion and its severity

    OpenAIRE

    Bo, Xiaohong; Ma, Likun; Fan, Jili; Jiang, Zhe; Zhou, Yuansong; Zhang, Lei; Li, Wanjun

    2015-01-01

    Objective: To evaluate the correlation of epicardial adipose tissue volume (EATV) with the coronary artery lesion and its severity. Methods: Inpatients with suspicious stable angina of coronary heart lesion were recruited. For patients with coronary artery lesions in CTA, further coronary angiography (CAG) was performed to evaluate the coronary artery lesion. Gensini scoring system was employed to assess the severity of coronary artery lesions. Results: Patients were classified as coronary he...

  10. Monte Carlo simulation of efficient data acquisition for an entire-body PET scanner

    Energy Technology Data Exchange (ETDEWEB)

    Isnaini, Ismet; Obi, Takashi [Tokyo Institute of Technology, 4259 Nagatsuta-cho, Midori-ku, Yokohama 226-8503 (Japan); Yoshida, Eiji, E-mail: rush@nirs.go.jp [National Institute of Radiological Sciences, 4-9-1 Inage-ku, Chiba 263-8555 (Japan); Yamaya, Taiga [National Institute of Radiological Sciences, 4-9-1 Inage-ku, Chiba 263-8555 (Japan)

    2014-07-01

    Conventional PET scanners can image the whole body using many bed positions. On the other hand, an entire-body PET scanner with an extended axial FOV, which can trace whole-body uptake images at the same time and improve sensitivity dynamically, has been desired. The entire-body PET scanner would have to process a large amount of data effectively. As a result, the entire-body PET scanner has high dead time at a multiplex detector grouping process. Also, the entire-body PET scanner has many oblique line-of-responses. In this work, we study an efficient data acquisition for the entire-body PET scanner using the Monte Carlo simulation. The simulated entire-body PET scanner based on depth-of-interaction detectors has a 2016-mm axial field-of-view (FOV) and an 80-cm ring diameter. Since the entire-body PET scanner has higher single data loss than a conventional PET scanner at grouping circuits, the NECR of the entire-body PET scanner decreases. But, single data loss is mitigated by separating the axially arranged detector into multiple parts. Our choice of 3 groups of axially-arranged detectors has shown to increase the peak NECR by 41%. An appropriate choice of maximum ring difference (MRD) will also maintain the same high performance of sensitivity and high peak NECR while at the same time reduces the data size. The extremely-oblique line of response for large axial FOV does not contribute much to the performance of the scanner. The total sensitivity with full MRD increased only 15% than that with about half MRD. The peak NECR was saturated at about half MRD. The entire-body PET scanner promises to provide a large axial FOV and to have sufficient performance values without using the full data.

  11. Imaging system models for small-bore DOI-PET scanners

    International Nuclear Information System (INIS)

    Takahashi, Hisashi; Kobayashi, Tetsuya; Yamaya, Taiga; Murayama, Hideo; Kitamura, Keishi; Hasegawa, Tomoyuki; Suga, Mikio

    2006-01-01

    Depth-of-interaction (DOI) information, which improves resolution uniformity in the field of view (FOV), is expected to lead to high-sensitivity PET scanners with small-bore detector rings. We are developing small-bore PET scanners with DOI detectors arranged in hexagonal or overlapped tetragonal patterns for small animal imaging or mammography. It is necessary to optimize the imaging system model because these scanners exhibit irregular detector sampling. In this work, we compared two imaging system models: (a) a parallel sub-LOR model in which the detector response functions (DRFs) are assumed to be uniform along the line of responses (LORs) and (b) a sub-crystal model in which each crystal is divided into a set of smaller volumes. These two models were applied to the overlapped tetragonal scanner (FOV 38.1 mm in diameter) and the hexagonal scanner (FOV 85.2 mm in diameter) simulated by GATE. We showed that the resolution non-uniformity of system model (b) was improved by 40% compared with that of system model (a) in the overlapped tetragonal scanner and that the resolution non-uniformity of system model (a) was improved by 18% compared with that of system model (b) in the hexagonal scanner. These results indicate that system model (b) should be applied to the overlapped tetragonal scanner and system model (a) should be applied to the hexagonal scanner. (author)

  12. Prevalence of Coronary Artery Intramyocardial Course in a Large Population of Clinical Patients Detected by Multislice Computed Tomography Coronary Angiography

    Energy Technology Data Exchange (ETDEWEB)

    De Rosa, R.; Sacco, M.; Tedeschi, C.; Pepe, R.; Capogrosso, P.; Montemarano, E.; Rotondo, A.; Runza, G.; Midiri, M.; Cademartiri, F. (UO di Radiologia, Ospedale San Gennaro, Napoli (Italy))

    2008-10-15

    Background: Intramyocardial course, an inborn coronary anomaly, is defined as a segment of a major epicardial coronary artery that runs intramurally through the myocardium; in particular, we distinguish myocardial bridging, in which the vessel returns to an epicardial position after the muscle bridge, and intramyocardial course, which is described as a vessel running and ending in the myocardium. Purpose: To evaluate the prevalence of myocardial bridging and intramyocardial course of coronary arteries as defined by multidetector computed tomography (MDCT) angiography. Material and Methods: The study population consisted of 242 consecutive patients (211 men, 31 women; mean age 59+-6 years) with atypical chest pain admitted to our hospital between December 2004 and September 2006. All MDCT examinations were performed using a 16-detector-row scanner (Aquilion 16 CFX; Toshiba Medical System, Tokyo, Japan). Patients with heart rate above 65 bpm received 50 mg atenolol orally for 3 days prior to the MDCT scan, or they increased their usual therapy with beta-blockers, in order to obtain a prescan heart rate <60 bpm. Curved multiplanar and 3D volume reconstructions were performed to explore coronary anatomy. Results: In 235 patients, the CT scan was successful and images were appropriate for evaluation. The prevalence of myocardial bridging and intramyocardial course of coronary arteries was 18.7% (47 cases) in our patient population. In 30 segments (63.8%), the vessels ran and ended in the myocardium. In the remaining 17 segments (36.2%), the vessels returned to an epicardial position after the muscle bridge. We found no difference in the prevalence of this inborn coronary anomaly when comparing different clinical characteristics of the study population (sex, age, body-mass index [BMI], etc.). The mean length of the subepicardial artery was 7 mm (range 5-12 mm), and the mean depth in the diastolic phase was 1.9 mm (range 1.2-2.3 mm). There was no significant difference of

  13. Population screening for coronary artery calcification does not increase mental distress and the use of psychoactive medication

    DEFF Research Database (Denmark)

    Nielsen, Anders Daldorph; Videbeh, Poul; Gerke, Oke

    2012-01-01

    PURPOSE:: Detection of coronary artery calcification (CAC) has been proposed for population screening. It remains unknown whether such a strategy would result in unnecessary concern among participants. Therefore, we set out to assess whether CAC screening affects the psychological well-being...... of screening participants. MATERIALS AND METHODS:: A random sample of 1825 middle-aged subjects (men and women, 50 or 60 y old) were invited for health screening. The European HeartScore was calculated, and a CAC score was measured using a cardiac computed tomography scanner. Therapeutic interventions...

  14. Impact of 64-slice coronary CT on the management of patients presenting with acute chest pain: results of a prospective two-centre study

    Energy Technology Data Exchange (ETDEWEB)

    Christiaens, Luc [Departement d' imagerie Cardiovasculaire, Assistance Publique- Hopitaux de Paris, Hopital Lariboisiere, Paris (France); CHU de Poitiers, Departement de Cardiologie, Poitiers (France); Duchat, Florent; Boudiaf, Mourad; Fargeaudou, Yann; Ledref, Olivier; Soyer, Philippe [Departement d' imagerie Cardiovasculaire, Assistance Publique- Hopitaux de Paris, Hopital Lariboisiere, Paris (France); Tasu, Jean-Pierre [CHU de Poitiers, Departement de Radiologie, Poitiers (France); Sirol, Marc [Departement d' imagerie Cardiovasculaire, Assistance Publique- Hopitaux de Paris, Hopital Lariboisiere, Paris (France); INSERM UFR U942, Insuffisance Cardiaque et Biomarqueurs, Universite Paris 7 - Denis Diderot, Hopital Lariboisiere, Paris (France); Universite Paris VII - Denis Diderot, Assistance Publique - Hopitaux de Paris, Service de Radiologie Vasculaire, Hopital Lariboisiere, Paris (France)

    2012-05-15

    Our two-centre prospective study evaluates the usefulness of 64-slice coronary computed tomography (CCT) to rule out significant coronary artery stenosis in patients admitted in emergency departments (ED) for acute coronary syndromes (ACS) with low-to-intermediate risk score. Patients (175) admitted for acute chest pain (ACP), unmodified electrocardiogram and first troponin measurement within normal ranges were included. A second troponin measurement and a 64-slice CCT within 24 h were performed. Major adverse cardiac events (MACE) were recorded during follow-up (6 months {+-} 2). 64-slice CCT was either normal or showed non-significant coronary stenosis in the majority of patients (78%). 64-slice CCT depicted significant stenosis (>50% diameter) in 22% of patient whereas initial clinical and biological evaluation was reassuring. For negative CCTs, elevated troponin at second measurement did not modify the strategy or treatment of patients. No MACEs were noted during follow up. In 12% of patients CCT identified unsuspected non-coronary abnormalities. Our study confirms 64-slice CCT utility to rule out significant coronary artery stenosis in 8/10 patients admitted in ED with ACP or ACS with low-to-intermediate risk score. Early discharge with a negative 64-slice CCT is associated with very low risk of cardiac events at 6 months. (orig.)

  15. Multi-parameter CAMAC compatible ADC scanner

    Energy Technology Data Exchange (ETDEWEB)

    Midttun, G J; Ingebretsen, F [Oslo Univ. (Norway). Fysisk Inst.; Johnsen, P J [Norsk Data A.S., Box 163, Oekern, Oslo 5, Norway

    1979-02-15

    A fast ADC scanner for multi-parameter nuclear physics experiments is described. The scanner is based on a standard CAMAC crate, and data from several different experiments can be handled simultaneously through a direct memory access (DMA) channel. The implementation on a PDP-7 computer is outlined.

  16. 3D whole body scanners revisited

    NARCIS (Netherlands)

    Daanen, H.A.M.; Haar, F.B. ter

    2013-01-01

    An overview of whole body scanners in 1998 (H.A.M. Daanen, G.J. Van De Water. Whole body scanners, Displays 19 (1998) 111-120) shortly after they emerged to the market revealed that the systems were bulky, slow, expensive and low in resolution. This update shows that new developments in sensing and

  17. Development of scintillation materials for PET scanners

    CERN Document Server

    Korzhik, Mikhail; Annenkov, Alexander N; Borissevitch, Andrei; Dossovitski, Alexei; Missevitch, Oleg; Lecoq, Paul

    2007-01-01

    The growing demand on PET methodology for a variety of applications ranging from clinical use to fundamental studies triggers research and development of PET scanners providing better spatial resolution and sensitivity. These efforts are primarily focused on the development of advanced PET detector solutions and on the developments of new scintillation materials as well. However Lu containing scintillation materials introduced in the last century such as LSO, LYSO, LuAP, LuYAP crystals still remain the best PET species in spite of the recent developments of bright, fast but relatively low density lanthanum bromide scintillators. At the same time Lu based materials have several drawbacks which are high temperature of crystallization and relatively high cost compared to alkali-halide scintillation materials. Here we describe recent results in the development of new scintillation materials for PET application.

  18. Compact beamforming in medical ultrasound scanners

    DEFF Research Database (Denmark)

    Tomov, Borislav Gueorguiev

    2003-01-01

    for high-quality imaging is large, and compressing it leads to better compactness of the beamformers. The existing methods for compressing and recursive generation of focusing data, along with original work in the area, are presented in Chapter 4. The principles and the performance limitations...... quality is comparable to that of the very good scanners currently on the market. The performance results have been achieved with the use of a simple oversampled converter of second order. The use of a higher order oversampled converter will allow higher pulse frequency to be used while the high dynamic...... channels, and even more channels are necessary for 3-dimensional (3D) diagnostic imaging. On the other hand, there is a demand for inexpensive portable devices for use outside hospitals, in field conditions, where power consumption and compactness are important factors. The thesis starts...

  19. A clinical molecular scanner: the Melanie project.

    Science.gov (United States)

    Hochstrasser, D F; Appel, R D; Vargas, R; Perrier, R; Vurlod, J F; Ravier, F; Pasquali, C; Funk, M; Pellegrini, C; Muller, A F

    1991-01-01

    We developed an expert system to analyze and interpret protein maps. This system, Melanie (medical electrophoresis analysis interactive expert), can distinguish between normal and cirrhotic liver and identify various types of cancer on the basis of protein patterns in biopsy specimens. Our findings suggest that some diseases associated with toxic compounds or modifications of the human genome can be diagnosed by expert systems that analyze protein maps. The combination of protein mapping and computer analysis could result in a clinically useful "molecular scanner". The massive amount of information analyzed and stored in such studies requires new strategies, including centralized databases and image transmission over networks. Increased understanding of protein expression and regulation will enhance the importance of the human genome project in medicine and biology.

  20. The economic potential of CT scanners for hardwood sawmills

    Science.gov (United States)

    Donald G. Hodges; Walter C. Anderson; Charles W. McMillin

    1990-01-01

    Research has demonstrated that a knowledge of internal log defects prior to sawing could improve lumber value yields significantly. This study evaluated the potential economic returns from investments in computerized tomographic (CT) scanners to detect internal defects in hardwood logs at southern sawmills. The results indicate that such investments would be profitable...

  1. Benchmarking Advanced Control Algorithms for a Laser Scanner System

    DEFF Research Database (Denmark)

    Stoustrup, Jakob; Ordys, A.W.; Smillie, I.

    1996-01-01

    The paper describes tests performed on the laser scanner system toassess feasibility of modern control techniques in achieving a requiredperformance in the trajectory following problem. The two methods tested areQTR H-infinity and Predictive Control. The results are ilustated ona simulation example....

  2. Incidence, feasibility and outcome of percutaneous coronary intervention after transcatheter aortic valve implantation with a self-expanding prosthesis. Results from a single center experience.

    Science.gov (United States)

    Allali, Abdelhakim; El-Mawardy, Mohamed; Schwarz, Bettina; Sato, Takao; Geist, Volker; Toelg, Ralph; Richardt, Gert; Abdel-Wahab, Mohamed

    2016-09-01

    Percutaneous coronary intervention (PCI) after transcatheter aortic valve implantation (TAVI) can become technically challenging after implantation of the self-expanding Medtronic CoreValve (MCV) device, which completely covers the aortic root. The aim of this study was to report on the incidence, feasibility and outcome of PCI after TAVI with the MCV device. Between 2007 and 2014, all patients subjected to PCI after MCV implantation in a single-center institutional TAVI database were retrospectively identified. Clinical, angiographic and procedural characteristics were reviewed and analyzed. We identified a total of 17 patients (5.7%) treated with 24 PCI procedures for 29 lesions at a median of 17.7months (range 1-72) after MCV implantation. The mean age was 79.7±6.8years and the mean logistic EuroSCORE was 30.3%±18.9%. Nine procedures were performed for patients with acute coronary syndrome. 89.6% of the treated lesions were of type B2/C and 79.3% were de novo ones. A median of one guiding catheter was necessary to intubate the target coronary ostium (range 1-10) and 95% of the lesions on the left coronary artery were treated through a Judkins catheter. In one primary PCI for STEMI the intubation of the right coronary ostium was not successful. Final procedural success was obtained in 95.8%, and peri-procedural death occurred in one patient. The need for PCI after MCV is not uncommon and is mostly related to coronary artery disease progression. PCI after MCV is usually feasible and safe, but coronary intubation in an emergency setting can be challenging. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Resultados atuais da cirurgia coronária em pacientes de alto risco Currente results for coronary artery bypass for high risk patients

    Directory of Open Access Journals (Sweden)

    Pedro R Salerno

    1988-04-01

    output state. Stroke occured in 2.81% and the infarction rate was 16.86%. During the same period 30 patients (16 males and 14 females mean age 64.03 years with unstable angina and in cardiogenic shock underwent emergency bypass. 86.66% were class IV and 13.33% class III. L. V. grade was IV 56.66% and III 13.33%. 40% had main left stenosis. Mean number of grafts was 2.75. 30% died in the OR and 30% died in 30 days. Stroke occured in 16.66% and 43.33% suffered a myocardial infartion. In conclusion the mortality and morbidity for patients undergoing emergency coronary artery bypass remain very high. This is particulary so for patients in cardiogenic shock Future developments in cardiplegic method may improve results.

  4. Intravascular ultrasound-guided optimized stent deployment. Immediate and 6 months clinical and angiographic results from the Multicenter Ultrasound Stenting in Coronaries Study (MUSIC Study)

    Science.gov (United States)

    de Jaegere, P; Mudra, H; Figulla, H; Almagor, Y; Doucet, S; Penn, I; Colombo, A; Hamm, C; Bartorelli, A; Rothman, M; Nobuyoshi, M; Yamaguchi, T; Voudris, V; DiMario, C; Makovski, S; Hausmann, D; Rowe, S; Rabinovich, S; Sunamura, M; van Es, G A

    1998-08-01

    A study was set up to validate the safety and feasibility of intravascular ultrasound-guided stenting without subsequent anticoagulation, and its impact on the 6 months restenosis rate. The study was designed to be multicentred, prospective, and observational. One hundred and sixty-one patients with stable angina and a de novo coronary artery lesion were enrolled. In four patients, the implantation of a Palmaz-Schatz (with spiral bridge) stent had failed. One of these four patients died 3 days following bypass surgery. In two other patients, intravascular ultrasound assessment was not performed. One hundred and twenty-five of the remaining 155 patients (81%) were treated with aspirin (100 mg x day(-1)), because all three criteria for optimized stent expansion were met. Twenty-two of the remaining 38 patients (25%), in whom at least one criterion was not met were treated with aspirin and acenocoumarol (3 months, INR 2.5-3.5), while 16 patients only received aspirin. Stent thrombosis was documented in two patients (1.3%) for which repeat angioplasty was performed. During the hospital stay, there were no deaths or Q-wave myocardial infarctions. Five patients (3.2%) sustained a non-Q-wave myocardial infarction. During the follow-up period (198+/-38 days, complete for all patients, except one), one patient (0.6%) sustained a Q-wave myocardial infarction, one (0.6%) underwent bypass surgery, and repeat angioplasty was performed in nine patients (5.7%). In two of the nine patients, repeat angioplasty involved another lesion. Therefore, the target lesion revascularization rate during follow-up was 4.5% (seven patients). At quantitative coronary angiography, the minimal lumen diameter (mean+/-SD) increased from 1.12+/-0.34 mm before to 2.89+/-0.35 mm after stenting. Repeat angiography at 6 months was performed in 144 patients (92%). The minimal lumen diameter at follow-up was 2.12+/-0.67 mm. Restenosis (diameter stenosis of 50% or more) was documented in 12 patients or 8

  5. RANTES/CCL5 and risk for coronary events: results from the MONICA/KORA Augsburg case-cohort, Athero-Express and CARDIoGRAM studies.

    Directory of Open Access Journals (Sweden)

    Christian Herder

    Full Text Available The chemokine RANTES (regulated on activation, normal T-cell expressed and secreted/CCL5 is involved in the pathogenesis of cardiovascular disease in mice, whereas less is known in humans. We hypothesised that its relevance for atherosclerosis should be reflected by associations between CCL5 gene variants, RANTES serum concentrations and protein levels in atherosclerotic plaques and risk for coronary events.We conducted a case-cohort study within the population-based MONICA/KORA Augsburg studies. Baseline RANTES serum levels were measured in 363 individuals with incident coronary events and 1,908 non-cases (mean follow-up: 10.2±4.8 years. Cox proportional hazard models adjusting for age, sex, body mass index, metabolic factors and lifestyle factors revealed no significant association between RANTES and incident coronary events (HR [95% CI] for increasing RANTES tertiles 1.0, 1.03 [0.75-1.42] and 1.11 [0.81-1.54]. None of six CCL5 single nucleotide polymorphisms and no common haplotype showed significant associations with coronary events. Also in the CARDIoGRAM study (>22,000 cases, >60,000 controls, none of these CCL5 SNPs was significantly associated with coronary artery disease. In the prospective Athero-Express biobank study, RANTES plaque levels were measured in 606 atherosclerotic lesions from patients who underwent carotid endarterectomy. RANTES content in atherosclerotic plaques was positively associated with macrophage infiltration and inversely associated with plaque calcification. However, there was no significant association between RANTES content in plaques and risk for coronary events (mean follow-up 2.8±0.8 years.High RANTES plaque levels were associated with an unstable plaque phenotype. However, the absence of associations between (i RANTES serum levels, (ii CCL5 genotypes and (iii RANTES content in carotid plaques and either coronary artery disease or incident coronary events in our cohorts suggests that RANTES may not be a

  6. Ultra-High-Resolution Computed Tomography of the Lung: Image Quality of a Prototype Scanner

    Science.gov (United States)

    Kakinuma, Ryutaro; Moriyama, Noriyuki; Muramatsu, Yukio; Gomi, Shiho; Suzuki, Masahiro; Nagasawa, Hirobumi; Kusumoto, Masahiko; Aso, Tomohiko; Muramatsu, Yoshihisa; Tsuchida, Takaaki; Tsuta, Koji; Maeshima, Akiko Miyagi; Tochigi, Naobumi; Watanabe, Shun-ichi; Sugihara, Naoki; Tsukagoshi, Shinsuke; Saito, Yasuo; Kazama, Masahiro; Ashizawa, Kazuto; Awai, Kazuo; Honda, Osamu; Ishikawa, Hiroyuki; Koizumi, Naoya; Komoto, Daisuke; Moriya, Hiroshi; Oda, Seitaro; Oshiro, Yasuji; Yanagawa, Masahiro; Tomiyama, Noriyuki; Asamura, Hisao

    2015-01-01

    Purpose The image noise and image quality of a prototype ultra-high-resolution computed tomography (U-HRCT) scanner was evaluated and compared with those of conventional high-resolution CT (C-HRCT) scanners. Materials and Methods This study was approved by the institutional review board. A U-HRCT scanner prototype with 0.25 mm x 4 rows and operating at 120 mAs was used. The C-HRCT images were obtained using a 0.5 mm x 16 or 0.5 mm x 64 detector-row CT scanner operating at 150 mAs. Images from both scanners were reconstructed at 0.1-mm intervals; the slice thickness was 0.25 mm for the U-HRCT scanner and 0.5 mm for the C-HRCT scanners. For both scanners, the display field of view was 80 mm. The image noise of each scanner was evaluated using a phantom. U-HRCT and C-HRCT images of 53 images selected from 37 lung nodules were then observed and graded using a 5-point score by 10 board-certified thoracic radiologists. The images were presented to the observers randomly and in a blinded manner. Results The image noise for U-HRCT (100.87 ± 0.51 Hounsfield units [HU]) was greater than that for C-HRCT (40.41 ± 0.52 HU; P < .0001). The image quality of U-HRCT was graded as superior to that of C-HRCT (P < .0001) for all of the following parameters that were examined: margins of subsolid and solid nodules, edges of solid components and pulmonary vessels in subsolid nodules, air bronchograms, pleural indentations, margins of pulmonary vessels, edges of bronchi, and interlobar fissures. Conclusion Despite a larger image noise, the prototype U-HRCT scanner had a significantly better image quality than the C-HRCT scanners. PMID:26352144

  7. Racial Differences in Abnormal Ambulatory Blood Pressure Monitoring Measures: Results From the Coronary Artery Risk Development in Young Adults (CARDIA) Study

    Science.gov (United States)

    Lewis, Cora E.; Diaz, Keith M.; Carson, April P.; Kim, Yongin; Calhoun, David; Yano, Yuichiro; Viera, Anthony J.; Shimbo, Daichi

    2015-01-01

    BACKGROUND Several ambulatory blood pressure monitoring (ABPM) measures have been associated with increased cardiovascular disease risk independent of clinic blood pressure (BP). African Americans have higher clinic BP compared with Whites but few data are available on racial differences in ABPM measures. METHODS We compared ABPM measures between African American (n = 178) and White (n = 103) participants at the Year 5 Coronary Artery Risk Development in Young Adults study visit. BP was measured during a study visit and the second and third measurements were averaged. ABPM was conducted over the following 24 hours. RESULTS Mean ± SD age of participants was 29.8±3.8 years and 30.8±3.5 years for African Americans and Whites, respectively. Mean daytime systolic BP (SBP) was 3.90 (SD 1.18) mm Hg higher among African Americans compared with Whites (P ABPM was higher among African Americans compared with Whites. CONCLUSIONS These data suggest racial differences in several ABPM measures exist. PMID:25376639

  8. The value of endothelium dependent vasodilatation in diagnosing coronary artery disease and its comparison with the results of routine diagnostic tests

    International Nuclear Information System (INIS)

    Ghaffari, S.; Toufan, M.

    2007-01-01

    To determine the predictive value of flow mediated vasodilatation (FMD) compared with angina pectoris, exercise electrocardiography and myocardial perfusion imaging (MPI). This study was carried out in Shahid Madani Heart Center, Tabriz, Iran from April 2004 to September 2006. A total of 92 patients with chest pain syndrome were enrolled in this study. Using high resolution ultrasound system endothelial function was evaluated and the result of the flow-mediated dilation (FMD %) was defined as the percent change in the internal diameter of the brachial artery during reactive hyperemia related to baseline. Coronary artery disease (CAD) was documented in 77 (83.7%) patients. The percentage of FMD was lower in patients with CAD compared with those without it (3.55 +- 3.71 versus 10.76 +- 4.61, p=0.001). In comparison with typical anginal chest pain (sensitivity 46.7%, specificity 80%) exercise stress test (sensitivity 75%, specificity 60%) and MPI (sensitivity 96.5%, specificity 55.6%) the receiver operator characteristic curve showed the percentage FMD optimal cut-off value as <= 7.41 with a sensitivity of 87.0%, specificity of 66.7%, negative predictive value of 93.0% and positive predictive value of 50%. In patients with chest pain syndrome, the FMD is a sensitive indicator of CAD with moderate specificity that is unable to predict accurately the extent and severity of it. (author)

  9. Study on motion artifacts in coronary arteries with an anthropomorphic moving heart phantom on an ECG-gated multidetector computed tomography unit

    International Nuclear Information System (INIS)

    Greuter, Marcel J.W.; Dorgelo, Joost; Tukker, Wim G.J.; Oudkerk, Matthijs

    2005-01-01

    Acquisition time plays a key role in the quality of cardiac multidetector computed tomography (MDCT) and is directly related to the rotation time of the scanner. The purpose of this study is to examine the influence of heart rate and a multisector reconstruction algorithm on the image quality of coronary arteries of an anthropomorphic adjustable moving heart phantom on an ECG-gated MDCT unit. The heart phantom and a coronary artery phantom were used on a MDCT unit with a rotation time of 500 ms. The movement of the heart was determined by analysis of the images taken at different phases. The results indicate that the movement of the coronary arteries on the heart phantom is comparable to that in a clinical setting. The influence of the heart rate on image quality and artifacts was determined by analysis of several heart rates between 40 and 80 bpm where the movement of the heart was synchronized using a retrospective ECG-gated acquisition protocol. The resulting reformatted volume rendering images of the moving heart and the coronary arteries were qualitatively compared as a result of the heart rate. The evaluation was performed on three independent series by two independent radiologists for the image quality of the coronary arteries and the presence of artifacts. The evaluation shows that at heart rates above 50 bpm the influence of motion artifacts in the coronary arteries becomes apparent. In addition the influence of a dedicated multisector reconstruction technique on image quality was determined. The results show that the image quality of the coronary arteries is not only related to the heart rate and that the influence of the multisector reconstruction technique becomes significant above 70 bpm. Therefore, this study proves that from the actual acquisition time per heart cycle one cannot determine an actual acquisition time, but only a mathematical acquisition time. (orig.)

  10. Out of lab calibration of a rotating 2D scanner for 3D mapping

    Science.gov (United States)

    Koch, Rainer; Böttcher, Lena; Jahrsdörfer, Maximilian; Maier, Johannes; Trommer, Malte; May, Stefan; Nüchter, Andreas

    2017-06-01

    Mapping is an essential task in mobile robotics. To fulfil advanced navigation and manipulation tasks a 3D representation of the environment is required. Applying stereo cameras or Time-of-flight cameras (TOF cameras) are one way to archive this requirement. Unfortunately, they suffer from drawbacks which makes it difficult to map properly. Therefore, costly 3D laser scanners are applied. An inexpensive way to build a 3D representation is to use a 2D laser scanner and rotate the scan plane around an additional axis. A 3D point cloud acquired with such a custom device consists of multiple 2D line scans. Therefore the scanner pose of each line scan need to be determined as well as parameters resulting from a calibration to generate a 3D point cloud. Using external sensor systems are a common method to determine these calibration parameters. This is costly and difficult when the robot needs to be calibrated outside the lab. Thus, this work presents a calibration method applied on a rotating 2D laser scanner. It uses a hardware setup to identify the required parameters for calibration. This hardware setup is light, small, and easy to transport. Hence, an out of lab calibration is possible. Additional a theoretical model was created to test the algorithm and analyse impact of the scanner accuracy. The hardware components of the 3D scanner system are an HOKUYO UTM-30LX-EW 2D laser scanner, a Dynamixel servo-motor, and a control unit. The calibration system consists of an hemisphere. In the inner of the hemisphere a circular plate is mounted. The algorithm needs to be provided with a dataset of a single rotation from the laser scanner. To achieve a proper calibration result the scanner needs to be located in the middle of the hemisphere. By means of geometric formulas the algorithms determine the individual deviations of the placed laser scanner. In order to minimize errors, the algorithm solves the formulas in an iterative process. First, the calibration algorithm was

  11. [Experimental evaluation of the role of the coronary sinus pressure in the regulation of coronary return volume via the coronary sinus. Surgical considerations in atrio-pulmonary diversion procedures].

    Science.gov (United States)

    Fantidis, P; Fernández Ruiz, M A; Madero Jarabo, R; Moreno Granados, F; Cordovilla Zurdo, G; Sanz Galeote, E

    1990-11-01

    In order to find out the validity of the vascular waterfall mechanism in coronary venous circulation, the role of coronary sinus pressure in the regulation of coronary return volume via the coronary sinus is studied in healthy animals. An experimental model of pressure regulation in the coronary sinus was prepared, and aortic pressure, EKG and the cardiac output (measured by thermodilution) were recorded. The return volume via the coronary sinus was measured at coronary sinus pressure of 10 or less, 15, 20, and 25 mmHg or more, for a total of 36 determinations. Increased coronary sinus pressure did not produce significant changes in aortic pressure, heart rate, cardiac index or coronary return volume via coronary sinus. When coronary sinus pressure was 25 mmHg or more, there was a significant decline in the average of coronary return volume via coronary sinus. Nevertheless, stepwise variant regression showed that the coronary sinus pressure per se does not condition the volume of coronary return via the coronary sinus. Our results suggest that in the healthy animals, the vascular waterfall mechanism in coronary venous circulation is not valid. Our results suggest that in the correction of congenital cardiac malformations using atriopulmonary anastomosis procedures, employing techniques that ensure coronary sinus drainage into the left atrium, in order to avoid the hemodynamic repercussions attributable to the vascular waterfall mechanism, is not justified.

  12. NMR of geophysical drill cores with a mobile Halbach scanner

    International Nuclear Information System (INIS)

    Talnishnikh, E.

    2007-01-01

    This thesis is devoted to a mobile NMR with an improved Halbach scanner. This is a lightweight tube-shaped magnet with sensitive volume larger and a homogeneity of the magnetic field higher than the previous prototype version. The improved Halbach scanner is used for analysis of water-saturated drill cores and plugs with diameters up to 60 mm. To provide the analysis, the standard 1D technique with the CPMG sequence as well as 2D correlation experiments were successfully applied and adapted to study properties of fluid-saturated sediments. Afterwards the Halbach scanner was calibrated to fast non-destructive measurements of porosity, relaxation time distributions, and estimation of permeability. These properties can be calculated directly from the NMR data using the developed methodology. Any independent measurements of these properties with other methods are not needed. One of the main results of this work is the development of a new NMR on-line core scanner for measurements of porosity in long cylindrical and semi cylindrical drill cores. Also dedicated software was written to operate the NMR on-line core scanner. The physical background of this work is the study of the diffusion influence on transverse relaxation. The diffusion effect in the presence of internal gradients in porous media was probed by 1D and 2D experiments. The transverse relaxation time distributions obtained from 1D and from 2D experiments are comparable but different in fine details. Two new methodologies were developed based on the results of this study. First is the methodology quantifying the influence of diffusion in the internal gradients of water-saturated sediments on transverse relaxation from 2D correlation experiments. The second one is the correction of the permeability estimation from the NMR data taking in account the influence of the diffusion. Furthermore, PFG NMR technique was used to study restricted diffusion in the same kind of samples. Preliminary results are reported

  13. NMR of geophysical drill cores with a mobile Halbach scanner

    Energy Technology Data Exchange (ETDEWEB)

    Talnishnikh, E.

    2007-08-21

    This thesis is devoted to a mobile NMR with an improved Halbach scanner. This is a lightweight tube-shaped magnet with sensitive volume larger and a homogeneity of the magnetic field higher than the previous prototype version. The improved Halbach scanner is used for analysis of water-saturated drill cores and plugs with diameters up to 60 mm. To provide the analysis, the standard 1D technique with the CPMG sequence as well as 2D correlation experiments were successfully applied and adapted to study properties of fluid-saturated sediments. Afterwards the Halbach scanner was calibrated to fast non-destructive measurements of porosity, relaxation time distributions, and estimation of permeability. These properties can be calculated directly from the NMR data using the developed methodology. Any independent measurements of these properties with other methods are not needed. One of the main results of this work is the development of a new NMR on-line core scanner for measurements of porosity in long cylindrical and semi cylindrical drill cores. Also dedicated software was written to operate the NMR on-line core scanner. The physical background of this work is the study of the diffusion influence on transverse relaxation. The diffusion effect in the presence of internal gradients in porous media was probed by 1D and 2D experiments. The transverse relaxation time distributions obtained from 1D and from 2D experiments are comparable but different in fine details. Two new methodologies were developed based on the results of this study. First is the methodology quantifying the influence of diffusion in the internal gradients of water-saturated sediments on transverse relaxation from 2D correlation experiments. The second one is the correction of the permeability estimation from the NMR data taking in account the influence of the diffusion. Furthermore, PFG NMR technique was used to study restricted diffusion in the same kind of samples. Preliminary results are reported

  14. Scanner Uniformity improvements for radiochromic film analysis with matt reflectance backing

    International Nuclear Information System (INIS)

    Butson, M.; Yu, P.K.N.

    2011-01-01

    Full text: A simple and reproducible method for increasing desktop scanner uniformity for the analysis of radiochromic films is presented. Scanner uniformity, especially in the non-scan direction, for transmission scanning is well known to be problematic for radiochromic film analysis and normally corrections need to be applied. These corrections are dependant on scanner coordinates and dose level applied which complicates dosimetry procedures. This study has highlighted that using reflectance scanning in combination with a matt, white backing material instead of the conventional gloss scanner finish, substantial increases in the scanner uniformity can be achieved within 90% of the scanning area. Uniformity within ±I% over the scanning area for our epsonV700 scanner tested was found. This is compared to within ±3% for reflection scanning with the gloss backing material and within ±4% for transmission scanning. The matt backing material used was simply 5 layers of standard quality white printing paper (80 g/m It was found that 5 layers was the optimal result for backing material however most of the improvements were seen with a minimum of 3 layers. Above 5 layers, no extra benefit was seen. This may eliminate the need to perform scanner corrections for position on the desktop scanners for radiochromic film dosimetry. (author)

  15. Accuracy of four different digital intraoral scanners: effects of the presence of orthodontic brackets and wire.

    Science.gov (United States)

    Jung, Yoo-Ran; Park, Ji-Man; Chun, Youn-Sic; Lee, Kkot-Nim; Kim, Minji

    The objective of this study was to compare the accuracy of four different digital intraoral scanners and the effects of buccal brackets and orthodontic wire. For this study, three sets of models (Control model, BKT model with buccal bracket, and WBKT model with buccal bracket and orthodontic wire) were scanned using four different types of intraoral scanners: E4D dentist, iTero, Trios, and Zfx IntraScan. The mesiodistal width of the teeth, intercanine width, and intermolar width measured by four scanners were compared. Three-dimensional (3D) images of the brackets were taken using the four scanners. Data were analyzed with one-way ANOVA, independent t test, and post-hoc Tukey test at a significance level of P brackets and orthodontic wire. Comparison of 3D bracket images scanned by the four scanners showed differences in image distortion among the scanners. Bracket characteristics did not affect the 3D bracket images. The four intraoral scanners used in this study differed in accuracy. However, the results acquired by iTero and Trios were more reliable. Effects of buccal brackets and orthodontic wire on the 3D images taken by intraoral scanners were not clinically significant.

  16. Diagnostic performance of computed tomography coronary angiography (from the Prospective National Multicenter Multivendor EVASCAN Study).

    Science.gov (United States)

    Gueret, Pascal; Deux, Jean-François; Bonello, Laurent; Sarran, Anthony; Tron, Christophe; Christiaens, Luc; Dacher, Jean-Nicolas; Bertrand, David; Leborgne, Laurent; Renard, Cedric; Caussin, Christophe; Cluzel, Philippe; Helft, Gerard; Crochet, Dominique; Vernhet-Kovacsik, Hélène; Chabbert, Valérie; Ferrari, Emile; Gilard, Martine; Willoteaux, Serge; Furber, Alain; Barone-Rochette, Gilles; Jankowski, Adrien; Douek, Philippe; Mousseaux, Elie; Sirol, Marc; Niarra, Ralph; Chatellier, Gilles; Laissy, Jean-Pierre

    2013-02-15

    Computed tomographic coronary angiography (CTCA) has been proposed as a noninvasive test for significant coronary artery disease (CAD), but only limited data are available from prospective multicenter trials. The goal of this study was to establish the diagnostic accuracy of CTCA compared to coronary angiography (CA) in a large population of symptomatic patients with clinical indications for coronary imaging. This national, multicenter study was designed to prospectively evaluate stable patients able to undergo CTCA followed by conventional CA. Data from CTCA and CA were analyzed in a blinded fashion at central core laboratories. The main outcome was the evaluation of patient-, vessel-, and segment-based diagnostic performance of CTCA to detect or rule out significant CAD (≥50% luminal diameter reduction). Of 757 patients enrolled, 746 (mean age 61 ± 12 years, 71% men) were analyzed. They underwent CTCA followed by CA 1.7 ± 0.8 days later using a 64-detector scanner. The prevalence of significant CAD in native coronary vessels by CA was 54%. The rate of nonassessable segments by CTCA was 6%. In a patient-based analysis, sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios of CTCA were 91%, 50%, 68%, 83%, 1.82, and 0.18, respectively. The strongest predictors of false-negative results on CTCA were high estimated pretest probability of CAD (odds ratio [OR] 1.97, p <0.001), male gender (OR 1.5, p <0.002), diabetes (OR 1.5, p <0.0001), and age (OR 1.2, p <0.0001). In conclusion, in this large multicenter study, CTCA identified significant CAD with high sensitivity. However, in routine clinical practice, each patient should be individually evaluated, and the pretest probability of obstructive CAD should be taken into account when deciding which method, CTCA or CA, to use to diagnose its presence and severity. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Non-invasive assessment of coronary artery bypass graft patency using 16-slice computed tomography angiography

    Directory of Open Access Journals (Sweden)

    Uren Neal G

    2007-06-01

    Full Text Available Abstract Background Invasive coronary angiography is the gold standard means of imaging bypass vessels and carries a small but potentially serious risk of local vascular complications, including myocardial infarction, stroke and death. We evaluated computed tomography as a non-invasive means of assessing graft patency. Methods Fifty patients with previous coronary artery bypass surgery who were listed for diagnostic coronary angiography underwent contrast enhanced computed tomography angiography using a 16-slice computed tomography scanner. Images were retrospectively gated to the electrocardiogram and two dimensional axial, multiplanar and three dimensional reconstructions acquired. Sensitivity, specificity, positive and negative predictive value, accuracy and level of agreement for detection of graft patency by multidetector computed tomography. Results A total of 116 grafts were suitable for analysis. The specificity of CT for the detection of graft patency was 100%, with a sensitivity of 92.8%, positive predictive value 100%, negative predictive value 85.8% and an accuracy of 94.8%. The kappa value of agreement between the two means of measuring graft patency was 0.9. Mean radiation dose was 9.0 ± 7.2 mSv for coronary angiography and 18.5 ± 4 mSv for computed tomography. Pooled analysis of eight studies, incorporating 932 grafts, confirmed a 97% accuracy for the detection of graft patency by multidetector computed tomography. Conclusion Computed tomography is an accurate, rapid and non-invasive method of assessing coronary artery bypass graft patency. However, this was achieved at the expense of an increase in radiation dose.

  18. Coronary Microvascular Function and Cardiovascular Risk Factors in Women With Angina Pectoris and No Obstructive Coronary Artery Disease

    DEFF Research Database (Denmark)

    Mygind, Naja Dam; Michelsen, Marie Mide; Peña, Adam

    2016-01-01

    BACKGROUND: The majority of women with angina-like chest pain have no obstructive coronary artery disease when evaluated with coronary angiography. Coronary microvascular dysfunction is a possible explanation and associated with a poor prognosis. This study evaluated the prevalence of coronary...... microvascular dysfunction and the association with symptoms, cardiovascular risk factors, psychosocial factors, and results from diagnostic stress testing. METHODS AND RESULTS: After screening 3568 women, 963 women with angina-like chest pain and a diagnostic coronary angiogram without significant coronary.......01), hypertension (P=0.02), current smoking (Ppain characteristics or results from diagnostic stress testing...

  19. Depression following acute coronary syndrome

    DEFF Research Database (Denmark)

    Joergensen, Terese Sara Hoej; Maartensson, Solvej; Ibfelt, Else Helene

    2016-01-01

    PURPOSE: Depression is common following acute coronary syndrome, and thus, it is important to provide knowledge to improve prevention and detection of depression in this patient group. The objectives of this study were to examine: (1) whether indicators of stressors and coping resources were risk...... factors for developing depression early and later after an acute coronary syndrome and (2) whether prior depression modified these associations. METHODS: The study was a register-based cohort study, which includes 87,118 patients with a first time diagnosis of acute coronary syndrome during the period...... 2001-2009 in Denmark. Cox regression models were used to analyse hazard ratios (HRs) for depression. RESULTS: 1.5 and 9.5 % develop early (≤30 days) and later (31 days-2 years) depression after the acute coronary syndrome. Among all patients with depression, 69.2 % had first onset depression, while 30...

  20. A Cross-Platform Smartphone Brain Scanner

    DEFF Research Database (Denmark)

    Larsen, Jakob Eg; Stopczynski, Arkadiusz; Stahlhut, Carsten

    We describe a smartphone brain scanner with a low-costwireless 14-channel Emotiv EEG neuroheadset interfacingwith multiple mobile devices. This personal informaticssystem enables minimally invasive and continuouscapturing of brain imaging data in natural settings. Thesystem applies an inverse...

  1. Coronary artery calcification in Kawasaki disease

    International Nuclear Information System (INIS)

    Ino, T.; Shimazaki, S.; Akimoto, K.; Park, I.; Nishimoto, K.; Yabuta, K.; Tanaka, A.

    1990-01-01

    To evaluate the angiographic features of coronary lesions in Kawasaki disease with coronary artery calcification, cinefluoroscopy and cineangiography were retrospectively reviewed in 116 patients who had undergone coronary angiography between 1982 and 1989. Angiographic abnormalities of coronary arteries were demonstrated in 55 of 116 patients. In 5 (9.1%) of the 55 patients, 9 with calcification were identified by cinefluoroscopy and chest X-ray. Eight of the 9 calcified lesions showed a circular or ring-shape configuration. Coronary angiography revealed a total occlusion of the right coronary artery with collateral circulation from the distal left coronary artery in 2 patients and a severe stenosis of the right coronary artery in 2 patients, in whom anticoagulant therapy had not been continued during the follow-up periods. The remaining patient in whom anticoagulant therapy had been continued had bilateral aneurysms but no significant stenosis. These results indicate that a ring-shape calcification on chest X-ray in 2 patients with a history of Kawasaki disease may suggest an involvement by coronary artery stenosis even when anticoagulant drugs had been given. Therefore, coronary angiography should be performed to evaluate the stenotic lesions if this type of calcification is found by routine radiographic examination. (orig.)

  2. Adenosine stress cardiovascular magnetic resonance with variable-density spiral pulse sequences accurately detects coronary artery disease: initial clinical evaluation.

    Science.gov (United States)

    Salerno, Michael; Taylor, Angela; Yang, Yang; Kuruvilla, Sujith; Ragosta, Michael; Meyer, Craig H; Kramer, Christopher M

    2014-07-01

    Adenosine stress cardiovascular magnetic resonance perfusion imaging can be limited by motion-induced dark-rim artifacts, which may be mistaken for true perfusion abnormalities. A high-resolution variable-density spiral pulse sequence with a novel density compensation strategy has been shown to reduce dark-rim artifacts in first-pass perfusion imaging. We aimed to assess the clinical performance of adenosine stress cardiovascular magnetic resonance using this new perfusion sequence to detect obstructive coronary artery disease. Cardiovascular magnetic resonance perfusion imaging was performed during adenosine stress (140 μg/kg per minute) and at rest on a Siemens 1.5-T Avanto scanner in 41 subjects with chest pain scheduled for coronary angiography. Perfusion images were acquired during injection of 0.1 mmol/kg Gadolinium-diethylenetriaminepentacetate at 3 short-axis locations using a saturation recovery interleaved variable-density spiral pulse sequence. Significant stenosis was defined as >50% by quantitative coronary angiography. Two blinded reviewers evaluated the perfusion images for the presence of adenosine-induced perfusion abnormalities and assessed image quality using a 5-point scale (1 [poor] to 5 [excellent]). The prevalence of obstructive coronary artery disease by quantitative coronary angiography was 68%. The average sensitivity, specificity, and accuracy were 89%, 85%, and 88%, respectively, with a positive predictive value and negative predictive value of 93% and 79%, respectively. The average image quality score was 4.4±0.7, with only 1 study with more than mild dark-rim artifacts. There was good inter-reader reliability with a κ statistic of 0.67. Spiral adenosine stress cardiovascular magnetic resonance results in high diagnostic accuracy for the detection of obstructive coronary artery disease with excellent image quality and minimal dark-rim artifacts. © 2014 American Heart Association, Inc.

  3. Assessment Of Coronary Arterial Stents By Multislice-CT Angiography

    International Nuclear Information System (INIS)

    Maintz, D.; Fallenberg, E. M.; Heindel, W.; Fischbach, R.; Grude, M.

    2003-01-01

    Purpose: To assess patency and lumen visibility of coronary artery stents by multislice-CT angiography (MSCTA) in comparison with conventional coronary angiography as the standard of reference. Material and Methods: 47 stents of 13 different types were evaluated in 29 patients. MSCTA was performed on a 4-slice scanner with a standard coronary protocol (detector collimation 4 x 1 mm; table feed 1.5 mm/rotation, 400 mAs, 120 kV). Image evaluation was performed by two readers who were blinded to the reports from the catheter angiography. MIP reconstructions were evaluated for image quality on a 4-point scale (1 = poor, 4 = excellent) and stent patency (contrast distal to the stent as an indirect patency sign). Axial images and multiplanar reformations through the stents were used for assessment of stent lumen visibility (measurement of the visible stent lumen diameter) and detection of relevant in-stent stenosis (50%). Results: Image quality was fair to good on average (score 2.64 ± 1.0) and depended on the heart rate (heart rate 45-60: average score 3.2, heart rate 61-70: average score 2.8, heart rate >71: average score 1.4). Thirty-seven stents were correctly classified as patent, 1 was correctly classified as occluded and 9 stents were not assessable due to insufficient image quality because of triggering artifacts. Parts of the stent lumen could be visualized in 30 cases. On average, 20-40% of the stent lumen diameter was visible. Twenty-five stents were correctly classified as having no stenosis, 1 was falsely classified as stenosed, 1 was correctly classified as occluded. In 20 stents lumen visibility was not sufficient for stenosis evaluation. Conclusion: Although the stent lumen may be partly visualized in most stents, a reliable evaluation of in-stent stenoses does not seem practical by 4-slice MSCT. Nevertheless, for stent patency evaluation, MS-CTA might provide valuable clinical information. With submillimeter MSCT (e.g. 16-slice scanners) and more

  4. Meta-analysis of randomized controlled trials and adjusted observational results of use of clopidogrel, aspirin, and oral anticoagulants in patients undergoing percutaneous coronary intervention

    DEFF Research Database (Denmark)

    D'Ascenzo, Fabrizio; Taha, Salma; Moretti, Claudio

    2015-01-01

    The optimal antiaggregant therapy after coronary stenting in patients receiving oral anticoagulants (OACs) is currently debated. MEDLINE and Cochrane Library were searched for studies reporting outcomes of patients who underwent PCI and who were on triple therapy (TT) or dual-antiplatelet therapy...

  5. Indication and short-term clinical outcomes of high-risk percutaneous coronary intervention with microaxial Impella® pump: results from the German Impella® registry.

    Science.gov (United States)

    Baumann, Stefan; Werner, Nikos; Ibrahim, Karim; Westenfeld, Ralf; Al-Rashid, Fadi; Sinning, Jan-Malte; Westermann, Dirk; Schäfer, Andreas; Karatolios, Konstantinos; Bauer, Timm; Becher, Tobias; Akin, Ibrahim

    2018-03-08

    Percutaneous coronary intervention (PCI) is an alternative strategy to coronary artery bypass grafting (CABG) in patients with high perioperative risk. The microaxial Impella ® pump (Abiomed, Danvers, MA, USA), used as prophylactic and temporary support, is currently the most common device for "protected high-risk PCI" to ensure hemodynamic stability during complex coronary intervention. The study is an observational, retrospective multi-center registry. Patients from nine tertiary hospitals in Germany, who have undergone protected high-risk PCI, are included in the present study. A total of 154 patients (mean age 72.6-10.8 years, 75.3% male) were enrolled. The majority were at a high operative risk illustrated by a logistic EuroSCORE of 14.7-17.4. The initial SYNTAX score was 32.0-13.3, indicating very complex CAD and could be reduced to 14.1-14.3 (p study show that protected PCI is a safe and effective approach to revascularize high-risk patients with complex coronary anatomy and comorbidities.

  6. Assessment of the safety and performance of the STENTYS self-expanding coronary stent in acute myocardial infarction: Results from the APPOSITION I study

    NARCIS (Netherlands)

    G. Amoroso (Giovanni); R.J.M. van Geuns (Robert Jan); C.M. Spaulding (Christian); S. Manzo-Silberman (Stephane); K. Hauptmann (Karl); R. Spaargaren (René); H.M. Garcia-Garcia (Hector); P.W.J.C. Serruys (Patrick); S. Verheye (Stefan)

    2011-01-01

    textabstractAims: In the setting of ST-elevation myocardial infarction (STEMI), epicardial vasoconstriction and throm- bus load may lead to stent undersizing and malapposition after primary percutaneous coronary intervention (PPCI), which can both be responsible for stent thrombosis or restenosis.

  7. Pressure-controlled intermittent coronary sinus occlusion (PICSO) in acute ST-segment elevation myocardial infarction: results of the Prepare RAMSES safety and feasibility study

    NARCIS (Netherlands)

    van de Hoef, Tim P.; Nijveldt, Robin; van der Ent, Martin; Neunteufl, Thomas; Meuwissen, Martijn; Khattab, Ahmed; Berger, Rudolf; Kuijt, Wichert J.; Wykrzykowska, Joanna; Tijssen, Jan G. P.; van Rossum, Albert C.; Stone, Gregg W.; Piek, Jan J.

    2015-01-01

    Pressure-controlled intermittent coronary sinus occlusion (PICSO) may improve myocardial perfusion after pPCI. We evaluated the safety and feasibility of PICSO after pPCI for STEMI, and explored its effects on infarct size and myocardial function. Thirty patients were enrolled following successful

  8. Thyrotrophin levels and coronary artery calcification: Cross-sectional results of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

    Science.gov (United States)

    Peixoto de Miranda, Érique José F; Bittencourt, Márcio Sommer; Staniak, Henrique Lane; Pereira, Alexandre C; Foppa, Murilo; Santos, Itamar S; Lotufo, Paulo A; Benseñor, Isabela M

    2017-11-01

    There is little information about the association between thyrotrophin (TSH) levels and coronary artery calcification (CAC). Our aim was to analyse the association between TSH quintiles and subclinical atherosclerosis measured by CAC, using baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Cross-sectional study. We excluded individuals using medications that affect thyroid function and who self-reported cardiovascular disease. We included euthyroid subjects and individuals with subclinical hypothyroidism (SCHypo) and subclinical hyperthyroidism (SCHyper). Logistic regression models evaluated CAC >100 Agatston units as the dependent variable, and increasing quintiles of TSH as the independent variable, adjusted for demographic and cardiovascular risk factors. Our sample included 3836 subjects, mean age 49 years (interquartile range 44-56); 1999 (52.1%) were female, 3551 (92.6%) were euthyroid, 239 (6.2%) had SCHypo and 46 (1.2%) had SCHyper. The frequency of women, White people and never smokers as well as body mass index and insulin resistance increased according to quintiles. The 1st quintile for TSH (0-0.99 mIU/L) was associated with CAC >100, using the 3rd quintile (1.39-1.85 mIU/L) as reference (adjusted OR=1.57, 95% CI: 1.05-2.35, P=.027), but no association was shown for the 5th quintile (2.68-35.5 mIU/L) compared to the 3rd. Restricting the analysis to euthyroid subjects did not change the results. For women, but not for men, we observed a U-shaped curve with 1st and 5th TSH quintiles associated with CAC>100. Low and low-normal (1st quintile) TSH levels were associated with CAC>100 Agatston units in a sample with subclinical thyroid disorders and euthyroid subjects. © 2017 John Wiley & Sons Ltd.

  9. Regular exercise behaviour and intention and symptoms of anxiety and depression in coronary heart disease patients across Europe: Results from the EUROASPIRE III survey.

    Science.gov (United States)

    Prugger, Christof; Wellmann, Jürgen; Heidrich, Jan; De Bacquer, Dirk; De Smedt, Delphine; De Backer, Guy; Reiner, Željko; Empana, Jean-Philippe; Fras, Zlatko; Gaita, Dan; Jennings, Catriona; Kotseva, Kornelia; Wood, David; Keil, Ulrich

    2017-01-01

    Regular exercise lowers the risk of cardiovascular death in coronary heart disease (CHD) patients. We aimed to investigate regular exercise behaviour and intention in relation to symptoms of anxiety and depression in CHD patients across Europe. This study was based on a multicentre cross-sectional survey. In the EUROpean Action on Secondary and Primary Prevention through Intervention to Reduce Events (EUROASPIRE) III survey, 8966 CHD patients patients exercised or intended to exercise regularly was assessed using the Stages of Change questionnaire in 8330 patients. Symptoms of anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale. Total physical activity was measured by the International Physical Activity Questionnaire in patients from a subset of 14 countries. Overall, 50.3% of patients were not intending to exercise regularly, 15.9% were intending to exercise regularly, and 33.8% were exercising regularly. Patients with severe symptoms of depression less frequently exercised regularly than patients with symptoms in the normal range (20.2%, 95% confidence interval (CI) 14.8-26.8 vs 36.7%, 95% CI 29.8-44.2). Among patients not exercising regularly, patients with severe symptoms of depression were less likely to have an intention to exercise regularly (odds ratio 0.62, 95% CI 0.46-0.85). Symptoms of anxiety did not affect regular exercise intention. In sensitivity analysis, results were consistent when adjusting for total physical activity. Lower frequency of regular exercise and decreased likelihood of exercise intention were observed in CHD patients with severe depressive symptoms. Severe symptoms of depression may preclude CHD patients from performing regular exercise. © The European Society of Cardiology 2016.

  10. Association between opium use and metabolic syndrome among an urban population in Southern Iran: Results of the Kerman Coronary Artery Disease Risk Factor Study (KERCADRS

    Directory of Open Access Journals (Sweden)

    Gholamreza Yousefzadeh

    2015-01-01

    Full Text Available BACKGROUND: Along with the established effects of opium on metabolic parameters, stimulatory or inhibitory effects of opium on metabolic syndrome are also predictable. This study aimed to examine the association of opium use with metabolic syndrome and its components. METHODS: This study was conducted on 5332 out of 5900 original sample participants enrolled in a population-based cohort entitled the Kerman Coronary Artery Disease Risk Study in Iran from 2009 to 2011. The subjects were divided into three groups of “non-opium users” (NOUs = 4340 subjects, “former opium users” (FOUs = 176 subjects, and dependent and occasional people named “current opium users” (COUs = 811 subjects. Metabolic syndrome was defined according to two International Diabetes Federation (IDF and National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III definition criteria. RESULTS: The overall prevalence of IDF defined-metabolic syndrome among NOUs, FOUs, and COUs was 36.4%, 27.3%, and 39.0%, respectively; which was significantly higher in the COUs group (P = 0.012. However, no significant difference was revealed across the three groups in prevalence of NCEP defined-metabolic syndrome (NOUs = 37.2%, FOUs = 30.1%, and COUs = 39.6%, P = 0.058. The odds for IDF defined-metabolic syndrome was higher in both COUs [odd ratio (OR = 1.28, P = 0.028] and FOUs (OR = 1.57, P = 0.045 compared with NOUs as the reference adjusting gender, age, body mass index, and cigarette smoking. However, the appearance of NCEP defined-metabolic syndrome could not be predicted by opium use. CONCLUSION: Opium use can be associated with an increased risk for metabolic syndrome based on IDF criteria and thus preventing the appearance of metabolic syndrome by avoiding opium use can be a certain approach to preventing cardiovascular disease.   

  11. Coronary imaging techniques with emphasis on CT and MRI

    International Nuclear Information System (INIS)

    Lederlin, Mathieu; Latrabe, Valerie; Corneloup, Olivier; Cochet, Hubert; Montaudon, Michel; Laurent, Francois; Thambo, Jean-Benoit

    2011-01-01

    Coronary artery imaging in children is challenging, with high demands both on temporal and spatial resolution due to high heart rates and smaller anatomy. Although invasive conventional coronary angiography remains the benchmark technique, over the past 10 years, CT and MRI have emerged in the field of coronary imaging. The choice of hardware is important. For CT, the minimum requirement is a 64-channel scanner. The temporal resolution of the scanner is most important for optimising image quality and minimising radiation dose. Manufacturers have developed several modes of electrocardiographic (ECG) triggering to facilitate dose reduction. Recent technical advances have opened new possibilities in MRI coronary imaging. As a non-ionising radiation technique, MRI is of great interest in paediatric imaging. It is currently recommended in centres with appropriate expertise for the screening of patients with suspected congenital coronary anomalies. However, MRI is still not feasible in infants. This review describes and discusses the technical requirements and the pros and cons of all three techniques. (orig.)

  12. Integral diagnosis of coronary atherosclerosis by coronary multidetector computed tomography and by invasive coronary angiography

    International Nuclear Information System (INIS)

    Llerena Rojas, Luis Roberto; Llerena Rojas, Lorenzo D; Mendoza Rodriguez, Vladimir

    2013-01-01

    Coronary angiography by multidetector computed tomography (CMDCT) visualizes the wall and lumen of coronary arteries. Invasive coronary angiography (INVCA) only visualizes the arterial lumen but with better resolution

  13. Coronary CT angiography using prospective ECG triggering. High diagnostic accuracy with low radiation dose

    International Nuclear Information System (INIS)

    Arnoldi, E.; Ramos-Duran, L.; Abro, J.A.; Costello, P.; Zwerner, P.L.; Schoepf, U.J.; Nikolaou, K.; Reiser, M.F.

    2010-01-01

    The purpose of this study was to evaluate the diagnostic performance of coronary CT angiography (coronary CTA) using prospective ECG triggering (PT) for the detection of significant coronary artery stenosis compared to invasive coronary angiography (ICA). A total of 20 patients underwent coronary CTA with PT using a 128-slice CT scanner (Definition trademark AS+, Siemens) and ICA. All coronary CTA studies were evaluated for significant coronary artery stenoses (≥50% luminal narrowing) by 2 observers in consensus using the AHA-15-segment model. Findings in CTA were compared to those in ICA. Coronary CTA using PT had 88% sensitivity in comparison to 100% with ICA, 95% to 88% specificity, 80% to 92% positive predictive value and 97% to 100% negative predictive value for diagnosing significant coronary artery stenosis on per segment per patient analysis, respectively. Mean effective radiation dose-equivalent of CTA was 2.6±1 mSv. Coronary CTA using PT enables non-invasive diagnosis of significant coronary artery stenosis with high diagnostic accuracy in comparison to ICA and is associated with comparably low radiation exposure. (orig.) [de

  14. Neurosurgical operating computerized tomographic scanner system

    International Nuclear Information System (INIS)

    Okudera, Hiroshi; Sugita, Kenichiro; Kobayashi, Shigeaki; Kimishima, Sakae; Yoshida, Hisashi.

    1988-01-01

    A neurosurgical operating computerized tomography scanner system is presented. This system has been developed for obtaining intra- and postoperative CT images in the operating room. A TCT-300 scanner (manufactured by the Toshiba Co., Tokyo) is placed in the operating room. The realization of a true intraoperative CT image requires certain improvements in the CT scanner and operating table. To adjust the axis of the co-ordinates of the motor system of the MST-7000 microsurgical operating table (manufactured by the Mizuho Ika Co., Tokyo) to the CT scanner, we have designed an interface and a precise motor system so that the computer of the CT scanner can directly control the movement of the operating table. Furthermore, a new head-fixation system has been designed for producing artifact-free intraoperative CT images. The head-pins of the head-fixation system are made of carbon-fiber bars and titanium tips. A simulation study of the total system in the operating room with the CT scanner, operating table, and head holder using a skull model yielded a degree of error similar to that in the phantom testing of the original scanner. Three patients underwent resection of a glial tumor using this system. Intraoperative CT scans taken after dural opening showed a bulging of the cortex, a shift in the central structure, and a displacement of the cortical subarachnoid spaces under the influence of gravity. With a contrast medium the edge of the surrounding brain after resection was enhanced and the residual tumor mass was demonstrated clearly. This system makes it possible to obtain a noninvasive intraoperative image in a situation where structural shifts are taking place. (author)

  15. Interesting images: Multiple coronary artery aneurysms.

    Science.gov (United States)

    Howard, Jonathon M; Viswanath, Omar; Armas, Alfredo; Santana, Orlando; Rosen, Gerald P

    2017-01-01

    We present the case of a 65-year-old male who presented with stable angina and dyspnea on exertion. His initial workup yielded a positive treadmill stress test for reversible apical ischemia, and transthoracic echocardiogram demonstrated impaired systolic function. Cardiac catheterization was then performed, revealing severe atherosclerotic disease including multiple coronary artery aneurysms. As a result, the patient was advised to and subsequently underwent a coronary artery bypass graft. This case highlights the presence of multiple coronary artery aneurysms and the ability to appreciate these pathologic findings on multiple imaging modalities, including coronary angiogram, transesophageal echocardiography, and direct visualization through the surgical field.

  16. Coffee Consumption and Coronary Artery Calcium Score: Cross-Sectional Results of ELSA-Brasil (Brazilian Longitudinal Study of Adult Health).

    Science.gov (United States)

    Miranda, Andreia M; Steluti, Josiane; Goulart, Alessandra C; Benseñor, Isabela M; Lotufo, Paulo A; Marchioni, Dirce M

    2018-03-24

    Available evidence for the relationship between coffee intake and subclinical atherosclerosis is limited and inconsistent. This study aimed to evaluate the association between coffee consumption and coronary artery calcium (CAC) in ELSA-Brasil (Brazilian Longitudinal Study of Adult Health). This cross-sectional study is based on baseline data from participants of the ELSA-Brasil cohort. Only participants living in São Paulo, Brazil, who underwent a CAC measurement (n=4426) were included. Coffee consumption was collected using a food frequency questionnaire. CAC was detected with computed tomography and expressed as Agatston units. CAC was further categorized as an Agatson score ≥100 (CAC ≥100). In multiple logistic regression analysis considering intake of coffee and smoking status interaction, significant inverse associations were observed between coffee consumption (>3 cups/d) and CAC≥100 (odds ratio [OR]: 0.85 [95% confidence interval, 0.58-1.24] for ≤1 cup/d; OR: 0.73 [95% confidence interval, 0.51-1.05] for 1-3 cups/d; OR: 0.33 [95% confidence interval, 0.17-0.65] for >3 cups/d). Moreover, there was a statistically significant interaction effect for coffee consumption and smoking status ( P =0.028 for interaction). After stratification by smoking status, the analysis revealed a lower OR of coronary calcification in never smokers drinking >3 cups/d (OR: 0.37 [95% confidence interval, 0.15-0.91]), whereas among current and former smokers, the intake of coffee was not significantly associated with coronary calcification. Habitual consumption of >3 cups/d of coffee decreased odds of subclinical atherosclerosis among never smokers. The consumption of coffee could exert a potential beneficial effect against coronary calcification, particularly in nonsmokers. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  17. RANTES/CCL5 and risk for coronary events: Results from the MONICA/KORA Augsburg case-cohort, Athero-express and CARDIoGRAM studies

    OpenAIRE

    Kathiresan, Sekar; Reilly, Muredach; Samani, Nilesh; Schunkert, Heribert; Erdmann, Jeanette; Moll, Frans; Boerwinkle, Eric; Hall, Anne; Hengstenberg, Christian; König, Inke; Laaksonen, Reijo; McPherson, Ruth; Thompson, John; Thorsteinsdottir, Unnur; Ziegler, Andreas

    2011-01-01

    textabstractBackground: The chemokine RANTES (regulated on activation, normal T-cell expressed and secreted)/CCL5 is involved in the pathogenesis of cardiovascular disease in mice, whereas less is known in humans. We hypothesised that its relevance for atherosclerosis should be reflected by associations between CCL5 gene variants, RANTES serum concentrations and protein levels in atherosclerotic plaques and risk for coronary events. Methods and Findings: We conducted a case-cohort study withi...

  18. Heart scanner - who's between a rock and a hard place?

    African Journals Online (AJOL)

    evidence of coronary heart disease succumbs to a fatal heart attack. Cardiac symptoms, positive stress test results and angiographically visible narrowings are all dependent on significant lumenal stenosis. Considerable atherosclerosis can be present in an asymptomatic patient in whom physical examination, stress testing ...

  19. Ultrasonic scanner for stainless steel weld inspections. [LMFBR

    Energy Technology Data Exchange (ETDEWEB)

    Kupperman, D. S.; Reimann, K. J.

    1978-09-01

    The large grain size and anisotropic nature of stainless steel weld metal make conventional ultrasonic testing very difficult. A technique is evaluated for minimizing the coherent ultrasonic noise in stainless steel weld metal. The method involves digitizing conventional ''A-scan'' traces and averaging them with a minicomputer. Results are presented for an ultrasonic scanner which interrogates a small volume of the weld metal while averaging the coherent ultrasonic noise.

  20. Wire scanner data analysis for the SSC Linac emittance measurement

    International Nuclear Information System (INIS)

    Yao, C.Y.; Hurd, J.W.; Sage, J.

    1993-07-01

    The wire scanners are designed in the SSC Linac for measurement of beam emittance at various locations. In order to obtain beam parameters from the scan signal, a data analysis program was developed that considers the problems of noise reduction, machine modeling, parameter fitting, and correction. This program is intended as a tool for Linac commissioning and also as part of the Linac control program. Some of the results from commissioning runs are presented

  1. Computer-aided diagnosis of pneumoconiosis abnormalities extracted from chest radiographs scanned with a CCD scanner

    International Nuclear Information System (INIS)

    Abe, Koji; Minami, Masahide; Nakamura, Munehiro

    2011-01-01

    This paper presents a computer-aided diagnosis for pneumoconiosis radiographs obtained with a common charge-coupled devices (CCD) scanner. Since the current computer-aided diagnosis systems of pneumoconiosis are not practical for medical doctors due to high costs of usage for a special scanner, we propose a novel system which measures abnormalities of pneumoconiosis from lung images obtained with a common CCD scanner. Experimental results of discriminations between normal and abnormal cases for 56 right-lung images including 6 standard pneumoconiosis images have shown that the proposed abnormalities are well extracted according to the standards of pneumoconiosis categories. (author)

  2. Comparison of working efficiency of terrestrial laser scanner in day and night conditions

    Science.gov (United States)

    Arslan, A. E.; Kalkan, K.

    2013-10-01

    Terrestrial Laser Scanning is a popular and widely used technique to scan existing objects, document historical sites and items, and remodel them if and when needed. Their ability to collect thousands of point data per second makes them an invaluable tool in many areas from engineering to historical reconstruction. There are many scanners in the market with different technical specifications. One main technical specification of laser scanners is range and illumination. In this study, it is tested to be determined the optimal working times of a laser scanner and the scanners consistency with its specifications sheet. In order to conduct this work, series of GNSS measurements in Istanbul Technical University have been carried out, connected to the national reference network, to determine precise positions of target points and the scanner, which makes possible to define a precise distance between the scanner and targets. Those ground surveys has been used for calibration and registration purposes. Two different scan campaigns conducted at 12 am and 11 pm to compare working efficiency of laser scanner in different illumination conditions and targets are measured with a handheld spectro-radiometer in order to determine their reflective characteristics. The obtained results are compared and their accuracies have been analysed.

  3. Comparison of two intraoral scanners based on three-dimensional surface analysis

    Directory of Open Access Journals (Sweden)

    Kyung-Min Lee

    2018-02-01

    Full Text Available Abstract Background This in vivo study evaluated the difference of two well-known intraoral scanners used in dentistry, namely iTero (Align Technology and TRIOS (3Shape. Methods Thirty-two participants underwent intraoral scans with TRIOS and iTero scanners, as well as conventional alginate impressions. The scans obtained with the two intraoral scanners were compared with each other and were also compared with the corresponding model scans by means of three-dimensional surface analysis. The average differences between the two intraoral scans on the surfaces were evaluated by color-mapping. The average differences in the three-dimensional direction between each intraoral scans and its corresponding model scan were calculated at all points on the surfaces. Results The average differences between the two intraoral scanners were 0.057 mm at the maxilla and 0.069 mm at the mandible. Color histograms showed that local deviations between the two scanners occurred in the posterior area. As for difference in the three-dimensional direction, there was no statistically significant difference between two scanners. Conclusions Although there were some deviations in visible inspection, there was no statistical significance between the two intraoral scanners.

  4. TH-CD-206-12: Image-Based Motion Estimation for Plaque Visualization in Coronary Computed Tomography Angiography

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, X; Sisniega, A; Zbijewski, W; Stayman, J [Johns Hopkins University, Balitmore, MD (United States); Contijoch, F; McVeigh, E [University of California, San Diego, San Diego, CA (United States)

    2016-06-15

    Purpose: Visualization and quantification of coronary artery calcification and atherosclerotic plaque benefits from coronary artery motion (CAM) artifact elimination. This work applies a rigid linear motion model to a Volume of Interest (VoI) for estimating motion estimation and compensation of image degradation in Coronary Computed Tomography Angiography (CCTA). Methods: In both simulation and testbench experiments, translational CAM was generated by displacement of the imaging object (i.e. simulated coronary artery and explanted human heart) by ∼8 mm, approximating the motion of a main coronary branch. Rotation was assumed to be negligible. A motion degraded region containing a calcification was selected as the VoI. Local residual motion was assumed to be rigid and linear over the acquisition window, simulating motion observed during diastasis. The (negative) magnitude of the image gradient of the reconstructed VoI was chosen as the motion estimation objective and was minimized with Covariance Matrix Adaptation Evolution Strategy (CMAES). Results: Reconstruction incorporated the estimated CAM yielded signification recovery of fine calcification structures as well as reduced motion artifacts within the selected local region. The compensated reconstruction was further evaluated using two image similarity metrics, the structural similarity index (SSIM) and Root Mean Square Error (RMSE). At the calcification site, the compensated data achieved a 3% increase in SSIM and a 91.2% decrease in RMSE in comparison with the uncompensated reconstruction. Conclusion: Results demonstrate the feasibility of our image-based motion estimation method exploiting a local rigid linear model for CAM compensation. The method shows promising preliminary results for the application of such estimation in CCTA. Further work will involve motion estimation of complex motion corrupted patient data acquired from clinical CT scanner.

  5. The effectiveness of German disease management programs (DMPs) in patients with type 2 diabetes mellitus and coronary heart disease: results from an observational longitudinal study.

    Science.gov (United States)

    Laxy, Michael; Stark, Renée; Meisinger, Christa; Kirchberger, Inge; Heier, Margit; von Scheidt, Wolfgang; Holle, Rolf

    2015-01-01

    Although the population-based German disease management programs (DMPs) for diabetes mellitus (DM) and coronary heart disease (CHD) are among the biggest worldwide, evidence on the effectiveness of these programs is still inconclusive or missing, particularly for high risk patients with comorbidities. The objective of this study was therefore to analyze the impact of DMPs on process and outcome parameters in patients with both, type 2 DM and CHD. Analyses are based on two postal surveys of patients from the KORA myocardial infarction registry (southern Germany) with type 2 DM and on two postal validation studies with patients' general physicians (2006, n = 312 and 2011, n = 212). The association between DMP enrollment (being enrolled in either DMP-DM or DMP-CHD) and guideline care (defined by several process indicators) at baseline (2006) and its development until follow-up (2011) was analyzed using logistic regression models accounting for the repeated measurements structure. The impact of DMP enrollment/guideline care on cumulated (quality-adjusted) life years ((QA)LYs) over a 4-year time horizon (2006-2010) was assessed using multiple linear regression methods. Logistic regression models were applied to analyze the association between DMP status and patient self-management at follow-up. Being enrolled in a DMP was associated with better guideline care at baseline [OR = 2.3 (95 % CI 1.27-4.03)], but not at follow-up [OR = 0.80 (95 % CI 0.40-1.58); p value for time-interaction management than patients not being enrolled into a DMP. The results of this study concerning the effectiveness of DMPs in patients with DM and CHD are mixed, but are weakly in favor of DMPs. However, we found a clear positive impact of guideline care on quality adjusted survival in this patient group. The development of the association between DMP enrollment and guideline care over the follow-up time indicates some external effects, which should be the subject of further

  6. Yoga based cardiac rehabilitation after coronary artery bypass surgery: One-year results on LVEF, lipid profile and psychological states – A randomized controlled study

    Science.gov (United States)

    Raghuram, Nagarathna; Parachuri, Venkateshwara Rao; Swarnagowri, M.V.; Babu, Suresh; Chaku, Ritu; Kulkarni, Ravi; Bhuyan, Bhagavan; Bhargav, Hemant; Nagendra, Hongasandra Ramarao

    2014-01-01

    Objective To compare the long term effects of yoga based cardiac rehabilitation program with only physiotherapy based program as an add-on to conventional rehabilitation after coronary artery bypass grafting (CABG) on risk factors. Methods In this single blind prospective randomized parallel two armed active control study, 1026 patients posted for CABG at Narayana Hrudayalaya Institute of Cardiac Sciences, Bengaluru (India) were screened. Of these, 250 male participants (35–65 years) who satisfied the selection criteria and consented were randomized into two groups. Within and between group comparisons were done at three points of follow up (i.e. 6th week, 6th month, and 12th month) by using Wilcoxon's signed ranks test and Mann Whitney U test respectively. Results Yoga group had significantly (p = 0.001, Mann Whitney) better improvement in LVEF than control group in those with abnormal baseline EF (yoga group (p = 0.038, between groups) in those with high baseline BMI (≥23) after 12 months. Yoga group showed significant (p = 0.008, Wilcoxon's) reduction in blood glucose at one year in those with high baseline FBS ≥110 mg/dl. There was significantly better improvement in yoga than the control group in HDL (p = 0.003), LDL (p = 0.01) and VLDL (p = 0.03) in those with abnormal baseline values. There was significantly better improvement (p = 0.02, between groups) in positive affect in yoga group. Within Yoga group, there was significant decrease in perceived stress (p = 0.001), anxiety (p = 0.001), depression (p = 0.001), and negative affect (p = 0.03) while in the control group there was reduction (p = 0.003) only in scores on anxiety. Conclusion Addition of yoga based relaxation to conventional post-CABG cardiac rehabilitation helps in better management of risk factors in those with abnormal baseline values and may help in preventing recurrence. PMID:25443601

  7. Digital Data Matrix Scanner Developnent At Marshall Space Flight Center

    Science.gov (United States)

    2004-01-01

    Research at NASA's Marshall Space Flight Center has resulted in a system for reading hidden identification codes using a hand-held magnetic scanner. It's an invention that could help businesses improve inventory management, enhance safety, improve security, and aid in recall efforts if defects are discovered. Two-dimensional Data Matrix symbols consisting of letters and numbers permanently etched on items for identification and resembling a small checkerboard pattern are more efficient and reliable than traditional bar codes, and can store up to 100 times more information. A team led by Fred Schramm of the Marshall Center's Technology Transfer Department, in partnership with PRI,Torrance, California, has developed a hand-held device that can read this special type of coded symbols, even if covered by up to six layers of paint. Before this new technology was available, matrix symbols were read with optical scanners, and only if the codes were visible. This latest improvement in digital Data Matrix technologies offers greater flexibility for businesses and industries already using the marking system. Paint, inks, and pastes containing magnetic properties are applied in matrix symbol patterns to objects with two-dimensional codes, and the codes are read by a magnetic scanner, even after being covered with paint or other coatings. The ability to read hidden matrix symbols promises a wide range of benefits in a number of fields, including airlines, electronics, healthcare, and the automotive industry. Many industries would like to hide information on a part, so it can be read only by the party who put it there. For instance, the automotive industry uses direct parts marking for inventory control, but for aesthetic purposes the marks often need to be invisible. Symbols have been applied to a variety of materials, including metal, plastic, glass, paper, fabric and foam, on everything from electronic parts to pharmaceuticals to livestock. The portability of the hand

  8. Quality assurance of computed tomography (CT) scanners

    International Nuclear Information System (INIS)

    Sankaran, A.; Sanu, K.K. . Email : a_sankaran@vsnl.com

    2004-01-01

    This article reviews the present status of research work and development of various test objects, phantoms and detector/instrumentation systems for quality assurance (QA) of computed tomography (CT) scanners, carried out in advanced countries, with emphasis on similar work done in this research centre. CT scanner is a complex equipment and routine quality control procedures are essential to the maintenance of image quality with optimum patient dose. Image quality can be ensured only through correlation between prospective monitoring of system components and tests of overall performance with standard phantoms. CT examinations contribute a large share to the population dose in advanced countries. The unique dosimetry problems in CT necessitate special techniques. This article describes a comprehensive kit developed indigenously for the following QA and type approval tests as well as for research studies on image quality/dosimetry on CT scanners

  9. Manually operated small envelope scanner system

    Energy Technology Data Exchange (ETDEWEB)

    Sword, Charles Keith

    2017-04-18

    A scanner system and method for acquisition of position-based ultrasonic inspection data are described. The scanner system includes an inspection probe and a first non-contact linear encoder having a first sensor and a first scale to track inspection probe position. The first sensor is positioned to maintain a continuous non-contact interface between the first sensor and the first scale and to maintain a continuous alignment of the first sensor with the inspection probe. The scanner system may be used to acquire two-dimensional inspection probe position data by including a second non-contact linear encoder having a second sensor and a second scale, the second sensor positioned to maintain a continuous non-contact interface between the second sensor and the second scale and to maintain a continuous alignment of the second sensor with the first sensor.

  10. How flatbed scanners upset accurate film dosimetry

    Science.gov (United States)

    van Battum, L. J.; Huizenga, H.; Verdaasdonk, R. M.; Heukelom, S.

    2016-01-01

    Film is an excellent dosimeter for verification of dose distributions due to its high spatial resolution. Irradiated film can be digitized with low-cost, transmission, flatbed scanners. However, a disadvantage is their lateral scan effect (LSE): a scanner readout change over its lateral scan axis. Although anisotropic light scattering was presented as the origin of the LSE, this paper presents an alternative cause. Hereto, LSE for two flatbed scanners (Epson 1680 Expression Pro and Epson 10000XL), and Gafchromic film (EBT, EBT2, EBT3) was investigated, focused on three effects: cross talk, optical path length and polarization. Cross talk was examined using triangular sheets of various optical densities. The optical path length effect was studied using absorptive and reflective neutral density filters with well-defined optical characteristics (OD range 0.2-2.0). Linear polarizer sheets were used to investigate light polarization on the CCD signal in absence and presence of (un)irradiated Gafchromic film. Film dose values ranged between 0.2 to 9 Gy, i.e. an optical density range between 0.25 to 1.1. Measurements were performed in the scanner’s transmission mode, with red-green-blue channels. LSE was found to depend on scanner construction and film type. Its magnitude depends on dose: for 9 Gy increasing up to 14% at maximum lateral position. Cross talk was only significant in high contrast regions, up to 2% for very small fields. The optical path length effect introduced by film on the scanner causes 3% for pixels in the extreme lateral position. Light polarization due to film and the scanner’s optical mirror system is the main contributor, different in magnitude for the red, green and blue channel. We concluded that any Gafchromic EBT type film scanned with a flatbed scanner will face these optical effects. Accurate dosimetry requires correction of LSE, therefore, determination of the LSE per color channel and dose delivered to the film.

  11. How flatbed scanners upset accurate film dosimetry

    International Nuclear Information System (INIS)

    Van Battum, L J; Verdaasdonk, R M; Heukelom, S; Huizenga, H

    2016-01-01

    Film is an excellent dosimeter for verification of dose distributions due to its high spatial resolution. Irradiated film can be digitized with low-cost, transmission, flatbed scanners. However, a disadvantage is their lateral scan effect (LSE): a scanner readout change over its lateral scan axis. Although anisotropic light scattering was presented as the origin of the LSE, this paper presents an alternative cause. Hereto, LSE for two flatbed scanners (Epson 1680 Expression Pro and Epson 10000XL), and Gafchromic film (EBT, EBT2, EBT3) was investigated, focused on three effects: cross talk, optical path length and polarization. Cross talk was examined using triangular sheets of various optical densities. The optical path length effect was studied using absorptive and reflective neutral density filters with well-defined optical characteristics (OD range 0.2–2.0). Linear polarizer sheets were used to investigate light polarization on the CCD signal in absence and presence of (un)irradiated Gafchromic film. Film dose values ranged between 0.2 to 9 Gy, i.e. an optical density range between 0.25 to 1.1. Measurements were performed in the scanner’s transmission mode, with red–green–blue channels. LSE was found to depend on scanner construction and film type. Its magnitude depends on dose: for 9 Gy increasing up to 14% at maximum lateral position. Cross talk was only significant in high contrast regions, up to 2% for very small fields. The optical path length effect introduced by film on the scanner causes 3% for pixels in the extreme lateral position. Light polarization due to film and the scanner’s optical mirror system is the main contributor, different in magnitude for the red, green and blue channel. We concluded that any Gafchromic EBT type film scanned with a flatbed scanner will face these optical effects. Accurate dosimetry requires correction of LSE, therefore, determination of the LSE per color channel and dose delivered to the film. (paper)

  12. A new crystal whole-body scanner for positron emitters

    International Nuclear Information System (INIS)

    Ostertag, H.; Kuebler, W.; Kubesch, R.; Lorenz, W.J.; Woerner, P.

    1980-01-01

    A multicrystal whole body scanner for positron emitters has been constructed. The annihilation quanta are measured in two opposing detector banks. Each detector bank consists of 64 NaI crystals of 1.5'' diameter x 3'' length. Directly opposing single detectors are in coincidence. The patient moves linearly between the stationary transverse detector banks. The scanning area of the system is 64 x 192 cm 2 . The spatial resolution is 2 cm at a sampling distance of 1 cm. The sensitivity is 6400 counts/s for a pure positron flood source with 1 μCi/cm 2 . The system is controlled by a microcomputer (DEC LSI-11). The scintigrams are shown on a display. Absolute activities can be calculated by mathematical comparison of consecutive emission and transmission scans. The design of the positron scanner and its capacibilities are described. Experimental and initial clinical results are presented. (author)

  13. Wire Scanner Beam Profile Measurements: LANSCE Facility Beam Development

    International Nuclear Information System (INIS)

    Gilpatrick, John D.; Batygin, Yuri K.; Gonzales, Fermin; Gruchalla, Michael E.; Kutac, Vincent G.; Martinez, Derwin; Sedillo, James Daniel; Pillai, Chandra; Rodriguez Esparza, Sergio; Smith, Brian G.

    2012-01-01

    The Los Alamos Neutron Science Center (LANSCE) is replacing Wire Scanner (WS) beam profile measurement systems. Three beam development tests have taken place to test the new wire scanners under beam conditions. These beam development tests have integrated the WS actuator, cable plant, electronics processors and associated software and have used H - beams of different beam energy and current conditions. In addition, the WS measurement-system beam tests verified actuator control systems for minimum profile bin repeatability and speed, checked for actuator backlash and positional stability, tested the replacement of simple broadband potentiometers with narrow band resolvers, and tested resolver use with National Instruments Compact Reconfigurable Input and Output (cRIO) Virtual Instrumentation. These beam tests also have verified how trans-impedance amplifiers react with various types of beam line background noise and how noise currents were not generated. This paper will describe these beam development tests and show some resulting data.

  14. Wire Scanner Beam Profile Measurements: LANSCE Facility Beam Development

    Energy Technology Data Exchange (ETDEWEB)

    Gilpatrick, John D. [Los Alamos National Laboratory; Batygin, Yuri K. [Los Alamos National Laboratory; Gonzales, Fermin [Los Alamos National Laboratory; Gruchalla, Michael E. [Los Alamos National Laboratory; Kutac, Vincent G. [Los Alamos National Laboratory; Martinez, Derwin [Los Alamos National Laboratory; Sedillo, James Daniel [Los Alamos National Laboratory; Pillai, Chandra [Los Alamos National Laboratory; Rodriguez Esparza, Sergio [Los Alamos National Laboratory; Smith, Brian G. [Los Alamos National Laboratory

    2012-05-15

    The Los Alamos Neutron Science Center (LANSCE) is replacing Wire Scanner (WS) beam profile measurement systems. Three beam development tests have taken place to test the new wire scanners under beam conditions. These beam development tests have integrated the WS actuator, cable plant, electronics processors and associated software and have used H{sup -} beams of different beam energy and current conditions. In addition, the WS measurement-system beam tests verified actuator control systems for minimum profile bin repeatability and speed, checked for actuator backlash and positional stability, tested the replacement of simple broadband potentiometers with narrow band resolvers, and tested resolver use with National Instruments Compact Reconfigurable Input and Output (cRIO) Virtual Instrumentation. These beam tests also have verified how trans-impedance amplifiers react with various types of beam line background noise and how noise currents were not generated. This paper will describe these beam development tests and show some resulting data.

  15. A simple scanner for Compton tomography

    CERN Document Server

    Cesareo, R; Brunetti, A; Golosio, B; Castellano, A

    2002-01-01

    A first generation CT-scanner was designed and constructed to carry out Compton images. This CT-scanner is composed of a 80 kV, 5 mA X-ray tube and a NaI(Tl) X-ray detector; the tube is strongly collimated, generating a X-ray beam of 2 mm diameter, whilst the detector is not collimated to collect Compton photons from the whole irradiated cylinder. The performances of the equipment were tested contemporaneous transmission and Compton images.

  16. The mechanism of directional coronary atherectomy

    NARCIS (Netherlands)

    V.A.W.M. Umans (Victor); E. Haine; J. Renkin; P.J. de Feyter (Pim); W. Wijns (William); P.W.J.C. Serruys (Patrick)

    1993-01-01

    textabstractAn attempt was made to assess the mechanism of directional coronary atherectomy using different methods of analysis. Quantitative coronary angiography was used as the gold standard to assess the immediate results of atherectomy, and a comparative quantitative analysis of atherectomy and

  17. Coronary heart disease

    Science.gov (United States)

    Heart disease, Coronary heart disease, Coronary artery disease; Arteriosclerotic heart disease; CHD; CAD ... buildup of plaque in the arteries to your heart. This may also be called hardening of the ...

  18. Experimental characterization of the Clear-PEM scanner spectrometric performance

    Energy Technology Data Exchange (ETDEWEB)

    Bugalho, R; Carrico, B; Ferreira, C S; Frade, M; Ferreira, M; Moura, R; Ortigao, C; Pinheiro, J F; Rodrigues, P; Rolo, I; Silva, J C; Trindade, A; Varela, J [Laboratorio de Instrumentacao e Fisica Experimental de Particulas (LIP), Av. Elias Garcia 14-1, 1000-149 Lisboa (Portugal)], E-mail: frade@lip.pt

    2009-10-15

    In the framework of the Clear-PEM project for the construction of a high-resolution and high-specificity scanner for breast cancer imaging, a Positron Emission Mammography tomograph has been developed and installed at the Instituto Portugues de Oncologia do Porto hospital. The Clear-PEM scanner is mainly composed by two planar detector heads attached to a robotic arm, trigger/data acquisition electronics system and computing servers. The detector heads hold crystal matrices built from 2 x 2 x 20 mm{sup 3} LYSO:Ce crystals readout by Hamamatsu S8550 APD arrays. The APDs are optically coupled to both ends of the 6144 crystals in order to extract the DOI information for each detected event. Each one of 12288 APD's pixels is read and controlled by Application Specific Integrated Circuits water-cooled by an external cooling unit. The Clear-PEM frontend boards innovative design results in a unprecedented integration of the crystal matrices, APDs and ASICs, making Clear-PEM the PET scanner with the highest number of APD pixels ever integrated so far. In this paper, the scanner's main technical characteristics, calibration strategies and the first spectrometric performance evaluation in a clinical environment are presented. The first commissioning results show 99.7% active channels, which, after calibration, have inter-pixel and absolute gain distributions with dispersions of, respectively, 12.2% and 15.3%, demonstrating that despite the large number of channels, the system is uniform. The mean energy resolution at 511 keV is of 15.9%, with a 8.8% dispersion, and the mean C{sub DOI}{sup -1} is 5.9%/mm, with a 7.8% dispersion. The coincidence time resolution, at 511 keV, for a energy window between 400 and 600 keV, is 5.2 ns FWHM.

  19. Comparison of everolimus- and paclitaxel-eluting stents in patients with acute and stable coronary syndromes: pooled results from the SPIRIT (A Clinical Evaluation of the XIENCE V Everolimus Eluting Coronary Stent System) and COMPARE (A Trial of Everolimus-Eluting Stents and Paclitaxel-Eluting Stents for Coronary Revascularization in Daily Practice) Trials.

    Science.gov (United States)

    Planer, David; Smits, Pieter C; Kereiakes, Dean J; Kedhi, Elvin; Fahy, Martin; Xu, Ke; Serruys, Patrick W; Stone, Gregg W

    2011-10-01

    This study sought to compare the clinical outcomes of everolimus-eluting stents (EES) versus paclitaxel-eluting stents (PES) in patients with acute coronary syndromes (ACS) and stable coronary artery disease (CAD). Although randomized trials have shown superiority of EES to PES, the safety and efficacy of EES in ACS is unknown. We performed a patient-level pooled analysis from the prospective, randomized SPIRIT (Clinical Evaluation of the XIENCE V Everolimus Eluting Coronary Stent System) II, III, IV, and COMPARE (A Trial of Everolimus-Eluting Stents and Paclitaxel-Eluting Stents for Coronary Revascularization in Daily Practice) trials in which 2,381 patients with ACS and 4,404 patients with stable CAD were randomized to EES or to PES. Kaplan-Meier estimates of death, myocardial infarction (MI), ischemia-driven target lesion revascularization, and stent thrombosis were assessed at 2 years and stratified by clinical presentation (ACS vs. stable CAD). At 2 years, patients with ACS compared with stable CAD had higher rates of death (3.2% vs. 2.4%, hazard ratio [HR]: 1.37 [95% confidence interval (CI): 1.02 to 1.85], p = 0.04) and MI (4.9% vs. 3.4%, HR: 1.45 [95% CI: 1.14 to 1.85], p = 0.02). In patients with ACS, EES versus PES reduced the rate of death or MI (6.6% vs. 9.3%, HR: 0.70 [95% CI: 0.52 to 0.94], p = 0.02), stent thrombosis (0.7% vs. 2.9%, HR: 0.25 [95% CI: 0.12 to 0.52], p = 0.0002), and ischemia-driven target lesion revascularization (4.7% vs. 6.2%, HR: 0.69 [95% CI: 0.48 to 0.99], p = 0.04). In patients with stable CAD, EES reduced the rate of death or MI (4.5% vs. 7.1%, HR: 0.62 [95% CI: 0.48 to 0.80], p = 0.0002), stent thrombosis (0.7% vs. 1.8%, HR: 0.34 [95% CI: 0.19 to 0.62], p = 0.0002), and ischemia-driven target lesion revascularization (3.9% vs. 6.9%, HR: 0.55 [95% CI: 0.42 to 0.73], p SPIRIT II]; NCT00180310; SPIRIT III: A Clinical Evaluation of the Investigational Device XIENCE V Everolimus Eluting Coronary Stent System [EECSS] in the

  20. Impact on adenosine stress cardiac magnetic resonance for recanalisation and follow up of chronic total coronary occlusions

    Energy Technology Data Exchange (ETDEWEB)

    Heyne, J.P. [Institute of Diagnostic and Interventional Radiology, Friedrich Schiller University Jena, Erlanger Allee 101, D-07740 Jena (Germany)], E-mail: Jens-Peter.Heyne@med.uni-jena.de; Goernig, M. [Clinic for Internal Medicine I, Friedrich Schiller University Jena, Erlanger Allee 101, D-07740 Jena (Germany)], E-mail: Matthias.Goernig@med.uni-jena.de; Feger, J. [Institute of Diagnostic and Interventional Radiology, Friedrich Schiller University Jena, Erlanger Allee 101, D-07740 Jena (Germany)], E-mail: Joachim.Feger@email.de; Kurrat, C. [Institute of Diagnostic and Interventional Radiology, Friedrich Schiller University Jena, Erlanger Allee 101, D-07740 Jena (Germany)], E-mail: Claudia.Kurrat@med.uni-jena.de; Werner, G.S. [Clinic for Internal Medicine I, Friedrich Schiller University Jena, Erlanger Allee 101, D-07740 Jena (Germany)], E-mail: Gerald.Werner@Klinikum-Darmstadt.de; Figulla, H.R. [Clinic for Internal Medicine I, Friedrich Schiller University Jena, Erlanger Allee 101, D-07740 Jena (Germany)], E-mail: Hans.Figulla@med.uni-jena.de; Kaiser, W.A. [Institute of Diagnostic and Interventional Radiology, Friedrich Schiller University Jena, Erlanger Allee 101, D-07740 Jena (Germany)], E-mail: Werner.Kaiser@med.uni-jena.de

    2007-09-15

    Objective: To evaluate the impact on cardiac magnetic resonance imaging (CMRI) with adenosine stress and delayed enhancement for indication and follow up after interventional recanalisation of chronic total coronary occlusions (CTOs). Material and methods: Twenty consecutive patients (15 males; 5 females; mean age 65 years) with CTO verified by cardiac catheterisation referred to CMRI. Sixteen of them got CMRI before and after coronary recanalisation. Wall motion abnormalities (WMAs), first pass perfusion with adenosine and viability were assessed using a 1.5 T MR scanner (Sonata; Siemens). CMRI results were compared with clinical classifications, the results of cardiac catheterisation and follow up angiography. Results: Sixteen patients had a successful recanalisation, 15 of the occluded coronary artery and one of collateral donor artery stenosis. After recanalisation all stress-induced progressive or new wall motion abnormalities (WMAs) of the corresponding segments and in the collateral donor territory (5 patients) and all adenosine induced perfusion defects (PD) or delay (12 patients) were regredient. 13/16 patients showed no transmural and one patient transmural delayed enhancement (DE) indicating myocardial scar. In 10/16 patients CSS grading of angina improved after recanalisation. Conclusion: After successful recanalisation of CTOs, patients with preinterventional stress-induced PDs and WMAs in viable myocardium did not display any signs of stress-induced ischemia postinterventionally. A comprehensive CMRI approach, including assessment of rest and stress WMAs, first pass perfusion and myocardial viability represents an important tool for the pre-interventional decision to recanalise CTOs and follow up.

  1. Effects of opium consumption on coronary artery disease risk factors and oral health: Results of Kerman Coronary Artery Disease Risk factors Study a population-based survey on 5900 subjects aged 15-75 years.

    Science.gov (United States)

    Najafipour, Hamid; Masoomi, Mohammad; Shahesmaeili, Armita; Haghdoost, Ali Akbar; Afshari, Mahdi; Nasri, Hamid Reza; Kahnooji, Masoomeh; Samadi, Sadra; Mirzazadeh, Ali

    2015-01-01

    Opium abuse as a relatively common behavior among Iranian population may have an association with the other coronary artery disease (CAD) risk factors. Here, we reported the prevalence of opium abuse and its co-exposures with oral health and other CAD risk factors. We recruited 5900 inhabitant aged 15-75 years using a randomized cluster household survey. All were interviewed for level of physical activity (PA), depression, anxiety and opium use and assessed for hypertension, diabetes, hyperlipidemia, and oral health status. Regarding to opium abuse, participants were grouped into: "Non-," "occasional," and "dependent" users. Using logistic regression model for every CAD risk factor, we assessed whether the co-exposure of opium and CAD risk factor is significant. Overall, 10.6% reported ever opium use including 5.6% dependent and 5% occasional users. The prevalence of opium abuse was increased from 2.1% in 15-25 years to 24.5% in 55-64 years group. Opium abuse, in occasional and dependent forms, was associated with depression (adjusted odds ratio [AOR] 1.81 and 2.49) and low PS (AOR 1.43 and 1.71 respectively). Dependents were less obese than nonusers (P Opium abuse had no significant association with hypertension, diabetes, oral health status and lipid profile. Opium abuse was associated with depression and low PA. No ameliorative effect was observed on hypertension, diabetes, and plasma lipid profile. Therefore, positive association of opium with depression and LPA and the incorrectness of belief on its ameliorative effect on three other important risk factors of CAD should be clearly highlighted in public health messages to the community.

  2. Heart rate at admission is a predictor of in-hospital mortality in patients with acute coronary syndromes: Results from 58 European hospitals: The European Hospital Benchmarking by Outcomes in acute coronary syndrome Processes study.

    Science.gov (United States)

    Jensen, Magnus T; Pereira, Marta; Araujo, Carla; Malmivaara, Anti; Ferrieres, Jean; Degano, Irene R; Kirchberger, Inge; Farmakis, Dimitrios; Garel, Pascal; Torre, Marina; Marrugat, Jaume; Azevedo, Ana

    2018-03-01

    The purpose of this study was to investigate the relationship between heart rate at admission and in-hospital mortality in patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Consecutive ACS patients admitted in 2008-2010 across 58 hospitals in six participant countries of the European Hospital Benchmarking by Outcomes in ACS Processes (EURHOBOP) project (Finland, France, Germany, Greece, Portugal and Spain). Cardiogenic shock patients were excluded. Associations between heart rate at admission in categories of 10 beats per min (bpm) and in-hospital mortality were estimated by logistic regression in crude models and adjusting for age, sex, obesity, smoking, hypertension, diabetes, known heart failure, renal failure, previous stroke and ischaemic heart disease. In total 10,374 patients were included. In both STEMI and NSTE-ACS patients, a U-shaped relationship between admission heart rate and in-hospital mortality was found. The lowest risk was observed for heart rates between 70-79 bpm in STEMI and 60-69 bpm in NSTE-ACS; risk of mortality progressively increased with lower or higher heart rates. In multivariable models, the relationship persisted but was significant only for heart rates >80 bpm. A similar relationship was present in both patients with or without diabetes, above or below age 75 years, and irrespective of the presence of atrial fibrillation or use of beta-blockers. Heart rate at admission is significantly associated with in-hospital mortality in patients with both STEMI and NSTE-ACS. ACS patients with admission heart rate above 80 bpm are at highest risk of in-hospital mortality.

  3. Accuracy of five intraoral scanners compared to indirect digitalization.

    Science.gov (United States)

    Güth, Jan-Frederik; Runkel, Cornelius; Beuer, Florian; Stimmelmayr, Michael; Edelhoff, Daniel; Keul, Christine

    2017-06-01

    Direct and indirect digitalization offer two options for computer-aided design (CAD)/ computer-aided manufacturing (CAM)-generated restorations. The aim of this study was to evaluate the accuracy of different intraoral scanners and compare them to the process of indirect digitalization. A titanium testing model was directly digitized 12 times with each intraoral scanner: (1) CS 3500 (CS), (2) Zfx Intrascan (ZFX), (3) CEREC AC Bluecam (BLU), (4) CEREC AC Omnicam (OC) and (5) True Definition (TD). As control, 12 polyether impressions were taken and the referring plaster casts were digitized indirectly with the D-810 laboratory scanner (CON). The accuracy (trueness/precision) of the datasets was evaluated by an analysing software (Geomagic Qualify 12.1) using a "best fit alignment" of the datasets with a highly accurate reference dataset of the testing model, received from industrial computed tomography. Direct digitalization using the TD showed the significant highest overall "trueness", followed by CS. Both performed better than CON. BLU, ZFX and OC showed higher differences from the reference dataset than CON. Regarding the overall "precision", the CS 3500 intraoral scanner and the True Definition showed the best performance. CON, BLU and OC resulted in significantly higher precision than ZFX did. Within the limitations of this in vitro study, the accuracy of the ascertained datasets was dependent on the scanning system. The direct digitalization was not superior to indirect digitalization for all tested systems. Regarding the accuracy, all tested intraoral scanning technologies seem to be able to reproduce a single quadrant within clinical acceptable accuracy. However, differences were detected between the tested systems.

  4. Coronary Artery Bypass in Octogenarians

    Directory of Open Access Journals (Sweden)

    Chen-Yen Chien

    2012-09-01

    Full Text Available Prevalence of coronary artery disease (CAD has increased with the expansion of life span among the elderly population in the world. Hence, the issue of the coronary artery bypass in octogenarians has attracted more attention. Recent literature about the topic revealed nearly the same excellent results as those in the younger population under the newly developed operative techniques and improving concept in perioperative management and postoperative care. In this article, we review the current status of the procedure that was thought to be dangerous in the earlier era, including its risk factors, result, and benefit.

  5. Determining the surface roughness coefficient by 3D Scanner

    Directory of Open Access Journals (Sweden)

    Karmen Fifer Bizjak

    2010-12-01

    Full Text Available Currently, several test methods can be used in the laboratory to determine the roughness of rock joint surfaces.However, true roughness can be distorted and underestimated by the differences in the sampling interval of themeasurement methods. Thus, these measurement methods produce a dead zone and distorted roughness profiles.In this paper a new rock joint surface roughness measurement method is presented, with the use of a camera-typethree-dimensional (3D scanner as an alternative to current methods. For this study, the surfaces of ten samples oftuff were digitized by means of a 3D scanner, and the results were compared with the corresponding Rock JointCoefficient (JRC values. Up until now such 3D scanner have been mostly used in the automotive industry, whereastheir use for comparison with obtained JRC coefficient values in rock mechanics is presented here for the first time.The proposed new method is a faster, more precise and more accurate than other existing test methods, and is apromising technique for use in this area of study in the future.

  6. Coronary ostium occlusion by coronary cusp displacement in Williams syndrome.

    Science.gov (United States)

    Shiohama, Tadashi; Fujii, Katsunori; Ebata, Ryota; Funabashi, Nobusada; Matsumiya, Goro; Saito, Yuko Kazato; Takechi, Fumie; Yonemori, Yoko; Nakatani, Yukio; Shimojo, Naoki

    2016-06-01

    Williams syndrome is a contiguous gene deletion syndrome resulting from a heterozygous deletion on chromosome 7q11.23, and is characterized by distinctive facial features and supravalvular aortic stenosis (SVAS). This syndrome rarely presents unpredictable cardiac death, and yet, as illustrated in the present case, it is still not possible to predict it, even on close monitoring. We herein describe the case of a 6-year-old Japanese girl with Williams syndrome, who had sudden cardiac collapse due to cardiac infarction after pharyngitis. Cardiac failure followed a critical course that did not respond to catecholamine support or heart rest with extracardiac mechanical support. Although marked coronary stenosis was not present, the left coronary cusp abnormally adhered to the aortic wall, which may synergistically cause coronary ostium occlusion with SVAS. Altered hemodynamic state, even that caused by the common cold, may lead to critical myocardial events in Williams syndrome with SVAS. © 2015 Japan Pediatric Society.

  7. Developments in holographic-based scanner designs

    Science.gov (United States)

    Rowe, David M.

    1997-07-01

    Holographic-based scanning systems have been used for years in the high resolution prepress markets where monochromatic lasers are generally utilized. However, until recently, due to the dispersive properties of holographic optical elements (HOEs), along with the high cost associated with recording 'master' HOEs, holographic scanners have not been able to penetrate major scanning markets such as the laser printer and digital copier markets, low to mid-range imagesetter markets, and the non-contact inspection scanner market. Each of these markets has developed cost effective laser diode based solutions using conventional scanning approaches such as polygon/f-theta lens combinations. In order to penetrate these markets, holographic-based systems must exhibit low cost and immunity to wavelength shifts associated with laser diodes. This paper describes recent developments in the design of holographic scanners in which multiple HOEs, each possessing optical power, are used in conjunction with one curved mirror to passively correct focal plane position errors and spot size changes caused by the wavelength instability of laser diodes. This paper also describes recent advancements in low cost production of high quality HOEs and curved mirrors. Together these developments allow holographic scanners to be economically competitive alternatives to conventional devices in every segment of the laser scanning industry.

  8. A PET scanner developed by CERN

    CERN Multimedia

    Laurent Guiraud

    1998-01-01

    This image shows a Position Emission Tomography (PET) scanner at the Hopital Cantonal Universitaire de Genève. Development of the multiwire proportional chamber at CERN in the mid-1970s was soon seen as a potential device for medical imaging. It is much more sensitive than previous devices and greatly reduced the dose of radiation received by the patient.

  9. Wire scanner software and firmware issues

    International Nuclear Information System (INIS)

    Gilpatrick, John Doug

    2008-01-01

    The Los Alamos Neutron Science Center facility presently has 110 slow wire scanning profile measurement instruments located along its various beam lines. These wire scanners were developed and have been operating for at least 30 years. While the wire scanners solved many problems to operate and have served the facility well they have increasingly suffered from several problems or limitations, such as maintenance and reliability problems, antiquated components, slow data acquisition, and etc. In order to refurbish these devices, these wire scanners will be replaced with newer versions. The replacement will consist of a completely new beam line actuator, new cables, new electronics and brand new software and firmware. This note describes the functions and modes of operation that LabVIEW VI software on the real time controller and FPGA LabVIEW firmware will be required. It will be especially interesting to understand the overall architecture of these LabVIEW VIs. While this note will endeavor to describe all of the requirements and issues for the wire scanners, undoubtedly, there will be missing details that will be added as time progresses.

  10. Learning and Teaching with a Computer Scanner

    Science.gov (United States)

    Planinsic, G.; Gregorcic, B.; Etkina, E.

    2014-01-01

    This paper introduces the readers to simple inquiry-based activities (experiments with supporting questions) that one can do with a computer scanner to help students learn and apply the concepts of relative motion in 1 and 2D, vibrational motion and the Doppler effect. We also show how to use these activities to help students think like…

  11. Current segmented gamma-ray scanner technology

    International Nuclear Information System (INIS)

    Bjork, C.W.

    1987-01-01

    A new generation of segmented gamma-ray scanners has been developed at Los Alamos for scrap and waste measurements at the Savannah River Plant and the Los Alamos Plutonium Facility. The new designs are highly automated and exhibit special features such as good segmentation and thorough shielding to improve performance

  12. Get Mobile – The Smartphone Brain Scanner

    DEFF Research Database (Denmark)

    Stahlhut, Carsten; Stopczynski, Arkadiusz; Petersen, Michael Kai

    This demonstration will provide live-interaction with a smartphone brain scanner consisting of a low-cost wireless 14-channel EEG headset (Emotiv Epoc) and a mobile device. With our system it is possible to perform real-time functional brain imaging on a smartphone device, including stimulus...

  13. Scanner and irradiation: optimization of protocols

    International Nuclear Information System (INIS)

    Duchemin, J.; Martine-Rollet, B.; Lienart, S.; Mobailly, M.; Florin, J.P.; Beregi, J.P.; Puech, N.

    2006-01-01

    The irradiation of the patient or the personnel increased with the arrival of the multi-detector scanners. The objective of this work is to realize a didactic poster to inform and make sensitive on the irradiation with scan so that to propose solutions of protection. (N.C.)

  14. submitter Dynamical Models of a Wire Scanner

    CERN Document Server

    Barjau, Ana; Dehning, Bernd

    2016-01-01

    The accuracy of the beam profile measurements achievable by the current wire scanners at CERN is limited by the vibrations of their mechanical parts. In particular, the vibrations of the carbon wire represent the major source of wire position uncertainty which limits the beam profile measurement accuracy. In the coming years, due to the Large Hadron Collider (LHC) luminosity upgrade, a wire traveling speed up to 20 $m s^{−1}$ and a position measurement accuracy of the order of 1 μm will be required. A new wire scanner design based on the understanding of the wire vibration origin is therefore needed. We present the models developed to understand the main causes of the wire vibrations observed in an existing wire scanner. The development and tuning of those models are based on measurements and tests performed on that CERN proton synchrotron (PS) scanner. The final model for the (wire + fork) system has six degrees-of-freedom (DOF). The wire equations contain three different excitation terms: inertia...

  15. High-definition computed tomography for coronary artery stents imaging: Initial evaluation of the optimal reconstruction algorithm

    Energy Technology Data Exchange (ETDEWEB)

    Cui, Xiaoming, E-mail: mmayzy2008@126.com; Li, Tao, E-mail: litaofeivip@163.com; Li, Xin, E-mail: lx0803@sina.com.cn; Zhou, Weihua, E-mail: wangxue0606@gmail.com

    2015-05-15

    Highlights: • High-resolution scan mode is appropriate for imaging coronary stent. • HD-detail reconstruction algorithm is stent-dedicated kernel. • The intrastent lumen visibility also depends on stent diameter and material. - Abstract: Objective: The aim of this study was to evaluate the in vivo performance of four image reconstruction algorithms in a high-definition CT (HDCT) scanner with improved spatial resolution for the evaluation of coronary artery stents and intrastent lumina. Materials and methods: Thirty-nine consecutive patients with a total of 71 implanted coronary stents underwent coronary CT angiography (CCTA) on a HDCT (Discovery CT 750 HD; GE Healthcare) with the high-resolution scanning mode. Four different reconstruction algorithms (HD-stand, HD-detail; HD-stand-plus; HD-detail-plus) were applied to reconstruct the stented coronary arteries. Image quality for stent characterization was assessed. Image noise and intrastent luminal diameter were measured. The relationship between the measurement of inner stent diameter (ISD) and the true stent diameter (TSD) and stent type were analysed. Results: The stent-dedicated kernel (HD-detail) offered the highest percentage (53.5%) of good image quality for stent characterization and the highest ratio (68.0 ± 8.4%) of visible stent lumen/true stent lumen for luminal diameter measurement at the expense of an increased overall image noise. The Pearson correlation coefficient between the ISD and TSD measurement and spearman correlation coefficient between the ISD measurement and stent type were 0.83 and 0.48, respectively. Conclusions: Compared with standard reconstruction algorithms, high-definition CT imaging technique with dedicated high-resolution reconstruction algorithm provides more accurate stent characterization and intrastent luminal diameter measurement.

  16. Subclinical Coronary Plaque Burden in Asymptomatic Relatives of Patients With Documented Premature Coronary Artery Disease

    DEFF Research Database (Denmark)

    Christiansen, Morten Krogh; Jensen, Jesper Møller; Bøtker, Hans Erik

    Introduction: A family history of premature coronary artery disease (CAD) is a well-known risk factor for adverse coronary events with age of onset being inversely related to the degree of heritability. Hypothesis: We hypothesized that asymptomatic first degree relatives, of patients with premature...... CAD, suffer a high burden of subclinical coronary atherosclerosis. Methods: First degree relatives, aged 30-65 years, of patients with a documented coronary revascularization procedure before the age of 40 years, were invited to participate in the study. Participants were matched by age, sex...... and absence of a family history, with patients referred for coronary CT angiography (CTA) because of atypical angina or non-anginal chest pain. A pooled blinded analysis was performed. The main outcome measure was the number of plaque-affected coronary segments. Results: 88 relatives and 88 symptomatic...

  17. Non-obstructive coronary artery disease assessed by coronary computed tomography angiography

    DEFF Research Database (Denmark)

    Nielsen, L.; Bøtker, H. E.; Sorensen, H.

    2015-01-01

    Introduction: Coronary CT angiography (CTA) detects non-obstructive coronary artery disease (CAD) that may not be recognized by functional testing, but the prognostic impact is not well understood. This study aimed to compare the risk of myocardial infarction (MI) and all-cause mortality...... in patients without or with non-obstructive and obstructive CAD assessed by coronary CTA. Methods: Consecutive patients without known coronary artery disease (CAD) and with chest pain who underwent coronary CTA (>64-detector row) between January 2007 and December 2012 in the 10 centers participating...... in the Western Denmark Cardiac Computed Tomography Registry were included. The endpoints were 3-year MI or all-cause mortality. The coronary CTA result was defined as normal (0% luminal stenosis), non-obstructive CAD (1%-49% luminal stenosis) or obstructive CAD (>50% luminal stenosis; 1-vessel, 2-vessel, or 3...

  18. Effects of injected dose, BMI and scanner type on NECR and image noise in PET imaging

    International Nuclear Information System (INIS)

    Chang Tingting; Chang Guoping; Clark, John W Jr; Kohlmyer, Steve; Rohren, Eric; Mawlawi, Osama R

    2011-01-01

    Noise equivalent count rate (NECR) and image noise are two different but related metrics that have been used to predict and assess image quality, respectively. The aim of this study is to investigate, using patient studies, the relationships between injected dose (ID), body mass index (BMI) and scanner type on NECR and image noise measurements in PET imaging. Two groups of 90 patients each were imaged on a GE DSTE and a DRX PET/CT scanner, respectively. The patients in each group were divided into nine subgroups according to three BMI (20-24.9, 25-29.9, 30-45 kg m -2 ) and three ID (296-444, 444-555, 555-740 MBq) ranges, resulting in ten patients/subgroup. All PET data were acquired in 3D mode and reconstructed using the VuePoint HD (registered) fully 3D OSEM algorithm (2 iterations, 21(DRX) or 20 (DSTE) subsets). NECR and image noise measurements for bed positions covering the liver were calculated for each patient. NECR was calculated from the trues, randoms and scatter events recorded in the DICOM header of each patient study, while image noise was determined as the standard deviation of 50 non-neighboring voxels in the liver of each patient. A t-test compared the NECR and image noise for different scanners but with the same BMI and ID. An ANOVA test on the other hand was used to compare the results of patients with different BMI but the same ID and scanner type as well as different ID but the same BMI and scanner type. As expected the t-test showed a significant difference in NECR between the two scanners for all BMI and ID subgroups. However, contrary to what is expected no such findings were observed for image noise measurement. The ANOVA results showed a statistically significant difference in both NECR and image noise among the different BMI for each ID and scanner subgroup. However, there was no statistically significant difference in NECR and image noise across different ID for each BMI and scanner subgroup. Although the GE DRX PET/CT scanner has better

  19. Radiation exposure and contrast agent use related to radial versus femoral arterial access during percutaneous coronary intervention (PCI)-Results of the FERARI study.

    Science.gov (United States)

    Becher, Tobias; Behnes, Michael; Ünsal, Melike; Baumann, Stefan; El-Battrawy, Ibrahim; Fastner, Christian; Kuschyk, Jürgen; Papavassiliu, Theano; Hoffmann, Ursula; Mashayekhi, Kambis; Borggrefe, Martin; Akin, Ibrahim

    2016-12-01

    Data regarding radiation exposure related to radial versus femoral arterial access in patients undergoing percutaneous coronary intervention (PCI) remain controversial. This study aims to evaluate patients enrolled in the FERARI study regarding radiation exposure, fluoroscopy time and contrast agent use. The Femoral Closure versus Radial Compression Devices Related to Percutaneous Coronary Interventions (FERARI) study evaluated prospectively 400 patients between February 2014 and May 2015 undergoing PCI either using the radial or femoral access. In these 400 patients, baseline characteristics, procedural data such as procedural duration, fluoroscopy time, dose-area product (DAP) as well as the amount of contrast agent used were documented and analyzed. Median fluoroscopy time was not significantly different in patients undergoing radial versus femoral access (12.2 vs. 9.8min, p=0.507). Furthermore, median DAP (54.5 vs. 52.0 Gycm2, p=0.826), procedural duration (46.0 vs. 45.0min, p=0.363) and contrast agent use (185.5 vs. 199.5ml, p=0.742) were also similar in radial and femoral PCI. There was no difference regarding median fluoroscopy time, procedural duration, radiation dose or contrast agent use between radial versus femoral arterial access in PCI. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Immediate multivessel percutaneous coronary intervention versus culprit lesion intervention in patients with acute myocardial infarction complicated by cardiogenic shock: results of the ALKK-PCI registry.

    Science.gov (United States)

    Zeymer, Uwe; Hochadel, Mathias; Thiele, Holger; Andresen, Dietrich; Schühlen, Helmut; Brachmann, Johannes; Elsässer, Albrecht; Gitt, Anselm; Zahn, Ralf

    2015-07-01

    Current guidelines recommend immediate multivessel percutaneous coronary intervention (PCI) in patients with cardiogenic shock, despite the lack of randomised trials. We sought to investigate the use and impact on outcome of multivessel PCI in current practice in cardiogenic shock in Germany. Between January 2008 and December 2011 a total of 735 consecutive patients with acute myocardial infarction, cardiogenic shock and multivessel coronary artery disease underwent immediate PCI in 41 hospitals in Germany. Of these, 173 (23.5%) patients were treated with immediate multivessel PCI. The acute success of PCI with respect to TIMI 3 flow did not differ between the groups (82.5% versus 79.6%). In-hospital mortality with multivessel PCI and culprit lesion PCI was 46.8% and 35.8%, respectively. In multivariate analysis multivessel PCI was associated with an increased mortality (odds ratio 1.5; 95% confidence interval 1.15-1.84). In current clinical practice in Germany multivessel PCI is used only in one quarter of patients with cardiogenic shock treated with primary PCI. We observed an adverse effect of immediate multivessel PCI. Therefore, a randomised trial is needed to determine the definitive role of multivessel PCI in cardiogenic shock.

  1. The mechatronic design of a fast wire scanner in IHEP U-70 accelerator

    Energy Technology Data Exchange (ETDEWEB)

    Baranov, V.T. [Institute for High Energy Physics in National Research Centre “Kurchatov Institute”, Protvino 142281 (Russian Federation); Makhov, S.S. [Microprivod Ltd., Moscow 111123 (Russian Federation); Savin, D.A.; Terekhov, V.I. [Institute for High Energy Physics in National Research Centre “Kurchatov Institute”, Protvino 142281 (Russian Federation)

    2016-10-11

    This paper presents the mechatronic design of a fast wire scanner based on a servomotor. The design of the wire scanner is motivated by the need to measure the transverse profile of the high power proton and carbon beams at the IHEP U-70 accelerator. This paper formulates the requirements to the fast wire scanner system for the high intensity proton beam at the U-70 accelerator. The results on the design of electro-mechanical device for the wire scanner with a wire traveling speed 10–20 m/s are presented. The solution consists in a brushless servomotor and standard motor control electronics. High radiation levels in the accelerator enclosure dictate the use of a resolver as the position feedback element.

  2. Improved quality of image got through whole-body CT scanner

    International Nuclear Information System (INIS)

    Asahina, Kiyotaka

    1980-01-01

    The quality of brain images taken with a whole-body CT scanner has so far been generally inferior in quality to those got through a CT scanner exclusively used for brains. In order to improve the whole-body CT scanner so as to get better brain image, its detection system has been made multichannel; the capacity of its X-ray tube, increased; and its software, innovated. As a result, the spatial resolution has been improved from 5.51 p/cm to 9.01 p/cm, the contrast resolution has been improved from 3.2 mm% to 1.5 mm%, with the noise maintained at 0.5%. In clinical examination, the image quality has been improved equally well for brains, abdomens and lungs. Especially high appreciation is given to the diagnosis information got through this new scanner. (author)

  3. A double-bent planar leaf flexure guide for a nano-scanner: experimental report

    International Nuclear Information System (INIS)

    Jeon, Jeong-Woo; Kim, Jong-Moon; Lee, Young-Hyoung; Lee, Dong-Yeon

    2014-01-01

    We describe an experimental study on the double-bent leaf flexure-guided nano-scanner introduced in a previous paper [J. Korean Phy. Soc. 57, 1581 (2010)]. The optimally-designed nanoscanner was fabricated. Its performances were verified using a finite element analysis (FEA). The nano-scanner is actuated by a voice coil motor. Its characteristics were measured with a laser interferometer. The first resonant frequency is calculated as 17.1 Hz. The performances of the nano-scanner, including sine tracking capability, a multi-step response, and range of travel check were evaluated using various experimental procedures. Test results reveal that the scanner traveled over a 4.0 mm range and had good nano-precision (4 nm).

  4. Performance evaluation of 8 CT scanners for clinical use in Italy

    International Nuclear Information System (INIS)

    Pinto, I.; De Denaro, M.; Giribona, P.; Gicericin, C.; Bravar, D.

    1988-01-01

    In the past few years the use of CT scanners has widely spread in Italian care institutions. This methodology has thus become an important creates the need for an accurate study of the various aspects of the phenomenon, e.g. technological, diagnostic and economic. In order to evaluate the quality of the CT scanners used in our country, the majors suppliers of the Italian market were asked to provide us with a unit from their production. Six out of 7 companies complied with our request. A standard protocol was used to evaluate the performance of 8 CT scanners, currently used in Italy. The following parameters were evaluated: spatial resolution, contrast resolution, noise, slice thickness, uniformity, linearity and radiation dose. Five currently-used operating modalities were employed. The results allow an overall assessment of the performance of the 8 CT scanners

  5. Ethnic differences in the occurrence of acute coronary syndrome: results of the Malaysian National Cardiovascular Disease (NCVD) Database Registry (March 2006 - February 2010).

    Science.gov (United States)

    Lu, Hou Tee; Nordin, Rusli Bin

    2013-11-06

    The National Cardiovascular Disease (NCVD) Database Registry represents one of the first prospective, multi-center registries to treat and prevent coronary artery disease (CAD) in Malaysia. Since ethnicity is an important consideration in the occurrence of acute coronary syndrome (ACS) globally, therefore, we aimed to identify the role of ethnicity in the occurrence of ACS among high-risk groups in the Malaysian population. The NCVD involves more than 15 Ministry of Health (MOH) hospitals nationwide, universities and the National Heart Institute and enrolls patients presenting with ACS [ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI) and unstable angina (UA)]. We analyzed ethnic differences across socio-demographic characteristics, hospital medications and invasive therapeutic procedures, treatment of STEMI and in-hospital clinical outcomes. We enrolled 13,591 patients. The distribution of the NCVD population was as follows: 49.0% Malays, 22.5% Chinese, 23.1% Indians and 5.3% Others (representing other indigenous groups and non-Malaysian nationals). The mean age (SD) of ACS patients at presentation was 59.1 (12.0) years. More than 70% were males. A higher proportion of patients within each ethnic group had more than two coronary risk factors. Malays had higher body mass index (BMI). Chinese had highest rate of hypertension and hyperlipidemia. Indians had higher rate of diabetes mellitus (DM) and family history of premature CAD. Overall, more patients had STEMI than NSTEMI or UA among all ethnic groups. The use of aspirin was more than 94% among all ethnic groups. Utilization rates for elective and emergency percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) were low among all ethnic groups. In STEMI, fibrinolysis (streptokinase) appeared to be the dominant treatment options (>70%) for all ethnic groups. In-hospital mortality rates for STEMI across ethnicity ranges from 8.1% to 10.1% (p = 0

  6. Dietary fiber and risk of coronary heart disease

    DEFF Research Database (Denmark)

    Pereira, Mark A; O'Reilly, Eilis; Augustsson, Katarina

    2004-01-01

    BACKGROUND: Few epidemiologic studies of dietary fiber intake and risk of coronary heart disease have compared fiber types (cereal, fruit, and vegetable) or included sex-specific results. The purpose of this study was to conduct a pooled analysis of dietary fiber and its subtypes and risk...... of coronary heart disease. METHODS: We analyzed the original data from 10 prospective cohort studies from the United States and Europe to estimate the association between dietary fiber intake and the risk of coronary heart disease. RESULTS: Over 6 to 10 years of follow-up, 5249 incident total coronary cases...... associated with risk of coronary heart disease....

  7. Noninvasive Diagnostic Technique in Stenotic Coronary Atherosclerosis

    Directory of Open Access Journals (Sweden)

    A. Yu. Vasilyev

    2005-01-01

    Full Text Available Objective: to determine the sensitivity and specificity of combined stress echocardiography (EchoCG using dipyri-damole and dobutamine in diagnosing and defining the extent of stenotic coronary lesions in coronary heart disease (CHD in a group of critically ill patients who are unable to perform a physical exercise.Materials and methods: the study included 57 male patients with suspected acute coronary syndrome who underwent stress EchoCG using dipyridamole in high doses in combination with dobutamine, as well as coronary angiography.Results: stress EchoCG could bring up to the diagnostic criteria in all the patients, of whom 9 patients were found at coronary angiography to have no coronary lesion, 34 and 14 patients had one- and many-vessel lesions, respectively. The sensitivity and specificity of combined stress EchoCG were significantly higher than those of EchoCG used in the diagnosis of CHD.Conclusion: stress EchoCG using dipyridamole in combination with dobutamine is a highly informative safe noninvasive technique for diagnosing CHD, its helps to identify patients with atypical acute coronary syndrome and to form a group of patients to be subject to urgent coronarography and angiosurgical intervention. The pattern of segmental contractile disorders at the height of exercise during combined stress Echo-CG makes it possible to define the site of stenotic coronary atherosclerosis with 97.3% sensitivity and to diagnose many-vessel lesion with 100% sensitivity and 100%specificity.

  8. Multislice CT imaging of anomalous coronary arteries

    International Nuclear Information System (INIS)

    Shi Heshui; Aschoff, Andrik J.; Brambs, Hans-Juergen; Hoffmann, Martin H.K.

    2004-01-01

    The purpose of the present study was to evaluate the role of 16 multislice computed tomography (MSCT) to identify the origin of anomalous coronary arteries and to confirm their anatomic course in relation to the great vessels. Accuracy of coronary artery disease (CAD) detection was a secondary aim and was tested with conventional angiograms (CA) serving as standard of reference. Two hundred and forty-two consecutive patients referred for noninvasive coronary CT imaging were reviewed for the study. Sixteen patients (6.6%) with anomalous coronary arteries were detected and included as the study group. MSCT and CA images were analyzed in a blinded fashion for accuracy of anomalous artery origin and path detection. Results were compared in a secondary consensus evaluation. Accuracy ratios to detect CAD with MSCT in all vessels were calculated. Coronary anomalies for all 16 patients were correctly displayed on MSCT. CA alone achieved correct identification of the abnormality in only 53% (P=0.016). Sensitivity and specificity of MSCT to detect significantly stenosed vessels was 90 and 92%. 16-MSCT is accurate to delineate abnormally branching coronary arteries and allows sufficiently accurate detection of obstructive coronary artery disease in distal branches. It should therefore be considered as a prime non-invasive imaging tool for suspected coronary anomalies. (orig.)

  9. Body scanners: are they dangerous for health?; Scanners corporels: dangereux pour la sante?

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    2010-07-01

    As there is a debate about the risk of cancer and of congenital malformation associated with the use of body scanners, notably in airports, this document recalls and comments the IAEA statement on this issue. According to a study performed by this international agency, the irradiation dose is very low. But the French IRSN is more prudent and recommends not to use X ray scanner, but to look for technologies which do not use ionizing radiation

  10. The performance characteristics of the Philips Gemini PET/CT scanner

    International Nuclear Information System (INIS)

    O'Keefe, G.J.; Papenfuss, A.T.; Scott, A.M.; Rowe, C.C.

    2002-01-01

    Full text: The Department of Nuclear Medicine, Centre for PET at the ARMC is commissioning a next generation PET/CT scanner based on gadolinium silicic dioxide (GSO) crystal technology to replace the BGO crystal PET scanner that has been in operation since 1992. The Gemini PET/CT scanner is a fully 3D PET system which offers significantly increased resolution and sensitivity allowing wholebody scans in under 30 minutes. Until the late 90's, PET scanners were largely used with septa for neurological imaging and the performance characteristics of PET scanners were presented according to the NEMA-NU2-94 standard which specifically addresses the performance of PET scanners for neurological applications. PET is now largely used without septa for oncological imaging and as such, the NEMA-NU2-94 standard does not adequately reflect performance. The NEMA-NU2-2001 standard was designed to incorporate the effects of out-of-FOV activity and its contribution to performance by virtue of the increased scatter and randoms that result when performing wholebody scans without the use of septa. As part of the acceptance program of the Allegro/Gemini systems, the NEMA-NU2-2001 standard will be used to characterise the spatial resolution, sensitivity, randoms and scatter contributions and the Noise Equivalent Count rate (NECr). These results will be presented and compared with the ECAT 951/31R performance characteristics. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  11. Syntax Score and Major Adverse Cardiac Events in Patients with Suspected Coronary Artery Disease: Results from a Cohort Study in a University-Affiliated Hospital in Southern Brazil.

    Science.gov (United States)

    Fuchs, Felipe C; Ribeiro, Jorge P; Fuchs, Flávio D; Wainstein, Marco V; Bergoli, Luis C; Wainstein, Rodrigo V; Zen, Vanessa; Kerkhoff, Alessandra C; Moreira, Leila B; Fuchs, Sandra C

    2016-09-01

    The importance of coronary anatomy in predicting cardiovascular events is well known. The use of traditional anatomical scores in routine angiography, however, has not been incorporated to clinical practice. SYNTAX score (SXscore) is a scoring system that estimates the anatomical extent of coronary artery disease (CAD). Its ability to predict outcomes based on a baseline diagnostic angiography has not been tested to date. To evaluate the performance of the SXscore in predicting major adverse cardiac events (MACE) in patients referred for diagnostic angiography. Prospective cohort of 895 patients with suspected CAD referred for elective diagnostic coronary angiography from 2008 to 2011, at a university-affiliated hospital in Brazil. They had their SXscores calculated and were stratified in three categories: no significant CAD (n = 495), SXscoreLOW-INTERMEDIATE: prospectiva de 895 pacientes com suspeita de DAC encaminhados para cineangiocoronariografia diagnóstica eletiva de 2008 a 2011, em hospital universitário no Brasil. Os pacientes tiveram seus SXescores calculados e foram estratificados em três categorias: 'sem DAC significativa' (n = 495); SXescoreBAIXO-INTERMEDIÁRIO: < 23 (n = 346); e SXescoreALTO: ≥ 23 (n = 54). O desfecho primário foi composto de morte cardíaca, infarto do miocárdio e revascularização tardia. Os desfechos secundários foram MACE e morte por todas as causas. Em média, os pacientes foram acompanhados por 1,8 ± 1,4 anos. Desfecho primário ocorreu em 2,2%, 15,3% e 20,4% nos grupos 'sem DAC significativa', SXescoreBAIXO-INTERMEDIÁRIO e SXescoreALTO, respectivamente (p < 0,001). Morte por todas as causas foi significativamente mais frequente no grupo de SXescoreALTO comparado ao grupo 'sem DAC significativa', 16,7% e 3,8% (p < 0,001), respectivamente. Após ajuste para fatores de confusão, todos os desfechos permaneceram associados com o SXescore. O SXescore prediz independentemente MACE em pacientes submetidos a

  12. Morphometry of the coronary ostia and the structure of coronary arteries in the shorthair domestic cat

    Science.gov (United States)

    Barszcz, Karolina; Kupczyńska, Marta; Klećkowska-Nawrot, Joanna; Janeczek, Maciej; Goździewska-Harłajczuk, Karolina; Dzierzęcka, Małgorzata; Janczyk, Paweł

    2017-01-01

    The aim of this study was to measure the area of the coronary ostia, assess their localization in the coronary sinuses and to determine the morphology of the stem of the left and right coronary arteries in the domestic shorthair cat. The study was conducted on 100 hearts of domestic shorthair cats of both sexes, aged 2–18 years, with an average body weight of 4.05 kg. A morphometric analysis of the coronary ostia was carried out on 52 hearts. The remaining 48 hearts were injected with a casting material in order to carry out a morphological assessment of the left and right coronary arteries. In all the studied animals, the surface of the left coronary artery ostium was larger than the surface of the right coronary artery ostium. There were four types of the left main coronary artery: type I (23 animals, 49%)–double-branched left main stem (giving off the left circumflex branch and the interventricular paraconal branch, which in turn gave off the septal branch), type II (12 animals, 26%)–double-branched left main stem (giving off the left circumflex branch and the interventricular paraconal branch without the septal branch), type III (11 animals, 23%)–triple-branched left main stem (giving off the left circumflex branch, interventricular branch and the septal branch, type IV (1 animal, 2%)–double-branched left main stem (giving off the interventricular paraconal branch and the left circumflex branch, which in turn gave off the septal branch). The left coronary artery ostium is greater than the right one. There is considerable diversity in the branches of proximal segment of the left coronary artery, while the right coronary artery is more conservative. These results can be useful in defining the optimal strategies in the endovascular procedures involving the coronary arteries or the aortic valve in the domestic shorthair cat. PMID:29020103

  13. Morphometry of the coronary ostia and the structure of coronary arteries in the shorthair domestic cat.

    Directory of Open Access Journals (Sweden)

    Karolina Barszcz

    Full Text Available The aim of this study was to measure the area of the coronary ostia, assess their localization in the coronary sinuses and to determine the morphology of the stem of the left and right coronary arteries in the domestic shorthair cat. The study was conducted on 100 hearts of domestic shorthair cats of both sexes, aged 2-18 years, with an average body weight of 4.05 kg. A morphometric analysis of the coronary ostia was carried out on 52 hearts. The remaining 48 hearts were injected with a casting material in order to carry out a morphological assessment of the left and right coronary arteries. In all the studied animals, the surface of the left coronary artery ostium was larger than the surface of the right coronary artery ostium. There were four types of the left main coronary artery: type I (23 animals, 49%-double-branched left main stem (giving off the left circumflex branch and the interventricular paraconal branch, which in turn gave off the septal branch, type II (12 animals, 26%-double-branched left main stem (giving off the left circumflex branch and the interventricular paraconal branch without the septal branch, type III (11 animals, 23%-triple-branched left main stem (giving off the left circumflex branch, interventricular branch and the septal branch, type IV (1 animal, 2%-double-branched left main stem (giving off the interventricular paraconal branch and the left circumflex branch, which in turn gave off the septal branch. The left coronary artery ostium is greater than the right one. There is considerable diversity in the branches of proximal segment of the left coronary artery, while the right coronary artery is more conservative. These results can be useful in defining the optimal strategies in the endovascular procedures involving the coronary arteries or the aortic valve in the domestic shorthair cat.

  14. Nonlinear registration of serial coronary CT angiography (CCTA) for assessment of changes in atherosclerotic plaque

    International Nuclear Information System (INIS)

    Woo, Jonghye; Dey, Damini; Cheng, Victor Y.; Hong, Byung-Woo; Ramesh, Amit; Sundaramoorthi, Ganesh; Nakazato, Ryo; Berman, Daniel S.; Germano, Guido; Kuo, C.-C. Jay; Slomka, Piotr J.

    2010-01-01

    Purpose: Coronary CT angiography (CCTA) is a high-resolution three-dimensional imaging technique for the evaluation of coronary arteries in suspected or confirmed coronary artery disease (CAD). Coregistration of serial CCTA scans would allow precise superimposition of images obtained at two different points in time, which could aid in recognition of subtle changes and precise monitoring of coronary plaque progression or regression. To this end, the authors aimed at developing a fully automatic nonlinear volume coregistration for longitudinal CCTA scan pairs. Methods: The algorithm combines global displacement and local deformation using nonlinear volume coregistration with a volume-preserving constraint. Histogram matching of intensities between two serial scans is performed prior to nonlinear coregistration with dense nonparametric local deformation in which sum of squared differences is used as a similarity measure. The approximate segmentation of coronary arteries obtained from commercially available software provides initial anatomical landmarks for the coregistration algorithm that help localize and emphasize the structure of interest. To avoid possible bias caused by incorrect segmentation, the authors convolve the Gaussian kernel with the segmented binary coronary tree mask and define an extended weighted region of interest. A multiresolution approach is employed to represent coarse-to-fine details of both volumes and the energy function is optimized using a gradient descent method. The authors applied the algorithm in ten paired CCTA datasets (20 scans in total) obtained within 10.7±5.7 months from each other on a dual source CT scanner to monitor progression of CAD. Results: Serial CCTA coregistration was successful in 9/10 cases as visually confirmed. The global displacement and local deformation of target registration error obtained from four anatomical landmarks were 2.22±1.15 and 1.56±0.74 mm, respectively, and the inverse consistency error of local

  15. Evaluation of PeneloPET Simulations of Biograph PET/CT Scanners

    Science.gov (United States)

    Abushab, K. M.; Herraiz, J. L.; Vicente, E.; Cal-González, J.; España, S.; Vaquero, J. J.; Jakoby, B. W.; Udías, J. M.

    2016-06-01

    Monte Carlo (MC) simulations are widely used in positron emission tomography (PET) for optimizing detector design, acquisition protocols, and evaluating corrections and reconstruction methods. PeneloPET is a MC code based on PENELOPE, for PET simulations which considers detector geometry, acquisition electronics and materials, and source definitions. While PeneloPET has been successfully employed and validated with small animal PET scanners, it required a proper validation with clinical PET scanners including time-of-flight (TOF) information. For this purpose, we chose the family of Biograph PET/CT scanners: the Biograph True-Point (B-TP), Biograph True-Point with TrueV (B-TPTV) and the Biograph mCT. They have similar block detectors and electronics, but a different number of rings and configuration. Some effective parameters of the simulations, such as the dead-time and the size of the reflectors in the detectors, were adjusted to reproduce the sensitivity and noise equivalent count (NEC) rate of the B-TPTV scanner. These parameters were then used to make predictions of experimental results such as sensitivity, NEC rate, spatial resolution, and scatter fraction (SF), from all the Biograph scanners and some variations of them (energy windows and additional rings of detectors). Predictions agree with the measured values for the three scanners, within 7% (sensitivity and NEC rate) and 5% (SF). The resolution obtained for the B-TPTV is slightly better (10%) than the experimental values. In conclusion, we have shown that PeneloPET is suitable for simulating and investigating clinical systems with good accuracy and short computational time, though some effort tuning of a few parameters of the scanners modeled may be needed in case that the full details of the scanners studied are not available.

  16. [Prognostic factors in patients with non-ST-segment elevation acute coronary syndrome concurrent with type 2 diabetes mellitus (according to the results of the registry)].

    Science.gov (United States)

    Golikov, A P; Berns, S A; Stryuk, R I; Shmidt, E A; Golikova, A A; Barbarash, O L

    To investigate factors that influence annual prognosis in patients with non-ST-segment elevation acute coronary syndrome ((NSTEACS) concurrent with type 2 diabetes mellitus (DM2). The registry of patients with NSTEACS (non-ST-segment elevation myocardial infarction (NSTEMI), unstable angina) included 415 patients, of them 335 had no carbohydrate metabolic disorders, 80 had DM2. The follow-up period, during which the prognosis was evaluated in the patients, was one year after hospital discharge following the index NSTEACS event. Lipidogram readings and the serum levels of endothelin-1 (ET-1), sP-selectin, sE-selectin, and sPECAM were determined on day 10 after admission to hospital. All the patients underwent coronary angiography (CA), Doppler ultrasound of peripheral arteries during their hospital stay. The patients with DM2 versus those without diabetes proved to be significantly older and to have a higher body mass index; among them there were more women, they were noted to have more frequently hypertension and less frequently smoked. The presence of DM2 was associated with significantly increased intima-media thickness and higher GRACE scores (p=0.013) as compared to those in the patients with normal carbohydrate metabolism. There were significant differences in high-density lipoprotein levels that were lower, as well as in triglyceride levels and atherogenic index, which were higher in patients with DM2 than in those without this condition. In addition, there were significant differences in ET-1, sP-selectin, sE-selectin, and sPECAM levels that were significantly higher in the DM2 group. Moreover, the levels of ET-1 and sPECAM were above normal in both the DM and non-DM2 groups. Assessment of poor outcomes at one year of the observation established that cardiovascular mortality rates were significantly higher and coronary angiography was performed much less frequently in the DM2 group. The most significant prognostic factors associated with a poor prognosis

  17. Clinical events in coronary heart disease patients with an ejection fraction of 40% or less: 3-year follow-up results.

    Science.gov (United States)

    Pischke, Claudia R; Elliott-Eller, Melanie; Li, Minmin; Mendell, Nancy; Ornish, Dean; Weidner, Gerdi

    2010-01-01

    It is unclear whether lifestyle changes can delay the need for surgical procedures in coronary heart disease (CHD) patients with asymptomatic reduced left ventricular ejection fraction (LVEF). The aim of this pilot study was to examine whether lifestyle changes can delay the need for surgical procedures in this population. We compared 3-year clinical events in 27 CHD patients eligible to receive revascularization (by insurance standards), but underwent lifestyle changes (low-fat diet, exercise, stress management) instead (intervention group [IG], LVEF Lifestyle Demonstration Project, an insurance-sponsored, community-based, secondary prevention study implemented at 8 hospital sites in the United States. At 3 months, there were more cardiac events in the UCG (6 events) than in the IG (1 event; P changes in lifestyle with no increased risk for cardiac events or overt heart failure over 3 years.

  18. 21 CFR 882.1925 - Ultrasonic scanner calibration test block.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ultrasonic scanner calibration test block. 882... Ultrasonic scanner calibration test block. (a) Identification. An ultrasonic scanner calibration test block is a block of material with known properties used to calibrate ultrasonic scanning devices (e.g., the...

  19. Imaging diagnosis of congenital heart disease with single coronary artery

    International Nuclear Information System (INIS)

    Zhu Ming; Li Yuhua; Zhong Yumin; Sun Aimin

    2003-01-01

    Objective: To report 56 cases of congenital heart disease with congenital single coronary artery and to evaluate the imaging diagnostic techniques. Methods: All 56 patients with congenital single coronary artery underwent angiocardiography. Contrast enhancement magnetic resonance angiography (CE MRA) was performed in 4 cases. 48 cases were confirmed by operation. Results: In these 56 cases, single left coronary artery was found in 44 cases and single right coronary artery was found in 12. Conclusion: Congenital heart disease with congenital single coronary artery is not rare and correct diagnosis is very important for surgery

  20. Complementary effects of thienopyridine pretreatment and platelet glycoprotein IIb/IIIa integrin blockade with eptifibatide in coronary stent intervention; results from the ESPRIT trial.

    Science.gov (United States)

    Dery, Jean-Pierre; Campbell, Mark E; Mathias, Jasmine; Pieper, Karen S; Harrington, Robert A; Madan, Mina; Gibson, C Michael; Tolleson, Thaddeus R; O'Shea, J Conor; Tcheng, James E

    2007-07-01

    This analysis sought to investigate the complementary effect of thienopyridine pretreatment and platelet glycoprotein (GP) IIb/IIIa integrin blockade in coronary stent intervention. Definitive evidence supporting combined antiplatelet therapy consisting of thienopyridine pretreatment and GP IIb/IIIa receptor blockade in patients undergoing percutaneous coronary intervention (PCI) with stent implantation is limited. We retrospectively analyzed clinical outcomes by thienopyridine use in the 2,040 patients randomized to eptifibatide or placebo who underwent PCI in the ESPRIT trial. A total of 901 patients received a loading dose of thienopyridine before PCI (group 1), 123 received thienopyridine pretreatment without a loading dose (group 2), and 1,016 were not treated with thienopyridine before PCI (group 3). The composite incidence of death or myocardial infarction at 30 days was significantly lower in group 1 than in groups 2 and 3 combined (OR, 0.71 [95%CI, 0.52-0.99]; P = 0.0417). A similar trend was seen for the composite of death, myocardial infarction, or urgent target vessel revascularization (unadjusted OR, 0.77 [0.57-1.05]; P = 0.1025). After adjusting for baseline characteristics, these differences were no longer significant. No interactions were identified with eptifibatide assignment for any of the group comparisons. Pretreatment with a loading dose of thienopyridine lowers the rate of ischemic complications regardless of treatment with a GP IIb/IIIa inhibitor. Conversely, the efficacy of eptifibatide is maintained whether or not a loading dose of a thienopyridine is administered. Optimal outcomes are achieved in patients receiving thienopyridine pretreatment along with platelet GP IIb/IIIa inhibitor therapy. (c) 2007 Wiley-Liss, Inc.

  1. Smoking cessation in European patients with coronary heart disease. Results from the EUROASPIRE IV survey: A registry from the European Society of Cardiology.

    Science.gov (United States)

    Snaterse, M; Deckers, J W; Lenzen, M J; Jorstad, H T; De Bacquer, D; Peters, R J G; Jennings, C; Kotseva, K; Scholte Op Reimer, W J M

    2018-05-01

    We investigated smoking cessation rates in coronary heart disease (CHD) patients throughout Europe; current and as compared to earlier EUROASPIRE surveys, and we studied characteristics of successful quitters. Analyses were done on 7998 patients from the EUROASPIRE-IV survey admitted for myocardial infarction, unstable angina and coronary revascularisation. Self-reported smoking status was validated by measuring carbon monoxide in exhaled air. Thirty-one percent of the patients reported being a smoker in the month preceding hospital admission for the recruiting event, varying from 15% in centres from Finland to 57% from centres in Cyprus. Smoking rates at the interview were also highly variable, ranging from 7% to 28%. The proportion of successful quitters was relatively low in centres with a low number of pre- event smokers. Overall, successful smoking cessation was associated with increasing age (OR 1.50; 95% CI 1.09-2.06) and higher levels of education (OR 1.38; 95% CI 1.08-1.75). Successful quitters more frequently reported that they had been advised (56% vs. 47%, p < .001) and to attend (81% vs. 75%, p < .01) a cardiac rehabilitation programme. Our study shows wide variation in cessation rates in a large contemporary European survey of CHD patients. Therefore, smoking cessation rates in patients with a CHD event should be interpreted in the light of pre-event smoking prevalence, and caution is needed when comparing cessation rates across Europe. Furthermore, we found that successful quitters reported more actions to make healthy lifestyle changes, including participating in a cardiac rehabilitation programme, as compared with persistent smokers. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. Association between gender, process of care measures, and outcomes in ACS in India: results from the detection and management of coronary heart disease (DEMAT registry.

    Directory of Open Access Journals (Sweden)

    Neha J Pagidipati

    Full Text Available Studies from high-income countries have shown that women receive less aggressive diagnostics and treatment than men in acute coronary syndromes (ACS, though their short-term mortality does not appear to differ from men. Data on gender differences in ACS presentation, management, and outcomes are sparse in India.The Detection and Management of Coronary Heart Disease (DEMAT Registry collected data from 1,565 suspected ACS patients (334 women; 1,231 men from ten tertiary care centers throughout India between 2007-2008. We evaluated gender differences in presentation, in-hospital and discharge management, and 30-day death and major adverse cardiovascular event (MACE; death, re-hospitalization, and cardiac arrest rates. Women were less likely to present with STEMI than men (38% vs. 55%, p<0.001. Overall inpatient diagnostics and treatment patterns were similar between men and women after adjustment for potential confounders. Optimal discharge management with aspirin, clopidogrel, beta-blockers, and statin therapy was lower for women than men, (58% vs. 65%, p = 0.03, but these differences were attenuated after adjustment (OR = 0.86 (0.62, 1.19. Neither the outcome of 30-day mortality (OR = 1.40 (0.62, 3.16 nor MACE (OR = 1.00 (0.67, 1.48 differed significantly between men and women after adjustment.ACS in-hospital management, discharge management, and 30-day outcomes did not significantly differ between genders in the DEMAT registry, though consistently higher treatment rates and lower event rates in men compared to women were seen. These findings underscore the importance of further investigation of gender differences in cardiovascular care in India.

  3. First-Generation Versus Second-Generation Drug-Eluting Stents in Coronary Chronic Total Occlusions: Two-Year Results of a Multicenter Registry.

    Directory of Open Access Journals (Sweden)

    Jong-Hwa Ahn

    Full Text Available Limited data are available regarding the long-term clinical outcomes of second-generation drug-eluting stents (DES versus first-generation DES in patients with coronary chronic total occlusion (CTO who undergo percutaneous coronary intervention (PCI. The aim of this study was to compare the clinical outcomes of second-generation DES with those of first-generation DES for the treatment of CTO.Between March 2003 and February 2012, 1,006 consecutive patients with CTO who underwent successful PCI using either first-generation DES (n = 557 or second-generation DES (n = 449 were enrolled in a multicenter, observational registry. Propensity-score matching was also performed. The primary outcome was cardiac death over a 2-year follow-up period. No significant differences were observed between the two groups regarding the incidence of cardiac death (first-generation DES versus second-generation DES; 2.5% vs 2.0%; hazard ratio [HR]: 0.86; 95% confidence interval [CI]: 0.37 to 1.98; p = 0.72 or major adverse cardiac events (MACE, 11.8% vs 11.4%; HR: 1.00; 95% CI: 0.67 to 1.50; p = 0.99. After propensity score matching, the incidences of cardiac death (HR: 0.86; 95% CI: 0.35 to 2.06; p = 0.86 and MACE (HR: 0.93; 95% CI: 0.63 to 1.37; p = 0.71 were still similar in both groups. Furthermore, no significant differences were observed between sirolimus-eluting, paclitaxel-eluting, zotarolimus-eluting, and everolimus-eluting stents regarding the incidence of cardiac death or MACE.This study shows that the efficacy of second-generation DES is comparable to that of first-generation DES for treatment of CTO over 2 years of follow-up.

  4. Cholesterol target value attainment and lipid-lowering therapy in patients with stable or acute coronary heart disease: Results from the Dyslipidemia International Study II.

    Science.gov (United States)

    Gitt, Anselm K; Lautsch, Dominik; Ferrières, Jean; De Ferrari, Gaetano M; Vyas, Ami; Baxter, Carl A; Bash, Lori D; Ashton, Veronica; Horack, Martin; Almahmeed, Wael; Chiang, Fu-Tien; Poh, Kian Keong; Brudi, Philippe; Ambegaonkar, Baishali

    2017-11-01

    Low-density lipoprotein cholesterol (LDL-C) is a major contributor to cardiovascular disease. In the Dyslipidemia International Study II (DYSIS II), we determined LDL-C target value attainment, use of lipid-lowering therapy (LLT), and cardiovascular outcomes in patients with stable coronary heart disease (CHD) and those suffering from an acute coronary syndrome (ACS). DYSIS II included patients from 18 countries. Patients with either stable CHD or an ACS were enrolled if they were ≥18 years old and had a full lipid profile available. Data were collected at a physician visit (CHD cohort) or at hospital admission and 120 days later (ACS cohort). A total of 10,661 patients were enrolled, 6794 with stable CHD and 3867 with an ACS. Mean LDL-C levels were low at 88 mg/dl and 108 mg/dl for the CHD and ACS cohorts respectively, with only 29.4% and 18.9% displaying a level below 70 mg/dl. LLT was utilized by 93.8% of the CHD cohort, with a mean daily statin dosage of 25 ± 18 mg. The proportion of the ACS cohort treated with LLT rose from 65.2% at admission to 95.6% at follow-up. LLT-treated patients, who were female, obese, or current smokers, were less likely to achieve an LDL-C level of <70 mg/dl, while those with type 2 diabetes, chronic kidney disease, or those taking a higher statin dosage were more likely. Few of these very high-risk patients achieved the LDL-C target, indicating huge potential for improving cardiovascular outcome by use of more intensive LLT. Copyright © 2017. Published by Elsevier B.V.

  5. Unsteady pressures on a blunt trailing edge measured with an embedded pressure scanner

    Science.gov (United States)

    Naughton, Jonathan; Nikoueeyan, Pourya; Hind, Michael; Strike, John; Dahland, Matz; Keeter, Steven

    2017-11-01

    Development of direct-mount pressure scanners can decrease the pneumatic tubing length required to connect the measurement ports to the scanner manifold resulting in improved dynamic range for unsteady pressure measurements. In this work, the performance of a direct-mount pressure scanner for time-resolved pressure measurement is demonstrated in a well-established flow; the pressure fluctuations near the base of flat plate is considered. The additive manufactured model is instrumented with a pressure scanner and flush-mounted high-speed pressure transducers. The configuration of the ports on the model allows for side-by-side comparison of the pressures measured via embedded pneumatic tubing routed to a pressure scanner with that measured by high-speed transducers. Prior to testing, the dynamic response of each embedded pressure port is dynamically calibrated via an in-situ calibration technique. Pressure data is then acquired for fixed angle-of-attack and different dynamic pitching conditions. The dynamic range of the measurements acquired via direct-mount scanner will be compared to those acquired by the high speed transducers for both static and dynamic pitching configurations. The uncertainties associated with Weiner deconvolution are also quantified for the measurements.

  6. Inter-operator and inter-device agreement and reliability of the SEM Scanner.

    Science.gov (United States)

    Clendenin, Marta; Jaradeh, Kindah; Shamirian, Anasheh; Rhodes, Shannon L

    2015-02-01

    The SEM Scanner is a medical device designed for use by healthcare providers as part of pressure ulcer prevention programs. The objective of this study was to evaluate the inter-rater and inter-device agreement and reliability of the SEM Scanner. Thirty-one (31) volunteers free of pressure ulcers or broken skin at the sternum, sacrum, and heels were assessed with the SEM Scanner. Each of three operators utilized each of three devices to collect readings from four anatomical sites (sternum, sacrum, left and right heels) on each subject for a total of 108 readings per subject collected over approximately 30 min. For each combination of operator-device-anatomical site, three SEM readings were collected. Inter-operator and inter-device agreement and reliability were estimated. Over the course of this study, more than 3000 SEM Scanner readings were collected. Agreement between operators was good with mean differences ranging from -0.01 to 0.11. Inter-operator and inter-device reliability exceeded 0.80 at all anatomical sites assessed. The results of this study demonstrate the high reliability and good agreement of the SEM Scanner across different operators and different devices. Given the limitations of current methods to prevent and detect pressure ulcers, the SEM Scanner shows promise as an objective, reliable tool for assessing the presence or absence of pressure-induced tissue damage such as pressure ulcers. Copyright © 2015 Bruin Biometrics, LLC. Published by Elsevier Ltd.. All rights reserved.

  7. Active Damping of a Piezoelectric Tube Scanner using Self-Sensing Piezo Actuation

    Science.gov (United States)

    Kuiper, S.; Schitter, G.

    2010-01-01

    In most Atomic Force Microscopes (AFM), a piezoelectric tube scanner is used to position the sample underneath the measurement probe. Oscillations stemming from the weakly damped resonances of the tube scanner are a major source of image distortion, putting a limitation on the achievable imaging speed. This paper demonstrates active damping of these oscillations in multiple scanning axes without the need for additional position sensors. By connecting the tube scanner in a capacitive bridge circuit the scanner oscillations can be measured in both scanning axes, using the same piezo material as an actuator and sensor simultaneously. In order to compensate for circuit imbalance caused by hysteresis in the piezo element, an adaptive balancing circuit is used. The obtained measurement signal is used for feedback control, reducing the resonance peaks in both scanning axes by 18 dB and the cross-coupling at those frequencies by 30 dB. Experimental results demonstrate a significant reduction in scanner oscillations when applying the typical triangular scanning signals, as well as a strong reduction in coupling induced oscillations. Recorded AFM images show a considerable reduction in image distortion due to the proposed control method, enabling artifact free AFM imaging at a speed of 122 lines per second with a standard piezoelectric tube scanner. PMID:26412944

  8. Coronary computed tomography angiography with 320-row detector and using the AIDR-3D: initial experience

    International Nuclear Information System (INIS)

    Sasdelli Neto, Roberto; Nomura, Cesar Higa; Macedo, Ana Carolina Sandoval; Bianco, Danilo Perussi; Kay, Fernando Uliana; Szarf, Gilberto; Teles, Gustavo Borges da Silva; Shoji, Hamilton; Santana Netto, Pedro Vieira; Passos, Rodrigo Bastos Duarte; Chate, Rodrigo Caruso; Ishikawa, Walther Yoshiharu; Lima, Joao Paulo Bacellar Costa; Rocha, Marcelo Assis; Marcos, Vinicius Neves; Funari, Marcelo Buarque de Gusmao; Failla, Bruna Bonaventura

    2013-01-01

    Coronary computed tomography angiography (coronary CTA) is a powerful non-invasive imaging method to evaluate coronary artery disease. Nowadays, coronary CTA estimated effective radiation dose can be dramatically reduced using state-of-the-art scanners, such as 320-row detector CT (320-CT), without changing coronary CTA diagnostic accuracy. To optimize and further reduce the radiation dose, new iterative reconstruction algorithms were released recently by several CT manufacturers, and now they are used routinely in coronary CTA. This paper presents our first experience using coronary CTA with 320-CT and the Adaptive Iterative Dose Reduction 3D (AIDR-3D). In addition, we describe the current indications for coronary CTA in our practice as well as the acquisition standard protocols and protocols related to CT application for radiation dose reduction. In conclusion, coronary CTA radiation dose can be dramatically reduced following the 'as low as reasonable achievable' principle by combination of exam indication and well-documented technics for radiation dose reduction, such as beta blockers, low-kV, and also the newest iterative dose reduction software as AIDR-3D. (author)

  9. Comparative evaluation of ultrasound scanner accuracy in distance measurement

    Science.gov (United States)

    Branca, F. P.; Sciuto, S. A.; Scorza, A.

    2012-10-01

    The aim of the present study is to develop and compare two different automatic methods for accuracy evaluation in ultrasound phantom measurements on B-mode images: both of them give as a result the relative error e between measured distances, performed by 14 brand new ultrasound medical scanners, and nominal distances, among nylon wires embedded in a reference test object. The first method is based on a least squares estimation, while the second one applies the mean value of the same distance evaluated at different locations in ultrasound image (same distance method). Results for both of them are proposed and explained.

  10. QUALITY OF LIFE AND COMPLIANCE TO THERAPY IN PATIENTS FOLLOWING SUCCESSFUL TRANSLUMINAL CORONARY ANGIOPLASTY, WHO WERE PRESCRIBED LESCOL XL (FLUVASTATIN ADDED TO STANDARD THERAPY. RESULTS OF THE LESQOL OPEN-LABEL OBSERVATIONAL STUDY

    Directory of Open Access Journals (Sweden)

    A. V. Susekov

    2010-01-01

    Full Text Available Aim. The main aim of the present study was to evaluate quality of life changes and compliance to therapy in patients following successful transluminal angioplasty, who were prescribed fluvastatin extended release in addition to standard treatment.Material and methods. This was a national prospective multicenter observational study. Patients with coronary heart disease following successful transluminal coronary angioplasty, who were prescribed fluvastatin extended release (Lescol Forte, Novartis 80 mg QD were included in the present observation. The following efficacy and safety parameters were evaluated: quality of life evaluated with SF-36 scale before and during treatment; hypolipidemic efficacy, compliance to therapy; adverse events and serious adverse events. Observation period was 6 months in all patients and 12 months in some patients at the discretion of the investigator.Results. 524 patients (79% men and 21% women completed the 6 months observation period and 116 patients were followed up for 12 months. Significant increase of all measures of SF-36 scales, physical and mental health was observed in 6 and 12 months of fluvastatin extended release treatment. Total and low density lipoprotein cholesterol reduction was 30.5% and 54.9% respectively, p<0.01, in 6 months and 34.2% and 34.3% respectively in 12 months of treatment, p<0.01. High density lipoprotein cholesterol was significantly increased by 22.5% in 12 months of treatment, p<0.01. There were very few adverse events and laboratory changes during the course of treatment.Conclusion. LESQOL study showed significant increase in quality of life and good hypolipidemic efficacy as well as good tolerability of fluvastatin extended release in patients after coronary angioplasty.

  11. Diagnostic accuracy and utility of coronary CT angiography with consideration of unevaluable results: A systematic review and multivariate Bayesian random-effects meta-analysis with intention to diagnose

    Energy Technology Data Exchange (ETDEWEB)

    Menke, Jan [University Medical Center Goettingen, Institute for Diagnostic and Interventional Radiology, Goettingen (Germany); Kowalski, Joerg [Dr. Lauterbach-Klinik, Department of Cardiology, Bad Liebenstein (Germany)

    2016-02-15

    To meta-analyze diagnostic accuracy, test yield and utility of coronary computed tomography angiography (CCTA) in coronary artery disease (CAD) by an intention-to-diagnose approach with inclusion of unevaluable results. Four databases were searched from 1/2005 to 3/2013 for prospective studies that used 16-320-row or dual-source CTs and provided 3 x 2 patient-level data of CCTA (positive, negative, or unevaluable) versus catheter angiography (positive or negative) for diagnosing ≥50 % coronary stenoses. A Bayesian multivariate 3 x 2 random-effects meta-analysis considered unevaluable CCTAs. Thirty studies (3422 patients) were included. Compared to 16-40 row CT, test yield and accuracy of CCTA has significantly increased with ≥64-row CT (P < 0.05). In ≥64-row CT, about 2.5 % (95 %-CI, 0.9-4.8 %) of diseased patients and 7.5 % (4.5-11.2 %) of non-diseased patients had unevaluable CCTAs. A positive likelihood ratio of 8.9 (6.1-13.5) indicated moderate suitability for identifying CAD. A negative likelihood ratio of 0.022 (0.01-0.04) indicated excellent suitability for excluding CAD. Unevaluable CCTAs had an equivocal likelihood ratio of 0.42 (0.22-0.71). In the utility analysis, CCTA was useful at intermediate pre-test probabilities (16-70 %). CCTA is useful at intermediate CAD pre-test probabilities. Positive CCTAs require verification to confirm CAD, unevaluable CCTAs require alternative diagnostics, and negative CCTAs exclude obstructive CAD with high certainty. (orig.)

  12. Laser scanner 3D terrestri e mobile

    Directory of Open Access Journals (Sweden)

    Mario Ciamba

    2013-08-01

    Full Text Available Recentemente si è svolto a Roma un evento dimostrativo per informare, professionisti e ricercatori del settore inerente il rilievo strumentale, sulle recenti innovazioni che riguardano i laser scanner 3d. Il mercato della strumentazione dedicata al rilevamento architettonico e dell'ambiente, offre molte possibilità di scelta. Oggi i principali marchi producono strumenti sempre più efficienti ed ideati per ambiti di applicazione specifici, permettendo ai professionisti, la giusta scelta in termini di prestazioni ed economia. A demonstration event was recently held in Rome with the aim to inform professionals and researchers on recent innovations on instrumental survey related to the 3d laser scanner. The market of instrumentation for architectural survey offers many possibilitiesof choice. Today the major brands produce instruments that are more efficient and designed for specific areas of application, allowing the right choice in terms of performance and economy.

  13. Laser scanner 3D terrestri e mobile

    Directory of Open Access Journals (Sweden)

    Mario Ciamba

    2013-08-01

    Full Text Available Recentemente si è svolto a Roma un evento dimostrativo per informare, professionisti e ricercatori del settore inerente il rilievo strumentale, sulle recenti innovazioni che riguardano i laser scanner 3d. Il mercato della strumentazione dedicata al rilevamento architettonico e dell'ambiente, offre molte possibilità di scelta. Oggi i principali marchi producono strumenti sempre più efficienti ed ideati per ambiti di applicazione specifici, permettendo ai professionisti, la giusta scelta in termini di prestazioni ed economia.A demonstration event was recently held in Rome with the aim to inform professionals and researchers on recent innovations on instrumental survey related to the 3d laser scanner. The market of instrumentation for architectural survey offers many possibilitiesof choice. Today the major brands produce instruments that are more efficient and designed for specific areas of application, allowing the right choice in terms of performance and economy.

  14. Detector Position Estimation for PET Scanners.

    Science.gov (United States)

    Pierce, Larry; Miyaoka, Robert; Lewellen, Tom; Alessio, Adam; Kinahan, Paul

    2012-06-11

    Physical positioning of scintillation crystal detector blocks in Positron Emission Tomography (PET) scanners is not always exact. We test a proof of concept methodology for the determination of the six degrees of freedom for detector block positioning errors by utilizing a rotating point source over stepped axial intervals. To test our method, we created computer simulations of seven Micro Crystal Element Scanner (MiCES) PET systems with randomized positioning errors. The computer simulations show that our positioning algorithm can estimate the positions of the block detectors to an average of one-seventh of the crystal pitch tangentially, and one-third of the crystal pitch axially. Virtual acquisitions of a point source grid and a distributed phantom show that our algorithm improves both the quantitative and qualitative accuracy of the reconstructed objects. We believe this estimation algorithm is a practical and accurate method for determining the spatial positions of scintillation detector blocks.

  15. Detector position estimation for PET scanners

    International Nuclear Information System (INIS)

    Pierce, Larry; Miyaoka, Robert; Lewellen, Tom; Alessio, Adam; Kinahan, Paul

    2012-01-01

    Physical positioning of scintillation crystal detector blocks in Positron Emission Tomography (PET) scanners is not always exact. We test a proof of concept methodology for the determination of the six degrees of freedom for detector block positioning errors by utilizing a rotating point source over stepped axial intervals. To test our method, we created computer simulations of seven Micro Crystal Element Scanner (MiCES) PET systems with randomized positioning errors. The computer simulations show that our positioning algorithm can estimate the positions of the block detectors to an average of one-seventh of the crystal pitch tangentially, and one-third of the crystal pitch axially. Virtual acquisitions of a point source grid and a distributed phantom show that our algorithm improves both the quantitative and qualitative accuracy of the reconstructed objects. We believe this estimation algorithm is a practical and accurate method for determining the spatial positions of scintillation detector blocks.

  16. Ghost signals in Allison emittance scanners

    International Nuclear Information System (INIS)

    Stockli, Martin P.; Leitner, M.; Moehs, D.P.; Keller, R.; Welton, R.F.

    2004-01-01

    For over 20 years, Allison scanners have been used to measure emittances of low-energy ion beams. We show that scanning large trajectory angles produces ghost signals caused by the sampled beamlet impacting on an electric deflection plate. The ghost signal strength is proportional to the amount of beam entering the scanner. Depending on the ions, and their velocity, the ghost signals can have the opposite or the same polarity as the main beam signals. The ghost signals cause significant errors in the emittance estimates because they appear at large trajectory angles. These ghost signals often go undetected because they partly overlap with the real signals, are mostly below the 1% level, and often hide in the noise. A simple deflection plate modification is shown to reduce the ghost signal strength by over 99%

  17. Ghost Signals In Allison Emittance Scanners

    International Nuclear Information System (INIS)

    Stockli, Martin P.; Leitner, M.; Keller, R.; Moehs, D.P.; Welton, R. F.

    2005-01-01

    For over 20 years, Allison scanners have been used to measure emittances of low-energy ion beams. We show that scanning large trajectory angles produces ghost signals caused by the sampled beamlet impacting on an electric deflection plate. The ghost signal strength is proportional to the amount of beam entering the scanner. Depending on the ions, and their velocity, the ghost signals can have the opposite or the same polarity as the main beam signals. The ghost signals cause significant errors in the emittance estimates because they appear at large trajectory angles. These ghost signals often go undetected because they partly overlap with the real signals, are mostly below the 1% level, and often hide in the noise. A simple deflection plate modification is shown to reduce the ghost signal strength by over 99%

  18. Anatomical studies of the coronary system in elasmobranchs: II. Coronary arteries in hexanchoid, squaloid, and carcharhinoid sharks.

    Science.gov (United States)

    De Andrés, A V; Muñoz-Chápuli, R; Sans-Coma, V; García-Garrido, L

    1992-07-01

    Coronary artery anatomy was studied in 16 shark species belonging to 9 families of the orders Hexanchiformes, Squaliformes, and Carcharhiniformes. The study included 101 specimens and used an injection-corrosion technique that obtained internal casts of the main trunks and coronary arterial branches. The results showed 2 main patterns of coronary arterial arrangement: the dorsoventral coronary trunk pattern, shared by lamnoid and advanced carcharhinoid sharks, and the lateral coronary trunk pattern, shown by hexanchoid and squaloid sharks. Scyliorhinus and Galeus had intermediate arrangements of their vessels.

  19. Neurosurgical operating computerized tomographic scanner system. The CT scanner in the operating theater

    Energy Technology Data Exchange (ETDEWEB)

    Okudera, Hiroshi; Sugita, Kenichiro; Kobayashi, Shigeaki; Kimishima, Sakae; Yoshida, Hisashi

    1988-12-01

    A neurosurgical operating computerized tomography scanner system is presented. This system has been developed for obtaining intra- and postoperative CT images in the operating room. A TCT-300 scanner (manufactured by the Toshiba Co., Tokyo) is placed in the operating room. The realization of a true intraoperative CT image requires certain improvements in the CT scanner and operating table. To adjust the axis of the co-ordinates of the motor system of the MST-7000 microsurgical operating table (manufactured by the Mizuho Ika Co., Tokyo) to the CT scanner, we have designed an interface and a precise motor system so that the computer of the CT scanner can directly control the movement of the operating table. Furthermore, a new head-fixation system has been designed for producing artifact-free intraoperative CT images. The head-pins of the head-fixation system are made of carbon-fiber bars and titanium tips. A simulation study of the total system in the operating room with the CT scanner, operating table, and head holder using a skull model yielded a degree of error similar to that in the phantom testing of the original scanner. Three patients underwent resection of a glial tumor using this system. Intraoperative CT scans taken after dural opening showed a bulging of the cortex, a shift in the central structure, and a displacement of the cortical subarachnoid spaces under the influence of gravity. With a contrast medium the edge of the surrounding brain after resection was enhanced and the residual tumor mass was demonstrated clearly. This system makes it possible to obtain a noninvasive intraoperative image in a situation where structural shifts are taking place.

  20. Cyanotic Congenital Heart Disease The Coronary Arterial Circulation

    Science.gov (United States)

    Perloff, Joseph K

    2012-01-01

    Background: The coronary circulation in cyanotic congenital heart disease (CCHD) includes the extramural coronary arteries, basal coronary blood flow, flow reserve, the coronary microcirculation, and coronary atherogenesis. Methods: Coronary arteriograms were analyzed in 59 adults with CCHD. Dilated extramural coronaries were examined histologically in six patients. Basal coronary blood flow was determined with N-13 positron emission tomography in 14 patients and in 10 controls. Hyperemic flow was induced by intravenous dipyridamole pharmacologic stress. Immunostaining against SM alpha-actin permitted microcirculatory morphometric analysis. Non-fasting total cholesterols were retrieved in 279 patients divided into four groups: Group A---143 cyanotic unoperated, Group B---47 rendered acyanotic by reparative surgery, Group C---41 acyanotic unoperated, Group D---48 acyanotic before and after operation. Results: Extramural coronary arteries were mildly or moderately dilated to ectatic in 49/59 angiograms. Histologic examination disclosed loss of medial smooth muscle, increased medial collagen, and duplication of internal elastic lamina. Basal coronary flow was appreciably increased. Hyperemic flow was comparable to controls. Remodeling of the microcirculation was based upon coronary arteriolar length, volume and surface densities. Coronary atherosclerosis was absent in both the arteriograms and the necropsy specimens. Conclusions: Extramural coronary arteries in CCHD dilate in response to endothelial vasodilator substances supplemented by mural attenuation caused by medial abnormalities. Basal coronary flow was appreciably increased, but hyperemic flow was normal. Remodeling of the microcirculation was responsible for preservation of flow reserve. The coronaries were atheroma-free because of the salutory effects of hypocholesterolemia, hypoxemia, upregulated nitric oxide, low platelet counts, and hyperbilirubinrmia. PMID:22845810

  1. The CT scanner as a therapy machine

    International Nuclear Information System (INIS)

    Iwamoto, K.S.; Norman, A.

    1990-01-01

    Many tumors in the brain and in other tissues can be delineated precisely in images obtained with a CT scanner. After the scan is obtained the patient is taken to another room for radiation therapy and is positioned in the beam with the aid of external markers, simulators or stereotactic devices. This procedure is time consuming and subject to error when precise localization of the beam is desired. The CT scanner itself, with the addition of the collimator, is capable of delivering radiation therapy with great precision without the need for external markers. The patient can be scanned and treated on the same table, the isocenter of the beam can be placed precisely in the center of the lesion, the beam can be restricted to just those planes in which the lesion appears, several arcs can be obtained by simply tilting the gantry, and the position of the patient in the beam can be monitored continuously during therapy. The authors describe the properties of the CTX, the CT scanner modified for therapy. (author). 6 refs.; 6 figs

  2. A scanner for single photon emission tomography

    International Nuclear Information System (INIS)

    Smith, D.B.; Cumpstey, D.E.; Evans, N.T.S.; Coleman, J.D.; Ettinger, K.V.; Mallard, J.R.

    1982-01-01

    The technique of single photon ECT has now been available for some eighteen years, but has yet still to be exploited fully. The difficulties of doing this lie in the need for gathering data of sufficiently good statistical accuracy in a reasonable counting time, in the uniformity of detector sensitivity, and in the means for correcting the image satisfactorily for photon attenuation within the body. The relative ease with which a general purpose gamma camera can be adapted to give rotation around the patient makes this an attractive practical approach to the problem. However, the sensitivity of gamma cameras over their field of view is by no means uniform, and their sensitivity is less good than that of purpose-designed scanners when no more than about ten sections through the body are required. There is therefore a need to assess the clinical usefulness of a whole body tomographic scanner of high sensitivity and uniformity. Such a machine is the Aberdeen Section Scanner Mark II described

  3. Impedance Characterisation of the SPS Wire Scanner

    CERN Document Server

    AUTHOR|(CDS)2091911; Prof. Sillanpää, Mika

    As a beam diagnostic tool, the SPS wire scanner interacts with the proton bunches traversing the vacuum pipes of the Super Proton Synchrotron particle accelerator. Following the interaction, the bunches decelerate or experience momentum kicks off-axis and couple energy to the cavity walls, resonances and to the diagnostic tool, the scanning wire. The beam coupling impedance and, in particular, the beam induced heating of the wire motivate the characterisation and redesign of the SPS wire scanner. In this thesis, we characterise RF-wise the low frequency modes of the SPS wire scanner. These have the highest contribution to the impedance. We measure the cavity modes in terms of resonance frequency and quality factor by traditional measurement techniques and data analysis. We carry out a 4-port measurement to evaluate the beam coupling to the scanning wire, that yields the spectral heating power. If combined with the simulations, one is able to extract the beam coupling impedance and deduce the spectral dissipa...

  4. Development and performance evaluation of an experimental fine pitch detector multislice CT scanner.

    Science.gov (United States)

    Imai, Yasuhiro; Nukui, Masatake; Ishihara, Yotaro; Fujishige, Takashi; Ogata, Kentaro; Moritake, Masahiro; Kurochi, Haruo; Ogata, Tsuyoshi; Yahata, Mitsuru; Tang, Xiangyang

    2009-04-01

    The authors have developed an experimental fine pitch detector multislice CT scanner with an ultrasmall focal spot x-ray tube and a high-density matrix detector through current CT technology. The latitudinal size of the x-ray tube focal spot was 0.4 mm. The detector dimension was 1824 channels (azimuthal direction) x 32 rows (longitudinal direction) at row width of 0.3125 mm, in which a thinner reflected separator surrounds each detector cell coupled with a large active area photodiode. They were mounted on a commercial 64-slice CT scanner gantry while the scan field of view (50 cm) and gantry rotation speed (0.35 s) can be maintained. The experimental CT scanner demonstrated the spatial resolution of 0.21-0.22 mm (23.8-22.7 lp/cm) with the acrylic slit phantom and in-plane 50%-MTF 9.0 lp/cm and 10%-MTF 22.0 lp/cm. In the longitudinal direction, it demonstrated the spatial resolution of 0.24 mm with the high-resolution insert of the CATPHAN phantom and 0.34 mm as the full width at half maximum of the slice sensitivity profile. In low-contrast detectability, 3 mm at 0.3% was visualized at the CTDI(vol) of 47.2 mGy. Two types of 2.75 mm diameter vessel phantoms with in-stent stenosis at 25%, 50%, and 75% stair steps were scanned, and the reconstructed images can clearly resolve the stenosis at each case. The experimental CT scanner provides high-resolution imaging while maintaining low-contrast detectability, demonstrating the potentiality for clinical applications demanding high spatial resolution, such as imaging of inner ear, lung, and bone, or low-contrast detectability, such as imaging of coronary artery.

  5. Assessment of myocardial collateral circulation by intracoronary injection of radioactive microspheres and selective coronary angiography

    International Nuclear Information System (INIS)

    Uhde, W.

    1986-01-01

    In 46 patients selective coronary angiography was performed followed by selective coronary perfusion scintigraphy and a comparative assessment was made of the contralateral coronary collateral circulation. Intracoronary injection of radioactively marked imcrospheres resulted in the detection of microcirculatory processes and made it possible to evaluate the relative efficiency of coronary collaterals. This in turn meant a low-risk supplement and extension of the findings of coronary angiography. This holds particularly true for the area of the left ventricular myocardium. (author)

  6. WE-FG-207B-01: BEST IN PHYSICS (IMAGING): Abdominal CT with Three K-Edge Contrast Materials Using a Whole-Body Photon-Counting Scanner: Initial Results of a Large Animal Experiment

    Energy Technology Data Exchange (ETDEWEB)

    Lakshmanan, M; Symons, R; Cork, T; Davies-Venn, C; Rice, K; Malayeri, A; Sandfort, V; Bluemke, D; Pourmorteza, A [National Institutes of Health Clinical Center, Bethesda, MD (United States)

    2016-06-15

    Purpose: To demonstrate the feasibility of in vivo three-material decomposition techniques using photon-counting CT (PCCT) with possible advantage of resolving arterial and venous flow of an organ simultaneously. Methods: Abdominal PCCT scans were acquired using a prototype whole-body PCCT with four energy thresholds (25/50/75/90keV) in a canine. Bismuth subsalicylate (60 mg) was administered orally one day prior to scanning. Immediately prior to CT scan, gadoteric acid (60 ml, Dotarem, Guerbet) was intravenously injected, followed in ten minutes by a 20mL injection of iodinated contrast (iopamidol 370 mg/mL, Bracco). Scans were acquired every ∼20 seconds, starting from the time of iodine injection. Linear material decomposition was performed using the least mean squares method to create concentration maps of iodine, gadolinium, and bismuth. The method was calibrated to vials with known concentrations of materials placed next to the animal. The accuracy of this method was tested on vials with known concentrations. Results: The material decomposition algorithm’s accuracy was confirmed to be within ±4mM in the test vials. In the animal, we could estimate the concentration of gadolinium in delayed-enhanced phase (10 minutes post-injection) in the abdomen. We could follow the wash-in and wash-out of iodine in arterial, venous, and excretory flow of the kidneys (20s, 80s, and 120s post-iodine injection) while gadolinium was present in the delayed-enhanced phase. Bismuth, which was used as a contrast agent for the gastro-intestinal tract, was easily differentiable from the other two contrast agents in the small intestine. Conclusion: This study shows the feasibility of using photon-counting CT with four energy thresholds to differentiate three k-edge contrast agents in vivo. This can potentially reduce radiation dose to patients by combining arterial and venous phases into a single acquisition.

  7. Applicability of optical scanner method for fine root dynamics

    Science.gov (United States)

    Kume, Tomonori; Ohashi, Mizue; Makita, Naoki; Khoon Kho, Lip; Katayama, Ayumi; Matsumoto, Kazuho; Ikeno, Hidetoshi

    2016-04-01

    Fine root dynamics is one of the important components in forest carbon cycling, as ~60 % of tree photosynthetic production can be allocated to root growth and metabolic activities. Various techniques have been developed for monitoring fine root biomass, production, mortality in order to understand carbon pools and fluxes resulting from fine roots dynamics. The minirhizotron method is now a widely used technique, in which a transparent tube is inserted into the soil and researchers count an increase and decrease of roots along the tube using images taken by a minirhizotron camera or minirhizotron video camera inside the tube. This method allows us to observe root behavior directly without destruction, but has several weaknesses; e.g., the difficulty of scaling up the results to stand level because of the small observation windows. Also, most of the image analysis are performed manually, which may yield insufficient quantitative and objective data. Recently, scanner method has been proposed, which can produce much bigger-size images (A4-size) with lower cost than those of the minirhizotron methods. However, laborious and time-consuming image analysis still limits the applicability of this method. In this study, therefore, we aimed to develop a new protocol for scanner image analysis to extract root behavior in soil. We evaluated applicability of this method in two ways; 1) the impact of different observers including root-study professionals, semi- and non-professionals on the detected results of root dynamics such as abundance, growth, and decomposition, and 2) the impact of window size on the results using a random sampling basis exercise. We applied our new protocol to analyze temporal changes of root behavior from sequential scanner images derived from a Bornean tropical forests. The results detected by the six observers showed considerable concordance in temporal changes in the abundance and the growth of fine roots but less in the decomposition. We also examined

  8. A new self-made digital slide scanner and microscope for imaging and quantification of fluorescent microspheres

    DEFF Research Database (Denmark)

    Henning, William; Bjerglund Andersen, Julie; Højgaard, Liselotte

    2015-01-01

    Objective: A low-cost microscope slide scanner was constructed for the purpose of digital imaging of newborn piglet brain tissue and to quantify fluorescent microspheres in tissue. Methods: Using a standard digital single-lens reflex (DSLR) camera, fluorescent imaging of newborn piglet brain tissue......-field imaging was tested by adding light diffuser film. Results: Cost of the slide scanner was a fraction of the cost of a commercial slide scanner. The slide scanner was able to image a large number of tissue slides in a semiautomatic manner and provided a large field of view (FOV) of 101 mm2 combined...... and an automatic algorithm to detect fluorescent microspheres in tissue was developed and validated and showed an acceptable difference to “gold standard” manual counting. The slide scanner can be regarded as a low-cost alternative for researchers when digital slide imaging and quantification of fluorescent...

  9. Scanners for analytic print measurement: the devil in the details

    Science.gov (United States)

    Zeise, Eric K.; Williams, Don; Burns, Peter D.; Kress, William C.

    2007-01-01

    Inexpensive and easy-to-use linear and area-array scanners have frequently substituted as colorimeters and densitometers for low-frequency (i.e., large area) hard copy image measurement. Increasingly, scanners are also being used for high spatial frequency, image microstructure measurements, which were previously reserved for high performance microdensitometers. In this paper we address characteristics of flatbed reflection scanners in the evaluation of print uniformity, geometric distortion, geometric repeatability and the influence of scanner MTF and noise on analytic measurements. Suggestions are made for the specification and evaluation of scanners to be used in print image quality standards that are being developed.

  10. Spontaneous Coronary Artery Dissection following Topical Hormone Replacement Therapy

    Directory of Open Access Journals (Sweden)

    Alexander L. Pan

    2012-01-01

    Full Text Available Spontaneous coronary artery dissection is a rare condition, usually presenting as an acute coronary syndrome, and is often seen in states associated with high systemic estrogen levels such as pregnancy or oral contraceptive use. While topical hormonal replacement therapy may result in increased estrogen levels similar to those documented with oral contraceptive use, there are no reported cases of spontaneous coronary dissection with topical hormonal replacement therapy. We describe a 53-year-old female who developed two spontaneous coronary dissections while on topical hormonal replacement therapy. The patient had no other risk factors for coronary dissection. After withdrawal from topical hormonal therapy, our patient has done well and has not had recurrent coronary artery dissections over a one-year follow-up period. The potential contributory role of topical hormonal therapy as a cause of spontaneous coronary dissection should be recognized.

  11. Incremental value of myocardial perfusion over coronary angiography by spectral computed tomography in patients with intermediate to high likelihood of coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Carrascosa, Patricia M., E-mail: investigacion@diagnosticomaipu.com.ar; Deviggiano, Alejandro; Capunay, Carlos; Campisi, Roxana; López Munain, Marina de; Vallejos, Javier; Tajer, Carlos; Rodriguez-Granillo, Gaston A.

    2015-04-15

    Highlights: •We evaluated myocardial perfusion by dual energy computed tomography (DECT). •We included patients with intermediate to high likelihood of coronary artery disease. •Stress myocardial perfusion by DECT had a reliable accuracy for the detection of ischemia. •Stress myocardial perfusion with DECT showed an incremental value over anatomical evaluation. •DECT imaging was associated to a significant reduction in radiation dose compared to SPECT. -- Abstract: Purpose: We sought to explore the diagnostic performance of dual energy computed tomography (DECT) for the evaluation of myocardial perfusion in patients with intermediate to high likelihood of coronary artery disease (CAD). Materials and methods: Consecutive patients with known or suspected CAD referred for myocardial perfusion imaging by single-photon emission computed tomography (SPECT) constituted the study population and were scanned using a DECT scanner equipped with gemstone detectors for spectral imaging, and a SPECT. The same pharmacological stress was used for both scans. Results: Twenty-five patients were prospectively included in the study protocol. The mean age was 63.4 ± 10.6 years. The total mean effective radiation dose was 7.5 ± 1.2 mSv with DECT and 8.2 ± 1.7 mSv with SPECT (p = 0.007). A total of 425 left ventricular segments were evaluated by DECT, showing a reliable accuracy for the detection of reversible perfusion defects [area under ROC curve (AUC) 0.84 (0.80–0.87)]. Furthermore, adding stress myocardial perfusion provided a significant incremental value over anatomical evaluation alone by computed tomography coronary angiography [AUC 0.70 (0.65–0.74), p = 0.003]. Conclusions: In this pilot investigation, stress myocardial perfusion by DECT demonstrated a significant incremental value over anatomical evaluation alone by CTCA for the detection of reversible perfusion defects.

  12. Ultrasound evaluation of forearm arteries in patients undergoing percutaneous coronary intervention via radial artery access: results of one-year follow-up.

    Science.gov (United States)

    Peruga, Jan Przemysław; Peruga, Jan Zbigniew; Kasprzak, Jarosław D; Kręcki, Radosław; Jankowski, Łukasz; Zając, Piotr; Plewka, Michał

    2015-01-01

    A proven advantage of radial over femoral arterial access has led to an increase in the number of interventions performed via radial artery access in patients with acute coronary syndromes. Both assessment of the pulse volume and the Allen's test are subjective and subject to investigator bias. An ultrasound examination of the forearm arteries provides important information about the anatomy of the forearm vessels, and indirectly also about the efficiency of collateral blood supply to the hand. It also enables determination of the relevant vessel diameter before the planned intervention, and may be used to assess local complications. To assess the morphology of forearm blood vessels and measure the diameter of both radial and ulnar arteries at the cannulation site using ultrasound imaging. We also aimed to identify potential vascular anomalies and local complications associated with radial artery puncture. The study included 109 patients with cardiologic indications for coronary angiography or coronary angioplasty. An ultrasound evaluation of forearm arteries was performed prior to the intervention, and the vascular anatomy was later verified by angiography during the procedure. Ultrasound measurements of the vessel diameter were also performed and local complications of the cannulation were assessed. Measurements were performed immediately after the procedure and at 30 days and 12 months. Fifty-nine right and 50 left forearm arteries were evaluated. Women were 29% of the study population. The mean patient age was 59.2 ± 7.9 years. The mean diameter of the right radial artery was 2.17 ± 0.54 mm, and the mean diameter of the left radial artery was 2.25 ± 0.43 mm. The measurements revealed gender-related differences in forearm artery diameter (p = 0.003). Vascular anomalies of the radial artery were identified by ultrasound examination in 10% of subjects. A significant dilatation of the cannulated blood vessel was observed which lasted up to 12 months. An

  13. Temperature dependence of APD-based PET scanners

    International Nuclear Information System (INIS)

    Keereman, Vincent; Van Holen, Roel; Vandenberghe, Stefaan; Vanhove, Christian

    2013-01-01

    Purpose: Solid state detectors such as avalanche photodiodes (APDs) are increasingly being used in PET detectors. One of the disadvantages of APDs is the strong decrease of their gain factor with increasing ambient temperature. The light yield of most scintillation crystals also decreases when ambient temperature is increased. Both effects lead to considerable temperature dependence of the performance of APD-based PET scanners. In this paper, the authors propose a model for this dependence and the performance of the LabPET8 APD-based small animal PET scanner is evaluated at different temperatures.Methods: The model proposes that the effect of increasing temperature on the energy histogram of an APD-based PET scanner is a compression of the histogram along the energy axis. The energy histogram of the LabPET system was acquired at 21 °C and 25 °C to verify the validity of this model. Using the proposed model, the effect of temperature on system sensitivity was simulated for different detector temperature coefficients and temperatures. Subsequently, the effect of short term and long term temperature changes on the peak sensitivity of the LabPET system was measured. The axial sensitivity profile was measured at 21 °C and 24 °C following the NEMA NU 4-2008 standard. System spatial resolution was also evaluated. Furthermore, scatter fraction, count losses and random coincidences were evaluated at different temperatures. Image quality was also investigated.Results: As predicted by the model, the photopeak energy at 25 °C is lower than at 21 °C with a shift of approximately 6% per °C. Simulations showed that this results in an approximately linear decrease of sensitivity when temperature is increased from 21 °C to 24 °C and energy thresholds are constant. Experimental evaluation of the peak sensitivity at different temperatures showed a strong linear correlation for short term (2.32 kcps/MBq/°C = 12%/°C, R = −0.95) and long term (1.92 kcps/MBq/°C = 10%/

  14. Correlation of radiation dose and heart rate in dual-source computed tomography coronary angiography

    International Nuclear Information System (INIS)

    Laspas, Fotios; Roussakis, Arkadios; Kritikos, Nikolaos; Efthimiadou, Roxani; Kehagias, Dimitrios; Andreou, John; Tsantioti, Dimitra

    2011-01-01

    Background: Computed tomography coronary angiography (CTCA) has been widely used since the introduction of 64-slice scanners and dual-source CT technology, but the relatively high radiation dose remains a major concern. Purpose: To evaluate the relationship between radiation exposure and heart rate (HR), in dual-source CTCA. Material and Methods: Data from 218 CTCA examinations, performed with a dual-source 64-slices scanner, were statistically evaluated. Effective radiation dose, expressed in mSv, was calculated as the product of the dose-length product (DLP) times a conversion coefficient for the chest (mSv = DLPx0.017). Heart rate range and mean heart rate, expressed in beats per minute (bpm) of each individual during CTCA, were also provided by the system. Statistical analysis of effective dose and heart rate data was performed by using Pearson correlation coefficient and two-sample t-test. Results: Mean HR and effective dose were found to have a borderline positive relationship. Individuals with a mean HR >65 bpm observed to receive a statistically significant higher effective dose as compared to those with a mean HR =65 bpm. Moreover, a strong correlation between effective dose and variability of HR of more than 20 bpm was observed. Conclusion: Dual-source CT scanners are considered to have the capability to provide diagnostic examinations even with high HR and arrhythmias. However, it is desirable to keep the mean heart rate below 65 bpm and heart rate fluctuation less than 20 bpm in order to reduce the radiation exposure

  15. Short-term results of a randomized trial examining timing of carotid endarterectomy in patients with severe asymptomatic unilateral carotid stenosis undergoing coronary artery bypass grafting.

    Science.gov (United States)

    Illuminati, Giulio; Ricco, Jean-Baptiste; Caliò, Francesco; Pacilè, Maria Antonietta; Miraldi, Fabio; Frati, Giacomo; Macrina, Francesco; Toscano, Michele

    2011-10-01

    This study evaluated the timing of carotid endarterectomy (CEA) in the prevention of stroke in patients with asymptomatic carotid stenosis >70% receiving a coronary artery bypass graft (CABG). From January 2004 to December 2009, 185 patients with unilateral asymptomatic carotid artery stenosis >70%, candidates for CABG, were randomized into two groups. In group A, 94 patients received a CABG with previous or simultaneous CEA. In group B, 91 patients underwent CABG, followed by CEA. All patients underwent preoperative helical computed tomography scans, excluding significant atheroma of the ascending aorta or aortic arch. Baseline characteristics of the patients, type of coronary artery lesion, and preoperative myocardial function were comparable in the two groups. In group A, all patients underwent CEA under general anesthesia with the systematic use of a carotid shunt, and 79 patients had a combined procedure and 15 underwent CEA a few days before CABG. In group B, all patients underwent CEA, 1 to 3 months after CABG, also under general anesthesia and with systematic carotid shunting. Two patients (one in each group) died of cardiac failure in the postoperative period. Operative mortality was 1.0% in group A and 1.1% in group B (P = .98). No strokes occurred in group A vs seven ipsilateral ischemic strokes in group B, including three immediate postoperative strokes and four late strokes, at 39, 50, 58, and 66 days, after CABG. These late strokes occurred in patients for whom CEA was further delayed due to an incomplete sternal wound healing or because of completion of a cardiac rehabilitation program. The 90-day stroke and death rate was 1.0% (one of 94) in group A and 8.8% (eight of 91) in group B (odds ratio [OR], 0.11; 95% confidence interval [CI], 0.01-0.91; P = .02). Logistic regression analysis showed that only delayed CEA (OR, 14.2; 95% CI, 1.32-152.0; P = .03) and duration of cardiopulmonary bypass (OR, 1.06; 95% CI, 1.02-1.11; P = .004) reliably predicted

  16. Dietary protein intake and coronary heart disease in a large community based cohort: results from the Atherosclerosis Risk in Communities (ARIC study [corrected].

    Directory of Open Access Journals (Sweden)

    Bernhard Haring

    Full Text Available Prospective data examining the relationship between dietary protein intake and incident coronary heart disease (CHD are inconclusive. Most evidence is derived from homogenous populations such as health professionals. Large community-based analyses in more diverse samples are lacking.We studied the association of protein type and major dietary protein sources and risk for incident CHD in 12,066 middle-aged adults (aged 45-64 at baseline, 1987-1989 from four U.S. communities enrolled in the Atherosclerosis Risk in Communities (ARIC Study who were free of diabetes mellitus and cardiovascular disease at baseline. Dietary protein intake was assessed at baseline and after 6 years of follow-up by food frequency questionnaire. Our primary outcome was adjudicated coronary heart disease events or deaths with following up through December 31, 2010. Cox proportional hazard models with multivariable adjustment were used for statistical analyses.During a median follow-up of 22 years, there were 1,147 CHD events. In multivariable analyses total, animal and vegetable protein were not associated with an increased risk for CHD before or after adjustment. In food group analyses of major dietary protein sources, protein intake from red and processed meat, dairy products, fish, nuts, eggs, and legumes were not significantly associated with CHD risk. The hazard ratios [with 95% confidence intervals] for risk of CHD across quintiles of protein from poultry were 1.00 [ref], 0.83 [0.70-0.99], 0.93 [0.75-1.15], 0.88 [0.73-1.06], 0.79 [0.64-0.98], P for trend  = 0.16. Replacement analyses evaluating the association of substituting one source of dietary protein for another or of decreasing protein intake at the expense of carbohydrates or total fats did not show any statistically significant association with CHD risk.Based on a large community cohort we found no overall relationship between protein type and major dietary protein sources and risk for CHD.

  17. A new electronic read-out for the YAPPET scanner

    International Nuclear Information System (INIS)

    Damiani, C.; Ramusino, A.C.A. Cotta; Malaguti, R.; Guerra, A. Del; Domenico, G. Di; Zavattini, G.

    2002-01-01

    A small animal PET-SPECT scanner (YAPPET) prototype was built at the Physics Department of the Ferrara University and is presently being used at the Nuclear Medicine Department for radiopharmaceutical studies on rats. The first YAPPET prototype shows very good performances, but needs some improvements before it can be fully used for intensive radiopharmaceutical research. The main problem of the actual prototype is its heavy electronics, based on NIM and CAMAC standard modules. For this reason a new, compact read-out electronics was developed and tested. The results of a first series of tests made on the first prototype will be presented in the paper

  18. A new electronic read-out for the YAPPET scanner

    CERN Document Server

    Damiani, C; Malaguti, R; Guerra, A D; Domenico, G D; Zavattini, G

    2002-01-01

    A small animal PET-SPECT scanner (YAPPET) prototype was built at the Physics Department of the Ferrara University and is presently being used at the Nuclear Medicine Department for radiopharmaceutical studies on rats. The first YAPPET prototype shows very good performances, but needs some improvements before it can be fully used for intensive radiopharmaceutical research. The main problem of the actual prototype is its heavy electronics, based on NIM and CAMAC standard modules. For this reason a new, compact read-out electronics was developed and tested. The results of a first series of tests made on the first prototype will be presented in the paper.

  19. Indications for coronary angiography

    International Nuclear Information System (INIS)

    Kaltenbach, M.; Vallbracht, C.

    1985-01-01

    Today selective coronary angiography, introduced by Sones in 1957, is used as clinical routine for diagnosing morphological changes in the coronary arteries. Hitherto, more recent techniques such as digital subtraction angiography cannot provide comparable information. Strict criteria for its indication depending on possible therapeutic consequences, have to be applied, although the risk is low with a letality of 0.01 to 0.05 percent. Radionuclear investigations can be used as additional tool in selected cases. The careful indication for coronary angiography usually implies the possible need for coronary bypass graft surgery of balloon angioplasty. (orig./MG) [de

  20. Experimental developments in dedicated scanners for positron emission tomography

    International Nuclear Information System (INIS)

    Damiani, Chiara

    2001-01-01

    The thesis describes a prototype of a new read out electronics developed for the YAPPET small animal PET tomograph at the Physics Laboratory of the University of Ferrara. The purpose of the new electronics was to make the YAPPET scanner easier to use and more suitable for duplication at other research institutes. The results of tests of the new electronics over a 3 year period are presented. The new electronics prototype attained the same performance as the present YAPPET electronics in energy, position, and time measurements. In addition, a significant improvement in count rate capability is now being studied. The second major component of this thesis is a description of the development of a new scanner prototype incorporating a PET detection system based on YAP:Ce scintillator matrix crystals and wave length shifting (WLS) fibers. Two ribbons of WLS fibers are mounted on the opposite sides of the scintillator matrix in order to read out the columns and the rows of the matrix and recognize the interaction point XY position. The thesis describes the investigation of the materials and methods to be used in this new design. The first tests with the new prototype detector are described in detail: the main result of these preliminary measurements is the evaluation of the light yield of the system which is a signal of about 10 photoelectrons on the detector for 511 keV photoelectric interactions. The new scanner design uses the YAPPET basic principles, but it should have improved performance with applicability to other fields such as scinti-mammography. Copies of this thesis can be obtained from the Department of Physics of the University of Pisa or the author

  1. [Comparison of 64 MDCT coronary CTA and coronary angiography in the detection of coronary artery stenosis in low risk patients with stable angina and acute coronary syndrome].

    Science.gov (United States)

    Cazalas, G; Sarran, A; Amabile, N; Chaumoitre, K; Marciano-Chagnaud, S; Jacquier, A; Paganelli, F; Panuel, M

    2009-09-01

    To determine the accuracy of 64 MDCT coronary CTA (CCTA) compared to coronary angiography in low risk patients with stable angina and acute coronary syndrome and determine the number of significant coronary artery stenoses ( 50%) in these patients. Materials and methods. Fifty-five patients underwent CCTA using a 32 MDCT unit with z flying focus allowing the acquisition of 64 slices of 0.6 mm thickness as well as coronary angiography (gold standard). Nine patients were excluded due to prior coronary artery bypass surgery (n=4), insufficient breath hold (n=3), calcium scoring>1000 (n=1) and delay between both examinations over 4 months (n=1). Forty-six patients: 27 males and 19 females were included. CCTA results were compared to coronary angiography per segment and artery with threshold detection of stenoses 50%. The degree of correlation between both examinations was performed using a regression analysis with a Pearson correlation coefficient<0.05 considered significant. The overall accuracy of CCTA was 90%; limitations related to the presence of calcifications, motion artifacts or insufficient vessel opacification. The correlation for all analyzed segments was 96.4%. Thirty-eight of 50 significant stenoses seen on coronary angiography were correctly detected on CCTA. Sensitivity, specificity, PPVC and NPV for detection of stenoses 50% were 76%, 98.3%, 80.3% and 97.7% respectively. Evaluation per segment had a NPV of 96.8% (interventricular and diagonal segments) to 100% (main trunk). Our results for specificity and NPV are similar to reports from the literature. This suggests that CCTA in this clinical setting may replace coronary angiography.

  2. Interrelation and independence of positive and negative psychological constructs in predicting general treatment adherence in coronary artery patients - Results from the THORESCI study.

    Science.gov (United States)

    van Montfort, Eveline; Denollet, Johan; Widdershoven, Jos; Kupper, Nina

    2016-09-01

    In cardiac patients, positive psychological factors have been associated with improved medical and psychological outcomes. The current study examined the interrelation between and independence of multiple positive and negative psychological constructs. Furthermore, the potential added predictive value of positive psychological functioning regarding the prediction of patients' treatment adherence and participation in cardiac rehabilitation (CR) was investigated. 409 percutaneous coronary intervention (PCI) patients were included (mean age = 65.6 ± 9.5; 78% male). Self-report questionnaires were administered one month post-PCI. Positive psychological constructs included positive affect (GMS) and optimism (LOT-R); negative constructs were depression (PHQ-9, BDI), anxiety (GAD-7) and negative affect (GMS). Six months post-PCI self-reported general adherence (MOS) and CR participation were determined. Factor Analysis (Oblimin rotation) revealed two components (r = − 0.56), reflecting positive and negative psychological constructs. Linear regression analyses showed that in unadjusted analyses both optimism and positive affect were associated with better general treatment adherence at six months (p psychological constructs (i.e. optimism) may be of incremental value to negative psychological constructs in predicting patients' treatment adherence. A more complete view of a patients' psychological functioning will open new avenues for treatment. Additional research is needed to investigate the relationship between positive psychological factors and other cardiac outcomes, such as cardiac events and mortality.

  3. Assessing the cardiology community position on transradial intervention and the use of bivalirudin in patients with acute coronary syndrome undergoing invasive management: results of an EAPCI survey.

    Science.gov (United States)

    Adamo, Marianna; Byrne, Robert A; Baumbach, Andreas; Haude, Michael; Windecker, Stephan; Valgimigli, Marco

    2016-10-20

    Our aim was to report on a survey initiated by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) collecting the opinion of the cardiology community on the invasive management of acute coronary syndrome (ACS), before and after the MATRIX trial presentation at the American College of Cardiology (ACC) 2015 Scientific Sessions. A web-based survey was distributed to all individuals registered on the EuroIntervention mailing list (n=15,200). A total of 572 and 763 physicians responded to the pre- and post-ACC survey, respectively. The radial approach emerged as the preferable access site for ACS patients undergoing invasive management with roughly every other responder interpreting the evidence for mortality benefit as definitive and calling for a guidelines upgrade to class I. The most frequently preferred anticoagulant in ACS patients remains unfractionated heparin (UFH), due to higher costs and greater perceived thrombotic risks associated with bivalirudin. However, more than a quarter of participants declared the use of bivalirudin would increase after MATRIX. The MATRIX trial reinforced the evidence for a causal association between bleeding and mortality and triggered consensus on the superiority of the radial versus femoral approach. The belief that bivalirudin mitigates bleeding risk is common, but UFH still remains the preferred anticoagulant based on lower costs and thrombotic risks.

  4. Breath-hold two-dimensional MR angiography of coronary arteries. Comparison with conventional coronary angiography in ten cases

    International Nuclear Information System (INIS)

    Li Liwei; Zhang Wanshi; Liu Chaozhong; Lu Xiaoyan; Xu Jiaxing

    1997-01-01

    Purpose: To assess the diagnostic value of two-dimensional coronary magnetic resonance (MR) angiography in patients evaluated for ischemic heart disease. Materials and methods: Ten patients who underwent selective cardiac catheterization with coronary MR angiography were evaluated with two-dimensional coronary MR angiography. Coronary MR angiography was performed with breath-hold fat-suppressed ECG-gated Turbo-FLASH with K-space segmentation using a 1.5 T imager. Results: The left main coronary artery, proximal left anterior descending artery, circumflex artery and right coronary artery were demonstrated in all cases. Continuous segments (mean) of left anterior descending, circumflex and right coronary arteries visualized on MRA were 6.72 +- 3.16 cm, 3.67 +- 4.81 cm and 7.93 +- 3.12 cm respectively. The overall sensitivity for detection of hemodynamically significant coronary artery lesion (≥50%) was 62.5% respectively. Conclusion: Breath-hold two-dimensional coronary MR angiography was useful in showing relatively long segments of the main coronary arteries and also has potential in depicting hemodynamically significant coronary artery lesions

  5. Safety and efficacy of angioplasty with intracoronary stenting in patients with unstable coronary syndromes. Comparison with stable coronary syndromes

    Directory of Open Access Journals (Sweden)

    Luís C. L. Correia

    2000-06-01

    Full Text Available OBJECTIVE: To assess safety and efficacy of coronary angioplasty with stent implantation in unstable coronary syndromes. METHODS: Retrospective analysis of in-hospital and late evolution of 74 patients with unstable coronary syndromes (unstable angina or infarction without elevation of the ST segment undergoing coronary angioplasty with stent placement. These 74 patients were compared with 31 patients with stable coronary syndromes (stable angina or stable silent ischemia undergoing the same procedure. RESULTS: No death and no need for revascularization of the culprit artery occurred in the in-hospital phase. The incidences of acute non-Q-wave myocardial infarction were 1.4% and 3.2% (p=0.6 in the unstable and stable coronary syndrome groups, respectively. In the late follow-up (11.2±7.5 months, the incidences of these events combined were 5.7% in the unstable coronary syndrome group and 6.9% (p=0.8 in the stable coronary syndrome group. In the multivariate analysis, the only variable with a tendency to significance as an event predictor was diabetes mellitus (p=0.07; OR=5.2; 95% CI=0.9-29.9. CONCLUSION: The in-hospital and late evolutions of patients with unstable coronary syndrome undergoing angioplasty with intracoronary stent implantation are similar to those of the stable coronary syndrome group, suggesting that this procedure is safe and efficacious when performed in unstable coronary syndrome patients.

  6. Quality control of some CT scanners in Khartoum state

    International Nuclear Information System (INIS)

    Yousif, Ali Mohammed Ali

    2013-06-01

    This study conduced with the aim to evaluate the performance of three CT scanner in Khartoum-Sudan through extensive quality control measurements. Image quality was assessed using a CATPHAN 412 CT image quality phantom. Image quality parameters evaluated were: CT image noise, uniformity, CT number linearity, Low Contrast Resolution, High Contrast Resolution, measurements were performed in accordance with guidelines set out by the Institute of physical science and engineering in medicine (IPEM 91). Image quality parameters tested were within the apoplectic limit specified in the relevant CT guidelines. Measured slice thickness ranged between 9.66-10.5 mm for large slice and 5.25-5.88 for medium slice. The correlation coefficient (R) between the measured and the reference CT number was better than 0.99 for all CT scanners. High resolution for large slice was 7 L P/ cm and 8 L P/ cm for small slice. Low contrast resolution with 1.0% nominal level ranged between 2-3 mm diameter of disc for large slice and 4-7 mm diameter disc for small slice. The measured noise ranged between 1.4-3.4 HU for large slice and 2.92-4.08 HU for small slice. Uniformity ranged between 3.08 to 2.075 HU for large slice and 3.22 to 1.4 HU for small slice thickness. The results indicate that routine maintenance, service and calibration, as well as the frequent quality control of CT scanners play a key rote in achieving the best performance of the system. Since computed tomography (CT) contributes the most to the collective dose compared to other radiological examinations, it is a necessity for quality control and quality assurance programs to be established in each radiology department.(Author)

  7. Comparison of CTAC and prone imaging for the detection of coronary artery disease using CZT SPECT.

    Science.gov (United States)

    Ito, Shimpei; Endo, Akihiro; Okada, Taiji; Nakamura, Taku; Sugamori, Takashi; Takahashi, Nobuyuki; Yoshitomi, Hiroyuki; Tanabe, Kazuaki

    2017-10-01

    Cadmium-zinc-telluride (CZT) cameras have improved the evaluation of patients with chest pain. However, inferior/inferolateral attenuation artifacts similar to those seen with conventional Anger cameras persist. We added prone acquisitions and CT attenuation correction (CTAC) to the standard supine image acquisition and analyzed the resulting examinations. Seventy-two patients referred for invasive coronary angiography (CAG), and who also underwent rest/stress myocardial perfusion imaging (MPI) on a CZT camera in the supine and prone positions plus CTAC imaging, to examine known or suspected CAD between April 2013 and March 2014 were included. A sixteen-slice CT scan acquired on a SPECT/CT scanner between rest and stress imaging provided data for iterative reconstruction. Sensitivity, specificity, accuracy, and positive and negative likelihood ratios (LRs) were calculated to compare MPI with CAG on a per-patient basis. Per-patient sensitivity, specificity, and accuracy of supine images to predict coronary abnormalities on CAG were 35% [95% confidence interval (CI) 19-52], 86% (95% CI 80-92), and 74% (95% CI 66-82); those of prone imaging were 65% (95% CI 45-81), 82% (95% CI 76-87), and 78% (95% CI 68-85); and those of CTAC were 59% (95% CI 41-71), 93% (95% CI 87-97), and 85% (95% CI 76-91), respectively. Prone acquisition and CTAC images improve the ability to assess the inferior/inferolateral area.

  8. Noninvasive Coronary Angiography with 64-Channel Multidetector Computed Tomography in Patients with Acute Coronary Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Ulimoen, G. R.; Gjoennaess, E.; Atar, D.; Dahl, T.; Stranden, E.; Sandbaek, G. (Dept. of Radiology, Dept. of Vascular Diagnosis and Research, and Division of Cardiology, Aker Univ. Hospital, Oslo (Norway))

    2008-12-15

    Background: Advances in computer tomography (CT) imaging technology in recent years have facilitated the possibility of noninvasive coronary angiography. Purpose: To compare the diagnostic accuracy of 64-channel multidetector computed tomography (MDCT) with conventional invasive coronary angiography (ICA) for the detection of significant coronary stenosis in patients with acute coronary syndrome (ACS). Material and Methods: MDCT was performed in 60 patients classified with non-ST-elevation infarction (NSTEMI) or unstable angina and scheduled for ICA within 3 days. The diagnostic accuracy of MDCT was evaluated using quantitative coronary angiography (QCA) as the gold standard. Results: 48 out of 60 patients had interpretable scans by both MDCT and ICA. On a segment-based analysis, 488 out of 665 segments with a diameter of =1.5 mm, as defined by QCA, were interpretable by MDCT. Sensitivity was 78%, specificity 87%, positive predictive value 47%, and negative predictive value 97% in detecting and excluding significant coronary stenosis, as defined with MDCT. On a per patient-based analysis, sensitivity was 89%, specificity 50%, positive predictive value 84%, and negative predictive value 60%. Conclusion: Limited diagnostic accuracy restricts the usefulness of coronary MDCT in patient groups with a high pretest probability of disease, such as in acute coronary syndrome.

  9. Noninvasive Coronary Angiography with 64-Channel Multidetector Computed Tomography in Patients with Acute Coronary Syndrome

    International Nuclear Information System (INIS)

    Ulimoen, G. R.; Gjoennaess, E.; Atar, D.; Dahl, T.; Stranden, E.; Sandbaek, G.

    2008-01-01

    Background: Advances in computer tomography (CT) imaging technology in recent years have facilitated the possibility of noninvasive coronary angiography. Purpose: To compare the diagnostic accuracy of 64-channel multidetector computed tomography (MDCT) with conventional invasive coronary angiography (ICA) for the detection of significant coronary stenosis in patients with acute coronary syndrome (ACS). Material and Methods: MDCT was performed in 60 patients classified with non-ST-elevation infarction (NSTEMI) or unstable angina and scheduled for ICA within 3 days. The diagnostic accuracy of MDCT was evaluated using quantitative coronary angiography (QCA) as the gold standard. Results: 48 out of 60 patients had interpretable scans by both MDCT and ICA. On a segment-based analysis, 488 out of 665 segments with a diameter of =1.5 mm, as defined by QCA, were interpretable by MDCT. Sensitivity was 78%, specificity 87%, positive predictive value 47%, and negative predictive value 97% in detecting and excluding significant coronary stenosis, as defined with MDCT. On a per patient-based analysis, sensitivity was 89%, specificity 50%, positive predictive value 84%, and negative predictive value 60%. Conclusion: Limited diagnostic accuracy restricts the usefulness of coronary MDCT in patient groups with a high pretest probability of disease, such as in acute coronary syndrome

  10. Inversion prepared coronary MR angiography: direct visualization of coronary blood flow

    International Nuclear Information System (INIS)

    Katoh, M.; Spuentrup, E.; Buecker, A.; Guenther, R.W.; Stuber, M.; Manning, W.J.; Botnar, R.M.

    2005-01-01

    Purpose: visualization of coronary blood flow by means of a slice-selective inversion pre-pulse in concert with bright-blood coronary MRA. Materials and methods: coronary magnetic resonance angiography (MRA) of the right coronary artery (RCA) was performed in eight healthy adult subjects on a 1.5 Tesla MR system (Gyroscan ACS-NT, Philips Medical Systems, Best, NL) using a free-breathing navigator-gated and cardiac-triggered 3D steady-state free-precession (SSFP) sequence with radial k-space sampling. Imaging was performed with and without a slice-selective inversion pre-pulse, which was positioned along the main axis of the coronary artery but perpendicular to the imaging volume. Objective image quality parameters such as SNR, CNR, maximal visible vessel length, and vessel border definition were analyzed. Results: in contrast to conventional bright-blood 3D coronary MRA, the selective inversion pre-pulse provided a direct measure of coronary blood flow. In addition, CNR between the RCA and right ventricular blood pool was increased and the vessels had a tendency towards better delineation. Blood SNR and CNR between right coronary blood and epicardial fat were comparable in both sequences. (orig.)

  11. Five-year clinical and functional multislice computed tomography angiographic results after coronary implantation of the fully resorbable polymeric everolimus-eluting scaffold in patients with de novo coronary artery disease

    DEFF Research Database (Denmark)

    Onuma, Yoshinobu; Dudek, Dariusz; Thuesen, Leif

    2013-01-01

    This study sought to demonstrate the 5-year clinical and functional multislice computed tomography angiographic results after implantation of the fully resorbable everolimus-eluting scaffold (Absorb BVS, Abbott Vascular, Santa Clara, California).......This study sought to demonstrate the 5-year clinical and functional multislice computed tomography angiographic results after implantation of the fully resorbable everolimus-eluting scaffold (Absorb BVS, Abbott Vascular, Santa Clara, California)....

  12. Dual-source CT coronary angiography in patients with premature heart-beats: initial experience

    International Nuclear Information System (INIS)

    Wang Yining; Zhang Zhuhua; Kong Lingyan; Song Lan; Mu Wenbin; Wang Yun; Jin Zhengyu

    2008-01-01

    Objective: To evaluate the feasibility of dual-source computed tomography (DSCT) coronary angiography in a population with premature heart-beats. Methods: Seventy patients with suspected coronary artery disease and premature heart-beats were routinely imaged on a DSCT scanner (Somatom Definition, Siemens AG, Germany). The images were reconstmcted before and after ECG editing. Two readers independently assessed image quality of all coronary segments using a four-point grading scale from excellent (1) to non-assessable (4). The results of the two groups were compared with a paired t-test, and a P value of less than 0.05 was considered significant. Results: The mean heart rate during examination ranged from 49 to 111 bpm[ mean(70.7±12.4) bpm]. Twenty-eight of 70 patients with relatively small variability of the heart rate [(41.0±18.4) bpm] got diagnostic image quality without ECG editing. In other 42 patients with larger variability of the heart rate [(71.4±28.7) bpm], the mean image quality scores were 2.09±1.27 and 1.50±0.79 before and after ECG editing, there was a significant difference (t= 13.764, P 2 =121.846, P<0.01). Finally, the diagnostic image accounted 98.0% (1014/1035) in all segments of 70 patients. Conclusion: DSCT can provide diagnostic images for patients with premature heart-beats. The image quality in patients with larger variability of the heart rate can be significantly improved through ECG editing. (authors)

  13. Two examples of indication specific radiation dose calculations in dental CBCT and Multidetector CT scanners.

    Science.gov (United States)

    Stratis, Andreas; Zhang, Guozhi; Lopez-Rendon, Xochitl; Politis, Constantinus; Hermans, Robert; Jacobs, Reinhilde; Bogaerts, Ria; Shaheen, Eman; Bosmans, Hilde

    2017-09-01

    To calculate organ doses and estimate the effective dose for justification purposes in patients undergoing orthognathic treatment planning purposes and temporal bone imaging in dental cone beam CT (CBCT) and Multidetector CT (MDCT) scanners. The radiation dose to the ICRP reference male voxel phantom was calculated for dedicated orthognathic treatment planning acquisitions via Monte Carlo simulations in two dental CBCT scanners, Promax 3D Max (Planmeca, FI) and NewTom VGi evo (QR s.r.l, IT) and in Somatom Definition Flash (Siemens, DE) MDCT scanner. For temporal bone imaging, radiation doses were calculated via MC simulations for a CBCT protocol in NewTom 5G (QR s.r.l, IT) and with the use of a software tool (CT-expo) for Somatom Force (Siemens, DE). All procedures had been optimized at the acceptance tests of the devices. For orthognathic protocols, dental CBCT scanners deliver lower doses compared to MDCT scanners. The estimated effective dose (ED) was 0.32mSv for a normal resolution operation mode in Promax 3D Max, 0.27mSv in VGi-evo and 1.18mSv in the Somatom Definition Flash. For temporal bone protocols, the Somatom Force resulted in an estimated ED of 0.28mSv while for NewTom 5G the ED was 0.31 and 0.22mSv for monolateral and bilateral imaging respectively. Two clinical exams which are carried out with both a CBCT or a MDCT scanner were compared in terms of radiation dose. Dental CBCT scanners deliver lower doses for orthognathic patients whereas for temporal bone procedures the doses were similar. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  14. Effect of intravenous TRO40303 as an adjunct to primary percutaneous coronary intervention for acute ST-elevation myocardial infarction: MITOCARE study results.

    Science.gov (United States)

    Atar, Dan; Arheden, Håkan; Berdeaux, Alain; Bonnet, Jean-Louis; Carlsson, Marcus; Clemmensen, Peter; Cuvier, Valérie; Danchin, Nicolas; Dubois-Randé, Jean-Luc; Engblom, Henrik; Erlinge, David; Firat, Hüseyin; Halvorsen, Sigrun; Hansen, Henrik Steen; Hauke, Wilfried; Heiberg, Einar; Koul, Sasha; Larsen, Alf-Inge; Le Corvoisier, Philippe; Nordrehaug, Jan Erik; Paganelli, Franck; Pruss, Rebecca M; Rousseau, Hélène; Schaller, Sophie; Sonou, Giles; Tuseth, Vegard; Veys, Julien; Vicaut, Eric; Jensen, Svend Eggert

    2015-01-07

    The MITOCARE study evaluated the efficacy and safety of TRO40303 for the reduction of reperfusion injury in patients undergoing revascularization for ST-elevation myocardial infarction (STEMI). Patients presenting with STEMI within 6 h of the onset of pain randomly received TRO40303 (n = 83) or placebo (n = 80) via i.v. bolus injection prior to balloon inflation during primary percutaneous coronary intervention in a double-blind manner. The primary endpoint was infarct size expressed as area under the curve (AUC) for creatine kinase (CK) and for troponin I (TnI) over 3 days. Secondary endpoints included measures of infarct size using cardiac magnetic resonance (CMR) and safety outcomes. The median pain-to-balloon time was 180 min for both groups, and the median (mean) door-to-balloon time was 60 (38) min for all sites. Infarct size, as measured by CK and TnI AUCs at 3 days, was not significantly different between treatment groups. There were no significant differences in the CMR-assessed myocardial salvage index (1-infarct size/myocardium at risk) (mean 52 vs. 58% with placebo, P = 0.1000), mean CMR-assessed infarct size (21.9 g vs. 20.0 g, or 17 vs. 15% of LV-mass) or left ventricular ejection fraction (LVEF) (46 vs. 48%), or in the mean 30-day echocardiographic LVEF (51.5 vs. 52.2%) between TRO40303 and placebo. A greater number of adjudicated safety events occurred in the TRO40303 group for unexplained reasons. This study in STEMI patients treated with contemporary mechanical revascularization principles did not show any effect of TRO40303 in limiting reperfusion injury of the ischaemic myocardium. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

  15. Fluidity of the dietary fatty acid profile and risk of coronary heart disease and ischemic stroke: Results from the EPIC-Netherlands cohort study.

    Science.gov (United States)

    Sluijs, I; Praagman, J; Boer, J M A; Verschuren, W M M; van der Schouw, Y T

    2017-09-01

    The fluidity of dietary fatty acids consumed has been suggested to inversely affect coronary heart disease (CHD) risk. Lipophilic index (LI) represents overall fluidity of the dietary fatty acid profile. Lipophilic load (LL) represents a combination of overall fluidity and absolute intake of dietary fatty acids. We investigated the relations of dietary LI and LL with risk of CHD and ischemic stroke (iStroke). We used data from the prospective EPIC-NL study, including 36,520 participants aged 20-70 years. LI and LL were calculated using dietary intake data estimated with a validated FFQ. Incident CHD (n = 2348) and iStroke (n = 479) cases were obtained through linkage to national registers during 15 years follow-up. LI and LL were not associated with CHD risk (HRs highest-versus-lowest-quartiles : 0.93 [95%CI: 0.83, 1.04], and 0.92 [95%CI: 0.79, 1.07], respectively), and neither with iStroke risk (HRs 1.15 (95%CI: 0.89, 1.48), and 0.98 (95%CI: 0.70, 1.38), respectively). Original fatty acid classes (SFA, MUFA and PUFA), and LI and LL stratified by these fatty acid classes, were overall not related to CHD and ischemic stroke either. In this Dutch population, neither the overall fluidity of the dietary fatty acid profile (LI), nor the combined fluidity and amount of fatty acids consumed (LL) were related to CHD or iStroke risk. Dietary LI and LL may have limited added value above original fatty acid classes and food sources in establishing the relation of fatty acid consumption with CVD. Copyright © 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

  16. Feasibility of visual aids for risk evaluation by hospitalized patients with coronary artery disease: results from face-to-face interviews.

    Science.gov (United States)

    Magliano, Carlos Alberto da Silva; Monteiro, Andrea Liborio; Tura, Bernardo Rangel; Oliveira, Claudia Silvia Rocha; Rebelo, Amanda Rebeca de Oliveira; Pereira, Claudia Cristina de Aguiar

    2018-01-01

    Communicating information about risk and probability to patients is considered a difficult task. In this study, we aim to evaluate the use of visual aids representing perioperative mortality and long-term survival in the communication process for patients diagnosed with coronary artery disease at the National Institute of Cardiology, a Brazilian public hospital specializing in cardiology. One-on-one interviews were conducted between August 1 and November 20, 2017. Patients were asked to imagine that their doctor was seeking their input in the decision regarding which treatment represented the best option for them. Patients were required to choose between alternatives by considering only the different benefits and risks shown in each scenario, described as the proportion of patients who had died during the perioperative period and within 5 years. Each participant evaluated the same eight scenarios. We evaluated their answers in a qualitative and quantitative analysis. The main findings were that all patients verbally expressed concern about perioperative mortality and that 25% did not express concern about long-term mortality. Twelve percent considered the probabilities irrelevant on the grounds that their prognosis would depend on "God's will." Ten percent of the patients disregarded the reported likelihood of perioperative mortality, deciding to focus solely on the "chance of being cured." In the quantitative analysis, the vast majority of respondents chose the "correct" alternatives, meaning that they made consistent and rational choices. The use of visual aids to present risk attributes appeared feasible in our sample. The impact of heuristics and religious beliefs on shared health decision making needs to be explored better in future studies.

  17. Current practices are variable in the evaluation and management of patients with anomalous aortic origin of a coronary artery: Results of a survey.

    Science.gov (United States)

    Agrawal, Hitesh; Mery, Carlos M; Day, Patrick E; Sexson Tejtel, S Kristen; McKenzie, E Dean; Fraser, Charles D; Qureshi, Athar M; Molossi, Silvana

    2017-09-01

    Anomalous aortic origin of a coronary artery (AAOCA) is the second leading cause of sudden cardiac death in young athletes in the USA. Long-term outcome data for these patients are lacking to date. There is insufficient knowledge on the best approach to these patients and they are managed in a nonuniform manner. An online survey of 15 questions regarding management of AAOCA was sent out to 198 cardiac healthcare providers. The goal was to define gaps in knowledge to justify a dedicated scientific forum for discussion of AAOCA. Descriptive statistics were performed. A total of 91 providers (46%) completed the survey including pediatric cardiology subspecialists (40%), general pediatric cardiologists (24%), cardiovascular (CV) surgeons (22%), adult cardiologists (10%), nurse practitioners (8%), cardiology fellows (3%) and CV anesthesiologist (1%). Forty-eight percent had been practicing for over 15 years and 28% were in their first 5 years of practice. Fifty-two percent of the providers cared for adults and 93% cared for children/adolescents. Eighty-eight percent were affiliated with an academic institution. All but one provider practiced in the USA, 62% practiced in Texas. Half of participants (50%) were very comfortable managing AAOCA patients and 36% were somewhat comfortable. Providers utilized various imaging tests to confirm the anatomy including computed tomography angiography 88%, cardiac magnetic resonance imaging 70%, cardiac catheterization 60%, echocardiogram 12%, IVUS 2% and myocardial perfusion scan 1%. The majority felt comfortable in counseling the families and felt that depending on the type of lesion these patients should get surgical referral (85%) vs clinical follow up (67%) with exercise restriction (65%). There is heterogeneity in the way AAOCA patients are currently evaluated and managed. A knowledge gap exists even with participants from academic institutions. Long-term data with a defined approach to management of these patients may help to

  18. Association between opium use and metabolic syndrome among an urban population in Southern Iran: Results of the Kerman Coronary Artery Disease Risk Factor Study (KERCADRS).

    Science.gov (United States)

    Yousefzadeh, Gholamreza; Shokoohi, Mostafa; Najafipour, Hamid; Eslami, Mahmood; Salehi, Farank

    2015-01-01

    Along with the established effects of opium on metabolic parameters, stimulatory or inhibitory effects of opium on metabolic syndrome are also predictable. This study aimed to examine the association of opium use with metabolic syndrome and its components. This study was conducted on 5332 out of 5900 original sample participants enrolled in a population-based cohort entitled the Kerman Coronary Artery Disease Risk Study in Iran from 2009 to 2011. The subjects were divided into three groups of "non-opium users" (NOUs = 4340 subjects), "former opium users" (FOUs = 176 subjects), and dependent and occasional people named "current opium users" (COUs = 811 subjects). Metabolic syndrome was defined according to two International Diabetes Federation (IDF) and National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) definition criteria. The overall prevalence of IDF defined-metabolic syndrome among NOUs, FOUs, and COUs was 36.4%, 27.3%, and 39.0%, respectively; which was significantly higher in the COUs group (P = 0.012). However, no significant difference was revealed across the three groups in prevalence of NCEP defined-metabolic syndrome (NOUs = 37.2%, FOUs = 30.1%, and COUs = 39.6%, P = 0.058). The odds for IDF defined-metabolic syndrome was higher in both COUs [odd ratio (OR) = 1.28, P = 0.028)] and FOUs (OR = 1.57, P = 0.045) compared with NOUs as the reference adjusting gender, age, body mass index, and cigarette smoking. However, the appearance of NCEP defined-metabolic syndrome could not be predicted by opium use. Opium use can be associated with an increased risk for metabolic syndrome based on IDF criteria and thus preventing the appearance of metabolic syndrome by avoiding opium use can be a certain approach to preventing cardiovascular disease.

  19. Use and impact of thrombectomy in primary percutaneous coronary intervention for acute myocardial infarction with persistent ST-segment elevation: results of the prospective ALKK PCI-registry.

    Science.gov (United States)

    Härle, Tobias; Zeymer, Uwe; Hochadel, Matthias; Schmidt, Karin; Zahn, Ralf; Darius, Harald; Behrens, Steffen; Lauer, Bernward; Mudra, Harald; Schächinger, Volker; Elsässer, Albrecht

    2015-10-01

    Data about the impact of thrombectomy in primary percutaneous coronary intervention (PCI) are inconsistent. The aim of our study was an evaluation of both the real-world use of thrombectomy and the impact of thrombectomy on outcome in unselected patients treated with primary PCI for ST-elevation myocardial infarction (STEMI). We used the data of the prospective ALKK PCI-registry of 35 hospitals from January 2010 to December 2013. A total of 10,755 patients receiving single-vessel primary PCI for acute STEMI were included. In 2176 patients (20.2 %) thrombectomy was performed. There was a wide range of use of thrombectomy in the different ALKK hospitals from 1.1 to 61.7 % (median 18.6 %, quartiles 6.0 and 40.3 %) with a general increase of use over the first years of the study period. In patients with and without thrombectomy there was TIMI 0 flow present before PCI in 6010 patients, TIMI 1 in 1338, TIMI 2 in 2002, and TIMI 3 in 1405. Patients with acute heart failure or cardiogenic shock received significantly more often thrombectomy. Fluoroscopy time (8.1 vs. 7.3 min, p PCI had significantly higher rates of TIMI 3 flow after PCI when treated with thrombectomy (87.1 vs. 84.1 %, p PCI TIMI 3 flow in patients with TIMI 1, 2 or 3 flow before PCI. Rates of major adverse cardiac and cerebrovascular events were similar in both groups in general and in all subgroups of TIMI flow. The use of thrombectomy in patients with STEMI is heterogenous between hospitals. Overall, there was no impact of thrombectomy on TIMI 3 patency or mortality after PCI. In the subgroup of STEMI patients with TIMI 0 flow before PCI individualized thrombectomy had a positive impact on restoration of normal blood flow.

  20. Coronary heart disease among adult population evacuated from the 30-km zone of the Chernobyl NPP (Descriptive epidemiologic research results. Observation period 1988-2012

    Directory of Open Access Journals (Sweden)

    Olga A. Kapustynskaia

    2015-02-01

    determination and analyses of the dynamics of the evacuated adults sickness rate of the coronary heart disease also including its particular types including of age at the time of the accident sex and from the moment of the accident. The materials of the Ukrainian public register of people who suffered from the Chernobyl accident (UPR and the statistical data of the Ministry of Healthcare about the sickness of the Ukrainian population are used in the article. Subject of inquiry: adult population at the time of the accident avacuated from the 30-km Zone of the Chernobyl APP. Object of research - Coronary heart disease. The research was made on the coronary heart disease in whole and also due to nosological forms: angina pectoris; cardiac infarction; chronic coronary heart disease. Descriptive epidemiologic research was made for the period of 1988-2010 years. The cohort of adult avacuated population constituted 55022 people, 22056 men and 32966 women off them. For the comparison the statistic data about the sickness of adult population of Ukraine were used. In the article was also used the method of inner comparison, which allows to evaluate the credibility of the sickness rate figures difference for the periods of observation. The analisys is carried through following five periods (1988-1992 years, 1993-1997 years, 1998-2002 years, 2003-2008 years, 2009-2010 years. In accordance with the 24-years medical observation was determined that the coronary heart disease incidence of the adult evacuated population has significant differences due to age, sex and time. The increase in the coronary heart disease incidence regardless age at the moment of the accident is to be considered for the period of 12-22 years. The peak of the sickness for those, who were 40-60 at the time of the accident, was registered for the third period of observation, i. e. after 12-16 years from the moment of the accident at the Chernobyl NPP, for those, evacuated at the age of 18-39 – after 17-22 years and

  1. Prevalence of Congenital Coronary Artery Anomalies and Variants in 2697 Consecutive Patients Using 64-Detector Row Coronary CTAngiography

    International Nuclear Information System (INIS)

    Shabestari, Abbas Arjmand; Akhlaghpoor, Shahram; Tayebivaljozi, Reza; Fattahi Masrour, Farzaneh

    2012-01-01

    Coronary artery anomalies are not common, but could be very serious. This study determines the frequency of coronary anomalies and normal variants by multi-detector-row computed tomography (MDCT). The results of cardiac MDCT study in 2697 consecutive patients were analyzed retrospectively. Acquisition was performed by a 64-detector row CT machine. Imaging results were assessed by experienced radiologists. Myocardial bridging was by far the most frequent coronary variant (n = 576, 21.3%). Eighty-three subjects (3.1%) showed other coronary anomalies and variants. Anomalies of origination and course of the left main coronary artery (LMCA) were detected in 1.09% of the subjects. The frequency of these anomalies in the right coronary artery (RCA), left circumflex artery (LCx), left anterior descending artery (LAD), posterior descending artery (PDA) and obtuse marginal (OM) artery were 1.24%, 0.33%, 0.1%, 0.07% and 0.03%, respectively. The single coronary pattern was seen in 0.18% and coronary fistulas in 0.07%. Based on the fact that coronary CT-angiography using MDCT can display different coronary anomalies, this study shows similar results to other reports on the subject. Future advances in the performance of CT machines will further improve the quality of CT-based cardiac imaging

  2. Astrometric properties of the Tautenburg Plate Scanner

    Science.gov (United States)

    Brunzendorf, Jens; Meusinger, Helmut

    The Tautenburg Plate Scanner (TPS) is an advanced plate-measuring machine run by the Thüringer Landessternwarte Tautenburg (Karl Schwarzschild Observatory), where the machine is housed. It is capable of digitising photographic plates up to 30 cm × 30 cm in size. In our poster, we reported on tests and preliminary results of its astrometric properties. The essential components of the TPS consist of an x-y table movable between an illumination system and a direct imaging system. A telecentric lens images the light transmitted through the photographic emulsion onto a CCD line of 6000 pixels of 10 µm square size each. All components are mounted on a massive air-bearing table. Scanning is performed in lanes of up to 55 mm width by moving the x-y table in a continuous drift-scan mode perpendicular to the CCD line. The analogue output from the CCD is digitised to 12 bit with a total signal/noise ratio of 1000 : 1, corresponding to a photographic density range of three. The pixel map is produced as a series of optionally overlapping lane scans. The pixel data are stored onto CD-ROM or DAT. A Tautenburg Schmidt plate 24 cm × 24 cm in size is digitised within 2.5 hours resulting in 1.3 GB of data. Subsequent high-level data processing is performed off-line on other computers. During the scanning process, the geometry of the optical components is kept fixed. The optimal focussing of the optics is performed prior to the scan. Due to the telecentric lens refocussing is not required. Therefore, the main source of astrometric errors (beside the emulsion itself) are mechanical imperfections in the drive system, which have to be divided into random and systematic ones. The r.m.s. repeatability over the whole plate as measured by repeated scans of the same plate is about 0.5 µm for each axis. The mean plate-to-plate accuracy of the object positions on two plates with the same epoch and the same plate centre has been determined to be about 1 µm. This accuracy is comparable to

  3. Coronary calcium scoring with MDCT: The radiation dose to the breast and the effectiveness of bismuth breast shield

    International Nuclear Information System (INIS)

    Yilmaz, Mehmet Halit; Yasar, Dogan; Albayram, Sait; Adaletli, Ibrahim; Ozer, Harun; Ozbayrak, Mustafa; Mihmanli, Ismail; Akman, Canan

    2007-01-01

    Objective: The purpose of our study was to determine the breast radiation dose during coronary calcium scoring with multidetector computerized tomography (MDCT). We also evaluated the degree of dose reduction by using a bismuth breast shield when performing coronary calcium scoring with MDCT. Materials and methods: The dose reduction achievable by shielding the adult (35 years or older) female breasts was studied in 25 women who underwent coronary calcium scoring with MDCT. All examinations were performed with a 16-MDCT scanner. To compare the shielded versus unshielded breast dose, the examinations were performed with (right breast) and without (left breast) breast shielding in all patients. With this technique the superficial breast doses were calculated. To determine the average glandular breast radiation dose, we imaged an anthropomorphic dosimetric phantom into which calibrated dosimeters were placed to measure the dose to the breast. The phantom was imaged using the same protocol. Radiation doses to the breasts with and without the breast shielding were measured and compared using the Student's t-test. Results: The mean radiation doses with and without the breast shield were 5.71 ± 1.1 mGy versus 9.08 ± 1.5 mGy, respectively. The breast shield provided a 37.12% decrease in radiation dose to the breast with shielding. The difference between the dose received by the breasts with and without bismuth shielding was significant, with a p-value of less than 0.001. Conclusion: The high radiation during MDCT greatly exceeds the recommended doses and should not be underestimated. Bismuth in plane shielding for coronary calcium scoring with MDCT decreased the radiation dose to the breast. We recommend routine use of breast shields in female patients undergoing calcium scoring with MDCT

  4. Large coronary intramural hematomas

    DEFF Research Database (Denmark)

    Antonsen, Lisbeth; Thayssen, Per; Jensen, Lisette Okkels

    2015-01-01

    Isolated spontaneous coronary intramural hematoma is a unique subset of spontaneous coronary artery dissection that is characterized by a hemorrhage limited to the medial-adventitial layers, causing subsequent hematoma formation without visible intimal flaps. It is an infrequent and serious...... diagnostics and treatment strategy. Coronary intramural hematomas can also occur iatrogenically, as a complication to percutaneous coronary intervention (PCI). Coronary angiography (CAG) has limited diagnostic value in the absence of intimal dissections, and lesions are often angiographically ambiguous....... Intravascular ultrasound (IVUS) is an important diagnostic tool in establishing the correct diagnosis, as it provides a complete vessel wall assessment, and enables morphometric information regarding the magnitude and severity of the underlying hematoma. Due to the rarity of this clinical scenario...

  5. A combined positron emission tomography (PET)-electron paramagnetic resonance imaging (EPRI) system: initial evaluation of a prototype scanner

    Science.gov (United States)

    Tseytlin, Mark; Stolin, Alexander V.; Guggilapu, Priyaankadevi; Bobko, Andrey A.; Khramtsov, Valery V.; Tseytlin, Oxana; Raylman, Raymond R.

    2018-05-01

    The advent of hybrid scanners, combining complementary modalities, has revolutionized the application of advanced imaging technology to clinical practice and biomedical research. In this project, we investigated the melding of two complementary, functional imaging methods: positron emission tomography (PET) and electron paramagnetic resonance imaging (EPRI). PET radiotracers can provide important information about cellular parameters, such as glucose metabolism. While EPR probes can provide assessment of tissue microenvironment, measuring oxygenation and pH, for example. Therefore, a combined PET/EPRI scanner promises to provide new insights not attainable with current imagers by simultaneous acquisition of multiple components of tissue microenvironments. To explore the simultaneous acquisition of PET and EPR images, a prototype system was created by combining two existing scanners. Specifically, a silicon photomultiplier (SiPM)-based PET scanner ring designed as a portable scanner was combined with an EPRI scanner designed for the imaging of small animals. The ability of the system to obtain simultaneous images was assessed with a small phantom consisting of four cylinders containing both a PET tracer and EPR spin probe. The resulting images demonstrated the ability to obtain contemporaneous PET and EPR images without cross-modality interference. Given the promising results from this initial investigation, the next step in this project is the construction of the next generation pre-clinical PET/EPRI scanner for multi-parametric assessment of physiologically-important parameters of tissue microenvironments.

  6. Factors influencing delay time and coronary arterial density during coronary angiography with DSCT

    International Nuclear Information System (INIS)

    Lijun Tang; Xiaomei Zhu; Yi Xu; Tongfu Yu; Hai Xu; Jinhua Tang; Dehang Wang; Dogra, Vikram

    2011-01-01

    Background: CT angiography (CTA) plays an important role in diagnosing coronary arterial disease. Delay time and density of the coronary arteries related with patient-specific factors are essential for getting an optimal CTA image. Purpose: To investigate various factors influencing delay time and coronary arterial density during coronary CTA with dual source CT. Material and Methods: One hundred and sixteen consecutive subjects who underwent cardiac DSCT with retrospective ECG-gating were included. Factors including gender, age, height, weight, transversal cardiac diameter (TCD), transversal thoracic diameter (TTD), heart rate (HR), body surface area (BSA = [weight x height/3600]1/2) and cardiothoracic ratio (CTR = TCD/TTD) were recorded, measured and calculated before administration of contrast media during coronary CT angiography. Delay time was determined as duration from the beginning of the injection to the density in the descending aorta at the level of right main pulmonary artery reaching a threshold of 100 HU. Coronary arterial density was measured at the mid portion of the right coronary artery. Regression analysis and stepwise regression analysis were used to investigate the influence of these factors on delay time and coronary arterial density. Results: Delay time decreased with an increasing HR and it was shorter in women than men. Delay time increased with an increasing TCD. Delay time could be predicted by the formula: DT = 16.651-0.110 x HR + 1.902 x gender + 0.394 x TCD (where DT is abbreviation for delay time, gender is 0 for women and 1 for men). Coronary arterial density decreased with an increasing HR and weight. Coronary arterial density could be predicted by the formula: CAD = 923.42-4.099 x HR-3.293 x weight (CAD = coronary arterial density). There was no relationship between the other factors mentioned above and delay time or coronary arterial density. Conclusion: Delay time is influenced by HR, gender and TCD. Coronary arterial density

  7. Morphological study on coronary ostial and clinicoangiographic analysis of isolated coronary ostial stenosis

    International Nuclear Information System (INIS)

    Kanoh, Tatsuji

    2007-01-01

    A morphological study of coronary ostia was performed in 70 autopsied human hearts, with particular attention being focused on the funnel-shaped structure, aging changes, and relation to atherosclerosis. The following results were obtained: The ostium is particularly well-defined and forms a funnel-shaped structure. The structure is predominantly a double circular shape on the right and comet-shaped on the left. The funnel-shaped structure of coronary ostia is characterized by a longitudinal smooth muscle arrangement in the inner layer and circular one in the outer layer. Including overhang formation, coronary sclerosis of the ostium appears mainly on the upper margin of the funnel-shaped structure of the right ostium and at the upper right margin of the left. In ischemic heart disease, along with changes in coronary arteries themselves, changes in the ostia of these arteries should be paid close attention. Ostial stenosis of the coronary artery in the absence of distal vessel obstructions, isolated ostial stenosis, is a rare form of coronary artery disease. In a previous review of the international literature, the incidence of coronary ostial stenosis varied between 0.13% and 2.7%. Among 7,500 patients undergoing selective coronary cineangiography at Juntendo University Hospital and Juntendo Urayasu Hospital from 1975 to 1990, five women (0.07%) were diagnosed as having ''isolated coronary ostial stenosis'', of which the cause is unknown. Atherosclerosis, particularly early premature atherome, congenital coronary anomaly, fibro-muscular dysplasia, Takayasu's aortitis, humoral factors, spasm, and iatrogenic events have been considered as its causes. In contrast to usual atherosclerotic coronary artery disease, patients with isolated coronary ostial stenosis of unknown etiology were characterized as being middle-aged, premenopausal, slender females having few coronary risk factors, experiencing severe angina pector is with marked ischemic electrocardiogram changes

  8. Circumference estimation using 3D-whole body scanners and shadow scanner

    NARCIS (Netherlands)

    Daanen, H.A.M.

    1998-01-01

    Clothing designers and manufacturers use traditional body dimensions as their basis. When 3D-whole body scanners are introduced to determine the body dimensions, a conversion has to be made, since scan determined circumference measures are slightly larger than the traditional values. This pilot

  9. 3D Laser Scanner for Underwater Manipulation

    Directory of Open Access Journals (Sweden)

    Albert Palomer

    2018-04-01

    Full Text Available Nowadays, research in autonomous underwater manipulation has demonstrated simple applications like picking an object from the sea floor, turning a valve or plugging and unplugging a connector. These are fairly simple tasks compared with those already demonstrated by the mobile robotics community, which include, among others, safe arm motion within areas populated with a priori unknown obstacles or the recognition and location of objects based on their 3D model to grasp them. Kinect-like 3D sensors have contributed significantly to the advance of mobile manipulation providing 3D sensing capabilities in real-time at low cost. Unfortunately, the underwater robotics community is lacking a 3D sensor with similar capabilities to provide rich 3D information of the work space. In this paper, we present a new underwater 3D laser scanner and demonstrate its capabilities for underwater manipulation. In order to use this sensor in conjunction with manipulators, a calibration method to find the relative position between the manipulator and the 3D laser scanner is presented. Then, two different advanced underwater manipulation tasks beyond the state of the art are demonstrated using two different manipulation systems. First, an eight Degrees of Freedom (DoF fixed-base manipulator system is used to demonstrate arm motion within a work space populated with a priori unknown fixed obstacles. Next, an eight DoF free floating Underwater Vehicle-Manipulator System (UVMS is used to autonomously grasp an object from the bottom of a water tank.

  10. 3D Laser Scanner for Underwater Manipulation.

    Science.gov (United States)

    Palomer, Albert; Ridao, Pere; Youakim, Dina; Ribas, David; Forest, Josep; Petillot, Yvan

    2018-04-04

    Nowadays, research in autonomous underwater manipulation has demonstrated simple applications like picking an object from the sea floor, turning a valve or plugging and unplugging a connector. These are fairly simple tasks compared with those already demonstrated by the mobile robotics community, which include, among others, safe arm motion within areas populated with a priori unknown obstacles or the recognition and location of objects based on their 3D model to grasp them. Kinect-like 3D sensors have contributed significantly to the advance of mobile manipulation providing 3D sensing capabilities in real-time at low cost. Unfortunately, the underwater robotics community is lacking a 3D sensor with similar capabilities to provide rich 3D information of the work space. In this paper, we present a new underwater 3D laser scanner and demonstrate its capabilities for underwater manipulation. In order to use this sensor in conjunction with manipulators, a calibration method to find the relative position between the manipulator and the 3D laser scanner is presented. Then, two different advanced underwater manipulation tasks beyond the state of the art are demonstrated using two different manipulation systems. First, an eight Degrees of Freedom (DoF) fixed-base manipulator system is used to demonstrate arm motion within a work space populated with a priori unknown fixed obstacles. Next, an eight DoF free floating Underwater Vehicle-Manipulator System (UVMS) is used to autonomously grasp an object from the bottom of a water tank.

  11. Interferometric Laser Scanner for Direction Determination

    Directory of Open Access Journals (Sweden)

    Gennady Kaloshin

    2016-01-01

    Full Text Available In this paper, we explore the potential capabilities of new laser scanning-based method for direction determination. The method for fully coherent beams is extended to the case when interference pattern is produced in the turbulent atmosphere by two partially coherent sources. The performed theoretical analysis identified the conditions under which stable pattern may form on extended paths of 0.5–10 km in length. We describe a method for selecting laser scanner parameters, ensuring the necessary operability range in the atmosphere for any possible turbulence characteristics. The method is based on analysis of the mean intensity of interference pattern, formed by two partially coherent sources of optical radiation. Visibility of interference pattern is estimated as a function of propagation pathlength, structure parameter of atmospheric turbulence, and spacing of radiation sources, producing the interference pattern. It is shown that, when atmospheric turbulences are moderately strong, the contrast of interference pattern of laser scanner may ensure its applicability at ranges up to 10 km.

  12. A 3D airborne ultrasound scanner

    Science.gov (United States)

    Capineri, L.; Masotti, L.; Rocchi, S.

    1998-06-01

    This work investigates the feasibility of an ultrasound scanner designed to reconstruct three-dimensional profiles of objects in air. There are many industrial applications in which it is important to obtain quickly and accurately the digital reconstruction of solid objects with contactless methods. The final aim of this project was the profile reconstruction of shoe lasts in order to eliminate the mechanical tracers from the reproduction process of shoe prototypes. The feasibility of an ultrasonic scanner was investigated in laboratory conditions on wooden test objects with axial symmetry. A bistatic system based on five airborne polyvinylidenedifluoride (PVDF) transducers was mechanically moved to emulate a cylindrical array transducer that can host objects of maximum width and height 20 cm and 40 cm respectively. The object reconstruction was based on a simplified version of the synthetic aperture focusing technique (SAFT): the time of flight (TOF) of the first in time echo for each receiving transducer was taken into account, a coarse spatial sampling of the ultrasonic field reflected on the array transducer was delivered and the reconstruction algorithm was based on the ellipsoidal backprojection. Measurements on a wooden cone section provided submillimetre accuracy in a controlled environment.

  13. Interferometric Laser Scanner for Direction Determination

    Science.gov (United States)

    Kaloshin, Gennady; Lukin, Igor

    2016-01-01

    In this paper, we explore the potential capabilities of new laser scanning-based method for direction determination. The method for fully coherent beams is extended to the case when interference pattern is produced in the turbulent atmosphere by two partially coherent sources. The performed theoretical analysis identified the conditions under which stable pattern may form on extended paths of 0.5–10 km in length. We describe a method for selecting laser scanner parameters, ensuring the necessary operability range in the atmosphere for any possible turbulence characteristics. The method is based on analysis of the mean intensity of interference pattern, formed by two partially coherent sources of optical radiation. Visibility of interference pattern is estimated as a function of propagation pathlength, structure parameter of atmospheric turbulence, and spacing of radiation sources, producing the interference pattern. It is shown that, when atmospheric turbulences are moderately strong, the contrast of interference pattern of laser scanner may ensure its applicability at ranges up to 10 km. PMID:26805841

  14. Role of coronary physiology in the contemporary management of coronary artery disease

    Science.gov (United States)

    Ruparelia, Neil; Kharbanda, Rajesh K

    2015-01-01

    Coronary artery disease (CAD) remains the leading cause of death worldwide with approximately 1 in 30 patients with stable CAD experiencing death or acute myocardial infarction each year. The presence and extent of resultant myocardial ischaemia has been shown to confer an increased risk of adverse outcomes. Whilst, optimal medical therapy (OMT) forms the cornerstone of the management of patients with stable CAD, a significant number of patients present with ischaemia refractory to OMT. Historically coronary angiography alone has been used to determine coronary lesion severity in both stable and acute settings. It is increasingly clear that this approach fails to accurately identify the haemodynamic significance of lesions; especially those that are visually “intermediate” in severity. Revascularisation based upon angiographic appearances alone may not reduce coronary events above OMT. Technological advances have enabled the measurement of physiological indices including the fractional flow reserve, the index of microcirculatory resistance and the coronary flow reserve. The integration of these parameters into the routine management of patients presenting to the cardiac catheterization laboratory with CAD represents a critical adjunctive tool in the optimal management of these patients by identifying patients that would most benefit from revascularisation and importantly also highlighting patients that would not gain benefit and therefore reducing the likelihood of adverse outcomes associated with coronary revascularisation. Furthermore, these techniques are applicable to a broad range of patients including those with left main stem disease, proximal coronary disease, diabetes mellitus, previous percutaneous coronary intervention and with previous coronary artery bypass grafting. This review will discuss current concepts relevant to coronary physiology assessment, its role in the management of both stable and acute patients and future applications. PMID

  15. Role of coronary physiology in the contemporary management of coronary artery disease.

    Science.gov (United States)

    Ruparelia, Neil; Kharbanda, Rajesh K

    2015-02-16

    Coronary artery disease (CAD) remains the leading cause of death worldwide with approximately 1 in 30 patients with stable CAD experiencing death or acute myocardial infarction each year. The presence and extent of resultant myocardial ischaemia has been shown to confer an increased risk of adverse outcomes. Whilst, optimal medical therapy (OMT) forms the cornerstone of the management of patients with stable CAD, a significant number of patients present with ischaemia refractory to OMT. Historically coronary angiography alone has been used to determine coronary lesion severity in both stable and acute settings. It is increasingly clear that this approach fails to accurately identify the haemodynamic significance of lesions; especially those that are visually "intermediate" in severity. Revascularisation based upon angiographic appearances alone may not reduce coronary events above OMT. Technological advances have enabled the measurement of physiological indices including the fractional flow reserve, the index of microcirculatory resistance and the coronary flow reserve. The integration of these parameters into the routine management of patients presenting to the cardiac catheterization laboratory with CAD represents a critical adjunctive tool in the optimal management of these patients by identifying patients that would most benefit from revascularisation and importantly also highlighting patients that would not gain benefit and therefore reducing the likelihood of adverse outcomes associated with coronary revascularisation. Furthermore, these techniques are applicable to a broad range of patients including those with left main stem disease, proximal coronary disease, diabetes mellitus, previous percutaneous coronary intervention and with previous coronary artery bypass grafting. This review will discuss current concepts relevant to coronary physiology assessment, its role in the management of both stable and acute patients and future applications.

  16. Influence of psychological and coronary parameters on coronary patient rehospitalization

    Directory of Open Access Journals (Sweden)

    Nikolić Gordana

    2010-01-01

    Full Text Available Introduction. Psychological reactions are often comorbid with coronary risk factors and could be important for a six-month outcome. Objective. Determination of anxiety level, depression and aggression, persistence of risk health behaviour, stress life events, and coronary risk factors after coronary event and a predictive value of those parameters for six-month rehospitalization. Methods. In the group with Angina Pectoris (E1=30 and the group with Acute Myocardial Infarction (E2=33, there were applied, at baseline and after 6 months, the following: Semistructured Clinical Interview based on ICD-10, for depressive episode and anxiety disorder, Hamilton Anxiety Scale (HAMA, Hamilton Depression Scale (HAMD, KON-6 sigma Scale for aggression, Holms-Rahe Scale (H-R for stress events and Questionnaire for risk behaviour: alcohol consumption, smoking, lack of physical activity. Group differences were assessed by t-test and chi-square test, p<0.05, regression analysis for assessing initial variables, a predictive value for six month rehospitalization. Results. After acute coronary event, the anxiety and depression levels were mild and aggression was low in E1 and mild in E2. Stress event score was significantly higher in E2 (H-R=115.18 than in E1 (H-R=72.20, p<0.05. After 6 months, the results were the same except for a significantly lower stress event score in E1 (H-R=49.48, and in E2 (H-R=91.65, but still significantly higher than in E1. Coronary parameters were reduced, smokers' rate was increased in E1. Alcohol consumption, hypercholesterolaemia and hereditary tendency were predictive for six- month rehospitalization. Conclusion. After acute cardiac event, hospitalized coronary patients had a mild anxiety, depression and aggression level as well as after six months. The infarct patients had experienced more stress life events in the previous year than the angina patients. Risk health behaviour did not change in the following six months, with the

  17. Coronary anomalies in Pakistani children with tetralogy of fallot

    International Nuclear Information System (INIS)

    Hussain, I.; Patel, N.

    2010-01-01

    To determine coronary artery anomalies in tetralogy of Fallot in Pakistani children as seen on angiography. Study Design: Case series. Place and Duration of Study: The National Institute of Cardiovascular Diseases, Karachi, Pakistan from July 2006 to July 2007. Methodology: Children under 15 years of age with echocardiographic diagnosis of tetralogy of Fallot were included in the study. All patients had pre-operative cardiac catheterization and angiography. Coronary arteries were studied with a nonselective aortic root angiogram in standard cranially tilted left anterior oblique view. The frequency of a normal and an anomalous coronary was determined. Results: Of the 83 patients, 78% were male and had a mean age of 8.9 years. Their mean weight was 14.3 kilograms. Seventy six (91.6%) had a normal coronary anatomy while 7 (8.4%) patients had anomalous coronary arteries. Among the patients with coronary anomalies, the commonest was a single origin coronary artery in 04 (57.14%) cases. Three (42.86%) had an anomalous origin of left anterior descending artery from the right coronary artery. Conclusion: Coronary artery anomalies were detected in 8.4% of the cases with tetralogy of Fallot. Single origin coronary artery anomaly was the commonest anomaly. (author)

  18. Posttraumatic Stress Disorder Disturbs Coronary Tone and Its Regulatory Mechanisms.

    Science.gov (United States)

    Lazuko, Svetlana S; Kuzhel, Olga P; Belyaeva, Lyudmila E; Manukhina, Eugenia B; Fred Downey, H; Tseilikman, Olga B; Komelkova, Maria V; Tseilikman, Vadim E

    2018-01-01

    Posttraumatic stress disorder (PTSD) is associated with myocardial injury, but changes in coronary regulatory mechanisms in PTSD have not been investigated. This study evaluated the effect of PTSD-inducing stress on coronary tone and its regulation by nitric oxide (NO) and voltage-gated K + channels. PTSD was induced by exposing rats to predator stress, 15 min daily for 10 days, followed by 14 stress-free days. Presence of PTSD was confirmed by the elevated plus-maze test. Coronary tone was evaluated from changes in coronary perfusion pressure of Langendorff isolated hearts. Predator stress induced significant decreases in coronary tone of isolated hearts and in blood pressure of intact rats. L-NAME, a non-selective NO synthase (NOS) inhibitor, but not S-MT, a selective iNOS inhibitor, and increased coronary tone of control rats. In PTSD rats, both L-NAME and S-MT increased coronary tone. Therefore, the stress-induced coronary vasodilation resulted from NO overproduction by both iNOS and eNOS. NOS induction was apparently due to systemic inflammation as evidenced by increased serum interleukin-1β and C-reactive protein in PTSD rats. Decreased corticosterone in PTSD rats may have contributed to inflammation and its effect on coronary tone. PTSD was also associated with voltage-gated K + channel dysfunction, which would have also reduced coronary tone.

  19. Daily quality controls analysis of a CT scanner simulator

    International Nuclear Information System (INIS)

    Vasques, Maira Milanelo; Santos, Gabriela R.; Furnari, Laura

    2016-01-01

    With the increasing technological developments, radiotherapy practices, which allow for better involvement of the tumor with the required therapeutic dose and minimize the complications of normal tissues, have become reality in several Radiotherapy services. The use of these resources in turn, was only possible due to the progress made in planning based on digital volumetric images of good quality, such as computed tomography (CT), which allow the correct delimitation of the tumor volume and critical structures. Specific tests for quality control in a CT scanner used in radiotherapy, named CT simulator, should be applied as part of the institutional Quality Assurance Program. This study presents the methodology used in the Instituto de Radiologia do Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP) for daily testing of the CT scanner simulator and the results obtained throughout more than two years. The experience gained in the period conducted showed that the tests are easy to perform and can be done in a few minutes by a trained professional. Data analysis showed good reproducibility, which allowed the tests could be performed less frequently, after 16 months of data collection. (author)

  20. Novel design of a parallax free Compton enhanced PET scanner

    International Nuclear Information System (INIS)

    Braem, A.; Chamizo, M.; Chesi, E.; Colonna, N.; Cusanno, F.; De Leo, R.; Garibaldi, F.; Joram, C.; Marrone, S.; Mathot, S.; Nappi, E.; Schoenahl, F.; Seguinot, J.; Weilhammer, P.; Zaidi, H.

    2004-01-01

    Molecular imaging by PET is a powerful tool in modern clinical practice for cancer diagnosis. Nevertheless, improvements are needed with respect to the spatial resolution and sensitivity of the technique for its application to specific human organs (breast, prostate, brain, etc.), and to small animals. Presently, commercial PET scanners do not detect the depth of interaction of photons in scintillators, which results in a not negligible parallax error. We describe here a novel concept of PET scanner design that provides full three-dimensional (3D) gamma reconstruction with high spatial resolution over the total detector volume, free of parallax errors. It uses matrices of long scintillators read at both ends by hybrid photon detectors. This so-called 3D axial concept also enhances the gamma detection efficiency since it allows one to reconstruct a significant fraction of Compton scattered events. In this note, we describe the concept, a possible design and the expected performance of this new PET device. We also report about first characterization measurements of 10 cm long YAP:Ce scintillation crystals

  1. A noble refractive optical scanner with linear response

    Science.gov (United States)

    Mega, Yair J.; Lai, Zhenhua; DiMarzio, Charles A.

    2013-03-01

    Many applications in various fields of science and engineering use steered optical beam systems. Currently, many methods utilize mirrors in order to steer the beam. However, this approach is an off-axis solution, which normally increases the total size of the system as well as its error and complexity. Other methods use a "Risely Prisms" based solution, which is on-axis solution, however it poses some difficulties from an engineering standpoint, and therefore isn't widely used. We present here a novel technique for steering a beam on its optical axis with a linear deflection response. We derived the formulation for the profile required of the refractive optical component necessary for preforming the beam steering. The functionality of the device was simulated analytically using Matlab, as well as using a ray-tracing software, Zemax, and showed agreement with the analytical model. An optical element was manufactured based on the proposed design and the device was tested. The results show agreement with our hypothesis. We also present some proposed geometries of the several other devices, all based on the same concept, which can be used for higher performance applications such as two-dimensional scanner, video rate scanner etc.

  2. A Moving 3D Laser Scanner for Automated Underbridge Inspection

    Directory of Open Access Journals (Sweden)

    Marco Tarabini

    2017-12-01

    Full Text Available Recent researches have proven that the underbridge geometry can be reconstructed by mounting a 3D laser scanner on a motorized cart travelling on a walkway located under the bridge. The walkway is moved by a truck and the accuracy of the bridge model depends on the accuracy of the trajectory of the scanning head with respect to a fixed reference system. In this paper, we describe a vision-based measurement system that can be used to identify the relative motion of the cart that moves the 3D laser scanner with respect to the walkway. The orientation of the walkway with respect to the bridge is determined using inclinometers and a camera that detect the position of a laser spot, while the position of the truck with respect to the bridge is measured using a conventional odometer. The accuracy of the proposed system was initially evaluated by numerical simulations and successively verified by experiments in laboratory conditions. The complete system has then been tested by comparing the geometry of buildings reconstructed using the proposed system with the geometry obtained with a static scan. Results showed that the error is less than 6 mm; given the satisfying quality of the point clouds obtained, it is also possible to detect small defects on the surface.

  3. Computed tomographic mammography using a conventional body scanner.

    Science.gov (United States)

    Chang, C H; Nesbit, D E; Fisher, D R; Fritz, S L; Dwyer, S J; Templeton, A W; Lin, F; Jewell, W R

    1982-03-01

    The technique for computed tomographic (CT) examination of the breasts using a conventional body scanner is described, and experience with 67 patients is reported. In the diagnosis of both malignant and benign breast lesions, the results with a body scanner were equal to those of a dedicated CT/M mammographic unit. Although the CT study of the breast cannot replace conventional mammography in screening or in routine diagnostic workup, the unique capability of demonstrating both anatomic changes and increased iodide concentration in a cancer provides many advantages over conventional mammography. CT mammography appears to have the capability to detect breast cancers that are occult to other methods. Indications for a CT study of the breasts are: (1) clinically suspected breast cancer, especially with a mammographically occult lesion; (2) questionable mammographic findings, including microcalcifications, tumor shape, architectural distortion, and uncertain lesion location; and (3) evaluation of postbiopsy or postlumpectomy breast cancers when a primary irradiation therapy is contemplated. Breast CT also appears to be a valuable diagnostic tool in searching for a second primary breast cancer, follow-up study of postirradiation of breast cancer, followup study for postmastectomy patients, and screening procedure for genetically high-risk patients, especially those with dense breasts.

  4. Quantitative image reconstruction for total-body PET imaging using the 2-meter long EXPLORER scanner

    Science.gov (United States)

    Zhang, Xuezhu; Zhou, Jian; Cherry, Simon R.; Badawi, Ramsey D.; Qi, Jinyi

    2017-03-01

    The EXPLORER project aims to build a 2 meter long total-body PET scanner, which will provide extremely high sensitivity for imaging the entire human body. It will possess a range of capabilities currently unavailable to state-of-the-art clinical PET scanners with a limited axial field-of-view. The huge number of lines-of-response (LORs) of the EXPLORER poses a challenge to the data handling and image reconstruction. The objective of this study is to develop a quantitative image reconstruction method for the EXPLORER and compare its performance with current whole-body scanners. Fully 3D image reconstruction was performed using time-of-flight list-mode data with parallel computation. To recover the resolution loss caused by the parallax error between crystal pairs at a large axial ring difference or transaxial radial offset, we applied an image domain resolution model estimated from point source data. To evaluate the image quality, we conducted computer simulations using the SimSET Monte-Carlo toolkit and XCAT 2.0 anthropomorphic phantom to mimic a 20 min whole-body PET scan with an injection of 25 MBq 18F-FDG. We compare the performance of the EXPLORER with a current clinical scanner that has an axial FOV of 22 cm. The comparison results demonstrated superior image quality from the EXPLORER with a 6.9-fold reduction in noise standard deviation comparing with multi-bed imaging using the clinical scanner.

  5. A LabVIEW® based generic CT scanner control software platform.

    Science.gov (United States)

    Dierick, M; Van Loo, D; Masschaele, B; Boone, M; Van Hoorebeke, L

    2010-01-01

    UGCT, the Centre for X-ray tomography at Ghent University (Belgium) does research on X-ray tomography and its applications. This includes the development and construction of state-of-the-art CT scanners for scientific research. Because these scanners are built for very different purposes they differ considerably in their physical implementations. However, they all share common principle functionality. In this context a generic software platform was developed using LabVIEW® in order to provide the same interface and functionality on all scanners. This article describes the concept and features of this software, and its potential for tomography in a research setting. The core concept is to rigorously separate the abstract operation of a CT scanner from its actual physical configuration. This separation is achieved by implementing a sender-listener architecture. The advantages are that the resulting software platform is generic, scalable, highly efficient, easy to develop and to extend, and that it can be deployed on future scanners with minimal effort.

  6. Analysis of the Performance of a Laser Scanner for Predictive Automotive Applications

    Science.gov (United States)

    Zeisler, J.; Maas, H.-G.

    2015-08-01

    In this paper we evaluate the use of a laser scanner for future advanced driver assistance systems. We focus on the important task of predicting the target vehicle for longitudinal ego vehicle control. Our motivation is to decrease the reaction time of existing systems during cut-in maneuvers of other traffic participants. A state-of-the-art laser scanner, the Ibeo Scala B2 R , is presented, providing its sensing characteristics and the subsequent high level object data output. We evaluate the performance of the scanner towards object tracking with the help of a GPS real time kinematics system on a test track. Two designed scenarios show phases with constant distance and velocity as well as dynamic motion of the vehicles. We provide the results for the error in position and velocity of the scanner and furthermore, review our algorithm for target vehicle prediction. Finally we show the potential of the laser scanner with the estimated error, that leads to a decrease of up to 40% in reaction time with best conditions.

  7. A combined positron emission tomography (PET)- electron paramagnetic resonance imaging (EPRI) system: initial evaluation of a prototype scanner.

    Science.gov (United States)

    Tseytlin, Mark; Stolin, Alexander V; Guggilapu, Priyaankadevi; Bobko, Andrey A; Khramtsov, Valery V; Tseytlin, Oxana; Raylman, Raymond R

    2018-04-20

    The advent of hybrid scanners, combining complementary modalities, has revolutionized imaging; enhancing clinical practice and biomedical research. In this project, we investigated the melding of two complementary, functional imaging methods: positron emission tomography (PET) and electron paramagnetic resonance imaging (EPRI). The PET radiotracers can provide important information about cellular parameters, such as glucose metabolism. While EPR probes can provide assessment of tissue microenvironment, measuring parameters such as oxygenation and pH, for example. A combined PET/EPRI scanner has the promise to provide new insights not attainable with current imagers by simultaneous acquisition of multiple components of tissue microenvironments. In this investigation, a prototype system was created by combing two existing scanners, modified for simultaneous imaging. Specifically, a silicon photomultiplier (SiPM) based PET scanner ring designed as a portable scanner was combined with an EPRI scanner designed for the imaging of small animals. The ability of the system to obtain simultaneous images was assessed with a small phantom consisting of four cylinders containing both PET and EPR tracers. The resulting images demonstrated the ability to obtain contemporaneous PET and ERP images without cross-modality interference. The next step in this project is the construction of pre-clinical PET/EPRI scanner for multi-parametric assessment of physiologically important parameters of tissue microenvironments. . © 2018 Institute of Physics and Engineering in Medicine.

  8. Was the Scanner Calibration Slide used for its intended purpose?

    Directory of Open Access Journals (Sweden)

    Zong Yaping

    2011-04-01

    Full Text Available Abstract In the article, Scanner calibration revisited, BMC Bioinformatics 2010, 11:361, Dr. Pozhitkov used the Scanner Calibration Slide, a key product of Full Moon BioSystems to generate data in his study of microarray scanner PMT response and proposed a mathematic model for PMT response 1. In the end, the author concluded that "Full Moon BioSystems calibration slides are inadequate for performing calibration," and recommended "against using these slides." We found these conclusions are seriously flawed and misleading, and his recommendation against using the Scanner Calibration Slide was not properly supported.

  9. SCT-4800T whole body X-ray CT scanner

    International Nuclear Information System (INIS)

    Okumura, Yoshitaka; Sato, Yukio; Kuwahara, Hiroshi

    1994-01-01

    A whole body X-ray CT scanner, the SCT-4800T (trade name: INTELLECT series), has been developed. This system is the first CT scanner that is combined with general radiographic functions. The general radiographic functions include a patient couch with film casette and several tube support systems along with the CT scanner. This newly designed CT scanner also features a compact and light-weight gantry with a 700 mm diameter apperture and user-friendly operater's console. The SCT-4800T brings a new level of patient and operator comfort to the emergency radiology examination site. (author)

  10. Input Scanners: A Growing Impact In A Diverse Marketplace

    Science.gov (United States)

    Marks, Kevin E.

    1989-08-01

    Just as newly invented photographic processes revolutionized the printing industry at the turn of the century, electronic imaging has affected almost every computer application today. To completely emulate traditionally mechanical means of information handling, computer based systems must be able to capture graphic images. Thus, there is a widespread need for the electronic camera, the digitizer, the input scanner. This paper will review how various types of input scanners are being used in many diverse applications. The following topics will be covered: - Historical overview of input scanners - New applications for scanners - Impact of scanning technology on select markets - Scanning systems issues

  11. Methods and apparatus for laser beam scanners with different actuating mechanisms

    Science.gov (United States)

    Chen, Si-hai; Xiang, Si-hua; Wu, Xin; Dong, Shan; Xiao, Ding; Zheng, Xia-wei

    2009-07-01

    In this paper, 3 types of laser beam scanner are introduced. One is transmissive beam scanner, which is composed of convex and concave microlens arrays (MLAs). By moving the concave lens in the plane vertical to the optical axis, the incident beam can be deflected in two dimensions. Those two kinds of MLAs are fabricated by thermal reflow and replication process. A set of mechanical scanner frame is fabricated with the two MLAs assembling in it. The testing result shown that the beam deflection angles are 9.5° and 9.6°, in the 2 dimension(2D) with the scanning frequency of 2 HZ and 8 HZ, respectively. The second type of laser beam scanner is actuated by voice coil actuators (VCAs). Based on ANSOFT MAXWELL software, we have designed VCAs with small size and large force which have optimized properties. The model of VCAs is built using AutoCAD and is analyzed by Ansoft maxwell. According to the simulation results, high performance VCAs are fabricated and tested. The result is that the force of the VCAs is 6.39N/A, and the displacement is +/-2.5mm. A set up of beam scanner is fabricated and actuated by the designed VCAs. The testing result shown that the two dimensional scanning angle is 15° and 10° respectively at the frequency of 60HZ. The two dimensional scanning angle is 8.3° and 6° respectively at the frequency of 100HZ. The third type of scanner is actuated by amplified piezoelectric actuators (APAs). The scanning mirror is actuated by the piezoelectric (PZ) actuators with the scanning frequency of 700HZ, 250HZ and 87HZ respectively. The optical scanning angle is +/-0.5° at the three frequencies.

  12. Congenital coronary artery fistula

    International Nuclear Information System (INIS)

    Oh, Yeon Hee; Kim, Hong; Zeon, Seoc Kil; Suh, Soo Jhi

    1986-01-01

    Congenital coronary artery fistula (CCAF) is communication of a coronary artery or its main branch with one of the atria or ventricles, the coronary sinus, the superior vena cava, or the pulmonary artery. In Korean peoples, only 4 cases of the CCAF were reported as rare as worldwide and authors want to report another case of CCAF, confirmed by operation. 10-year-old girl shows a fistula between sinus node artery of the right coronary artery and right atrium on root aortogram with left-to-right shunt and Qp/Qs=1.58, in which simple ligation of the sinus node artery from right coronary artery was performed. All of the 5 Korean CCAF (4 were previously reported and 1 of authors) were originated from right coronary artery, and of which 4 were opening into right ventricle and 1 of authors were into right atrium. Associated cardiac anomaly was noted in only 1 case as single coronary artery. Ages were from 9 months of age to 10 years old and no adult left case were found. 3 were female and 2 were male patients.

  13. Percutaneous brachial artery catheterization for coronary angiography and percutaneous coronary interventions (pci): an encouraging experience of 100 cases

    International Nuclear Information System (INIS)

    Islam, Z.U.; Maken, G.R.; Saif, M.; Khattak, Z.A.

    2013-01-01

    Objective: To evaluate the practicability and safety of the percutaneous transbrachial approach (TBA) for diagnostic coronary angiography and therapeutic percutaneous coronary interventions. Study Design: Quasi experimental study. Place and Duration of Study: The study was carried out in Armed Forces Institute of Cardiology- National Institute of Heart Diseases (AFIC-NIHD) from March 2009 to May 2011. Patients and Methods: We collected data of 100 consecutive patients who underwent coronary catheterization by the percutaneous transbrachial approach. Transbrachial catheterization was performed only if the radial access failed or radial pulse was fe