A comprehensive whole-body approach to noninvasive evaluation of coronary and extracoronary vasculature is currently not available. The objective of our study was to assess the potential of 64-slice computed tomography angiography (64-CTA) for whole-body evaluation of atherosclerosis burden. Seventy-eight patients referred for coronary imaging underwent whole-body 64-CTA using an adjusted strategy for the administration of contrast medium with dose-saving algorithms involving ECG modulation and reduced tube voltage. Arterial segments (15 coronary, 32 systemic) were evaluated for significant (a parts per thousand yen50%) steno-occlusive disease while arterovenous density was evaluated at seven extracoronary locations. Homogeneous attenuation (mean 321 +/- 20 HU) was obtained throughout the systemic vasculature. Atherosclerosis was observed in 238/995 (24%) coronary and 368/2441 (15%) systemic segments. Significant stenoses/occlusions were present in 214 (21%)/24 (2.5%) coronary segments while asymptomatic clinically relevant stenoses were present in 49 systemic segments. Sensitivity, specificity, positive and negative predictive values of coronary 64-CTA among 52 patients who also underwent quantitative coronary angiography were 92%, 95%, 81% and 98%, respectively. ECG modulation decreased radiation exposure to 14.1-15.4 mSv per patient. Comprehensive, noninvasive assessment of atherosclerosis can be performed by whole-body 64-CTA and may have a positive impact on secondary prevention.
Imaging coronary and extracoronary atherosclerosis: feasibility and impact of whole-body computed tomography angiography / Napoli, Alessandro; Catalano, Carlo; Francone, Marco; Vincenzo, Sciacca; Carbone, Iacopo; Greco, Cesare; Passariello, Roberto; Francesca Antonella, Calabrese; CAVALLO MARINCOLA, Beatrice; Miles A., Kirchin; Vestri, Anna Rita; Arca, Marcello; Iuliano, Luigi; Roberto, Passariello. - In: EUROPEAN RADIOLOGY. - ISSN 0938-7994. - STAMPA. - 19:7(2009), pp. 1704-1714. [10.1007/s00330-009-1342-5]
Imaging coronary and extracoronary atherosclerosis: feasibility and impact of whole-body computed tomography angiography
NAPOLI, ALESSANDRO;CATALANO, Carlo;FRANCONE, MARCO;CARBONE, IACOPO;GRECO, Cesare;PASSARIELLO, Roberto;CAVALLO MARINCOLA, BEATRICE;VESTRI, Anna Rita;ARCA, Marcello;IULIANO, Luigi;
2009
Abstract
A comprehensive whole-body approach to noninvasive evaluation of coronary and extracoronary vasculature is currently not available. The objective of our study was to assess the potential of 64-slice computed tomography angiography (64-CTA) for whole-body evaluation of atherosclerosis burden. Seventy-eight patients referred for coronary imaging underwent whole-body 64-CTA using an adjusted strategy for the administration of contrast medium with dose-saving algorithms involving ECG modulation and reduced tube voltage. Arterial segments (15 coronary, 32 systemic) were evaluated for significant (a parts per thousand yen50%) steno-occlusive disease while arterovenous density was evaluated at seven extracoronary locations. Homogeneous attenuation (mean 321 +/- 20 HU) was obtained throughout the systemic vasculature. Atherosclerosis was observed in 238/995 (24%) coronary and 368/2441 (15%) systemic segments. Significant stenoses/occlusions were present in 214 (21%)/24 (2.5%) coronary segments while asymptomatic clinically relevant stenoses were present in 49 systemic segments. Sensitivity, specificity, positive and negative predictive values of coronary 64-CTA among 52 patients who also underwent quantitative coronary angiography were 92%, 95%, 81% and 98%, respectively. ECG modulation decreased radiation exposure to 14.1-15.4 mSv per patient. Comprehensive, noninvasive assessment of atherosclerosis can be performed by whole-body 64-CTA and may have a positive impact on secondary prevention.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
