scholarly journals Comparison of myocardial contrast stress-echocardiography and standard stress-echocardiography in detecting myocardial ischemia in patients with different severity of coronary artery stenoses

2020 ◽  
Vol 92 (4) ◽  
pp. 45-50
Author(s):  
L. S. Atabaeva ◽  
M. A. Saidova ◽  
V. N. Shitov ◽  
I. I. Staroverov
Keyword(s):  
Coronary Artery ◽  
Myocardial Perfusion ◽  
Myocardial Ischemia ◽  
Diagnostic Accuracy ◽  
Stress Echocardiography ◽  
Diagnostic Value ◽  
Contrast Enhanced ◽  
Coronary Artery Stenoses ◽  
Coronary Stenoses ◽  
Sensitivity Specificity

Aim. To compare diagnostic value between standard stress-echocardiography and myocardial contrast stress echocardiography in detection of myocardial ischemia in patients with different severity of coronary artery stenoses. Materials and methods. Myocardial contrast stress-echocardiography and standard stress-echocardiography were performed in 38 patients with coronary artery stenoses over 50% by angiography. Of all lesions 39 were intermediate (5075%) and 33 over 75% stenoses. Fractional flow reserve (FFR) was measured in 12 coronary arteries. During myocardial contrast stress-echocardiography wall motion and myocardial perfusion was assessed. Results. Adequate visualisation increased from 81.6% in unenhanced segments to 96.1% in contrast-enhanced segments. The sensitivity, specificity, and diagnostic accuracy of standard stress-echocardiography and myocardial contrast stress-echocardiography in intermediate (5075%) coronary stenoses were 44%, 83%, 56% and 56%, 94% и 64% respectively compare to angiography. Taking into account the 12 arteries with evaluated FFR, these parameters increased to 52%, 93% и 65% in standard stress-echocardiography and to 68%, 100% and 75% in myocardial contrast stress-echocardiography. In coronary stenoses over 75% the sensitivity, specificity, and diagnostic accuracy of standard stress-echocardiography and myocardial contrast stress-echocardiography were 78%, 88%, 80% and 86%, 100%, 92% respectively Conclusion. Use of contrast-enhanced stress-echorardiography significantly increased the diagnostic value of this method by improving endocardial border visualization and possibilities of myocardial perfusion assessment.

scholarly journals The diagnostic value of measuring the momentary blood flow reserve versus non-invasive methods to detect myocardial ischemia in assessing the functional significance of borderline coronary artery stenoses

2017 ◽  
Vol 89 (4) ◽  
pp. 15-21
Author(s):  
D I Darensky ◽  
V V Gramovich ◽  
E A Zharova ◽  
A A Ansheles ◽  
V B Sergienko ◽  
...  
Keyword(s):  
Blood Flow ◽  
Coronary Artery ◽  
Myocardial Ischemia ◽  
Photon Emission ◽  
Diagnostic Value ◽  
Emission Computed Tomography ◽  
Stress Tests ◽  
Non Invasive ◽  
Flow Reserve ◽  
Coronary Stenoses

Aim. To estimate the diagnostic value of measuring the momentary blood flow reserve (MBFR) versus the surrogate non-invasive standard (SNS) for myocardial ischemia verification (MIV) (a combination of stress echocardiography and single-photon emission computed tomography). Subjects and methods. The investigation enrolled 50 patients with stable angina in the presence of chronic coronary heart disease (CHD) or suspected CHD, in whom coronary angiography (CA) revealed borderline coronary stenoses (50—70% lumen diameters). The examination algorithm had two options. In one option, when included in the study, patients had already CA results not older than 1 month, and MBFR was measured 4—7 days after non-invasive stress tests. In the other option, MBFR in the area of borderline coronary artery stenosis was measured simultaneously with CA; and the noninvasive stress tests were carried out in the following week. A total of 74 coronary stenoses were examined. Results. SNS for MIV was positive in 14 (28%) patients. When comparing with the non-invasive methods of myocardial ischemia verification, the area under the ROC curve for MBFR was 0.961±0.019 (95% confidence interval, 0.888—0.992). The optimal cut-point was 0.92, which is corresponded by a sensitivity of 100% and a specificity of 84%. Conclusion. When compared with SNS for MIV, the method for measuring MBFR has a high diagnostic accuracy.

scholarly journals ULTRASOUND CONTRAST-ENHANCED STRESS ECHOCARDIOGRAPHY WITH MYOCARDIAL PERFUSION FOR FUNCTIONAL ASSESSMENT OF INTERMEDIATE STENOSIS IN THE LEFT ANTERIOR DESCENDING CORONARY ARTERY IN PATIENT WITH PREMATURE VENTRICULAR COMPLEXE

2019 ◽  
Vol 34 (1) ◽  
pp. 137-144
Author(s):  
I. S. Bessonov ◽  
D. V. Krinochkin ◽  
V. A. Kuznetsov ◽  
A. O. Dyakova ◽  
N. Y. Khorkova ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Myocardial Perfusion ◽  
Functional Assessment ◽  
Stress Echocardiography ◽  
Clinical Case ◽  
Arterial Diameter ◽  
Premature Ventricular Complexes ◽  
Ultrasound Contrast ◽  
Contrast Enhanced ◽  
Potential Benefits

The presence of the intermediate stenosis (30 to 50% of arterial diameter) according to coronary angiography in patients with premature ventricular complexes often represents a complicated clinical task and requires additional confirmation of myocardial ischemia. The present clinical case demonstrates the opportunities and potential benefits of contrast-enhanced stress echocardiography with assessment of myocardial perfusion in diagnosing the hemodynamic significance of the intermediate lesion of the left anterior descending artery in patient with premature ventricular complexes.

scholarly journals ULTRASOUND CONTRAST-ENHANCED STRESS ECHOCARDIOGRAPHY WITH MYOCARDIAL PERFUSION FOR FUNCTIONAL ASSESSMENT OF INTERMEDIATE STENOSIS IN THE LEFT ANTERIOR DESCENDING CORONARY ARTERY IN PATIENT WITH PREMATURE VENTRICULAR COMPLEXE

2019 ◽  
Vol 34 (1) ◽  
pp. 137-144
Author(s):  
I. S. Bessonov ◽  
D. V. Krinochkin ◽  
V. A. Kuznetsov ◽  
A. O. Dyakova ◽  
N. Y. Khorkova ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Myocardial Perfusion ◽  
Functional Assessment ◽  
Stress Echocardiography ◽  
Clinical Case ◽  
Arterial Diameter ◽  
Premature Ventricular Complexes ◽  
Ultrasound Contrast ◽  
Contrast Enhanced ◽  
Potential Benefits

The presence of the intermediate stenosis (30 to 50% of arterial diameter) according to coronary angiography in patients with premature ventricular complexes often represents a complicated clinical task and requires additional confirmation of myocardial ischemia. The present clinical case demonstrates the opportunities and potential benefits of contrast-enhanced stress echocardiography with assessment of myocardial perfusion in diagnosing the hemodynamic significance of the intermediate lesion of the left anterior descending artery in patient with premature ventricular complexes.

Abstract 4710: Diagnostic Accuracy of Myocardial Perfusion on Myocardial Contrast Echocardiography in Patients with Acute Coronary Syndrome: Results from the Assessment of Coronary Heart Disease with Myocardial Contrast Echocardiography 2 (ACTMCE2) Multicenter Trial

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Konomi Sakata ◽  
Hiroshi Ito ◽  
Hiroshi Wada ◽  
Hiroyuki Watanabe ◽  
Tadamichi Sakuma ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Myocardial Perfusion ◽  
Diagnostic Accuracy ◽  
Contrast Echocardiography ◽  
Multicenter Trial ◽  
Myocardial Contrast Echocardiography ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Sensitivity Specificity

Background: Intravenous myocardial contrast echocardiography (MCE) at rest and during vasodilator stress is a reliable bedside technique for assessment of myocardial perfusion in patients with coronary artery disease. The aim of this study is to evaluate diagnostic accuracy of myocardial perfusion abnormalities using MCE at rest in patients with acute coronary syndrome (ACS). This study is the first MCE multicenter trial for the evaluation of ACS in Japan. Methods: We performed triggered MCE at rest in 102 patients (mean age: 65 ± 11 years) with suspected ACS. We obtained 1:1 and 1:6 end-systolic triggered MCE images at four- and two-chamber views. We detected myocardial ischemia by the appearance of myocardial perfusion abnormalities (defect or reduction) in 1:1 end-systolic triggered MCE image. We assessed the appearance of regional wall motion abnormality (RWMA) at the same time. Quantitative coronary angiography was performed in all patients within 1 week (2.6 ± 2.2 days) after MCE. Results: Eighty-four of 102 (82%) patients were diagnosed ACS (unstable angina: 70 patients; non-ST-segment elevation myocardial infarction: 11 patients; ST-segment elevation myocardial infarction: 3 patients) and demonstrated significant coronary artery stenosis (stenosis = or >75%) that required coronary revascularization therapy. The sensitivity, specificity, and accuracy of myocardial perfusion abnormality by MCE at rest for diagnosing ACS were 79%, 86%, and 83%, respectively. On each coronary artery, the sensitivity, specificity, and accuracy of MCE for diagnosing ACS were 85%, 71%, and 79% in the left anterior descending artery; 70%, 92%, and 84% in the left circumflex artery; 77%, 89%, and 84% in the right coronary artery, respectively. The sensitivity, specificity, and accuracy of RWMA for diagnosing ACS were 49%, 90%, and 71%, respectively, and the sensitivity of MCE for diagnosing ACS was significantly higher than that of RWMA. Conclusion: Intravenous myocardial contrast echocardiography at rest without stress examination is a feasible noninvasive method for accurate diagnosis of ACS. In this multicenter study, MCE at rest improved the diagnostic accuracy of echocardiography for diagnosing ACS.

Noninvasive Evaluation of Coronary Artery Bypass Grafts with 16-Slice Multidetector Computed Tomography

2012 ◽  
Vol 15 (1) ◽  
pp. 12 ◽  
Author(s):  
Levent Sahiner ◽  
Ali Oto ◽  
Kudret Aytemir ◽  
Tuncay Hazirolan ◽  
Musturay Karcaaltincaba ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Diagnostic Accuracy ◽  
Multidetector Computed Tomography ◽  
Coronary Artery Bypass ◽  
Predictive Value ◽  
Artery Bypass ◽  
Time Interval ◽  
Mdct Angiography ◽  
Sensitivity Specificity

<p><b>Background:</b> The aim of this study was to investigate the diagnostic accuracy of 16-slice multislice, multidetector computed tomography (MDCT) angiography for the evaluation of grafts in patients with coronary artery bypass grafting (CABG).</p><p><b>Methods:</b> Fifty-eight consecutive patients with CABG who underwent both MDCT and conventional invasive coronary angiography were included. The median time interval between the 2 procedures was 10 days (range, 1-32 days). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MDCT for the detection of occluded grafts were calculated. The accuracy of MDCT angiography for detecting significant stenoses in patent grafts and the evaluability of proximal and distal anastomoses were also investigated.</p><p><b>Results:</b> Optimal diagnostic images could not be obtained for only 3 (2%) of 153 grafts. Evaluation of the remaining 150 grafts revealed values for sensitivity, specificity, PPV, NPV, and diagnostic accuracy of the MDCT angiography procedure for the diagnosis of occluded grafts of 87%, 97%, 94%, 93%, and 92%, respectively. All of the proximal anastomoses were optimally visualized. In 4 (8%) of 50 patent arterial grafts, however, the distal anastomotic region could not be evaluated because of motion and surgical-clip artifacts. The accuracy of MDCT angiography for the detection of significant stenotic lesions was relatively low (the sensitivity, specificity, PPV, and NPV were 67%, 98%, 50%, and 99%, respectively). The number of significant lesions was insufficient to reach a reliable conclusion, however.</p><p><b>Conclusion:</b> Our study showed that MDCT angiography with 16-slice systems has acceptable diagnostic performance for the evaluation of coronary artery bypass graft patency.</p>

scholarly journals Accuracy of MSCT Coronary Angiography with 64 Row CT Scanner—Facing the Facts

2010 ◽  
Vol 4 ◽  
pp. CMC.S3864 ◽  
Author(s):  
M. Wehrschuetz ◽  
E. Wehrschuetz ◽  
H. Schuchlenz ◽  
G. Schaffler
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Diagnostic Potential ◽  
Coronary Artery Stenoses ◽  
Artery Disease ◽  
Msct Angiography

Improvements in multislice computed tomography (MSCT) angiography of the coronary vessels have enabled the minimally invasive detection of coronary artery stenoses, while quantitative coronary angiography (QCA) is the accepted reference standard for evaluation thereof. Sixteen-slice MSCT showed promising diagnostic accuracy in detecting coronary artery stenoses haemodynamically and the subsequent introduction of 64-slice scanners promised excellent and fast results for coronary artery studies. This prompted us to evaluate the diagnostic accuracy, sensitivity, specificity, and the negative und positive predictive value of 64-slice MSCT in the detection of haemodynamically significant coronary artery stenoses. Thirty-seven consecutive subjects with suspected coronary artery disease were evaluated with MSCT angiography and the results compared with QCA. All vessels were considered for the assessment of significant coronary artery stenosis (diameter reduction ≥ 50%). Thirteen patients (35%) were identified as having significant coronary artery stenoses on QCA with 6.3% (35/555) affected segments. None of the coronary segments were excluded from analysis. Overall sensitivity for classifying stenoses of 64-slice MSCT was 69%, specificity was 92%, positive predictive value was 38% and negative predictive value was 98%. The interobserver variability for detection of significant lesions had a κ-value of 0.43. Sixty-four-slice MSCT offers the diagnostic potential to detect coronary artery disease, to quantify haemodynamically significant coronary artery stenoses and to avoid unnecessary invasive coronary artery examinations.

scholarly journals Diagnostic value of [18F]FDG PET/MRI for staging in patients with ovarian cancer

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Hideaki Tsuyoshi ◽  
Tetsuya Tsujikawa ◽  
Shizuka Yamada ◽  
Hidehiko Okazawa ◽  
Yoshio Yoshida
Keyword(s):  
Ovarian Cancer ◽  
Fdg Pet ◽  
Diagnostic Value ◽  
Mri Contrast ◽  
Diagnostic Potential ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Imaging Results ◽  
N Stage ◽  
Sensitivity Specificity

Abstract Purpose To evaluate the diagnostic potential of PET/MRI with 2-[18F]fluoro-2-deoxy-d-glucose ([18F]FDG) in ovarian cancer. Materials and methods Participants comprised 103 patients with suspected ovarian cancer underwent pretreatment [18F]FDG PET/MRI, contrast-enhanced CT (ceCT) and pelvic dynamic contrast-enhanced MRI (ceMRI). Diagnostic performance of [18F]FDG PET/MRI and ceMRI for assessing the characterization and the extent of the primary tumor (T stage) and [18F]FDG PET/MRI and ceCT for assessing nodal (N stage) and distant (M stage) metastases was evaluated by two experienced readers. Histopathological and follow-up imaging results were used as the gold standard. The McNemar test was employed for statistical analysis. Results Accuracy for the characterization of suspected ovarian cancer was significantly better for [18F]FDG PET/MRI (92.5%) [95% confidence interval (CI) 0.84–0.95] than for ceMRI (80.6%) (95% CI 0.72–0.83) (p < 0.05). Accuracy for T status was 96.4% (95% CI 0.96–0.96) and 92.9% (95% CI 0.93–0.93) for [18F]FDG PET/MRI and ceMRI/ceCT, respectively. Patient-based accuracies for N and M status were 100% (95% CI 0.88–1.00) and 100% (95% CI 0.88–1.00) for [18F]FDG PET/MRI and 85.2% (95% CI 0.76–0.85) and 30.8% (95% CI 0.19–0.31) for ceCT and M staging representing significant differences (p < 0.01). Lesion-based sensitivity, specificity and accuracy for N status were 78.6% (95% CI 0.57–0.91), 95.7% (95% CI 0.93–0.97) and 93.9% (95% CI 0.89–0.97) for [18F]FDG PET/MRI and 42.9% (95% CI 0.24–0.58), 96.6% (95% CI 0.94–0.98) and 90.8% (95% CI 0.87–0.94) for ceCT. Conclusions [18F]FDG PET/MRI offers better sensitivity and specificity for the characterization and M staging than ceMRI and ceCT, and diagnostic value for T and N staging equivalent to ceMRI and ceCT, suggesting that [18F]FDG PET/MRI might represent a useful diagnostic alternative to conventional imaging modalities in ovarian cancer.

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