Abstract:

Background: most accurate visualization of tumor, determination of stage and spread of tumor process is substantially significant for children who undergo treatment in accordance to protocols of the international SIOPEL group. According to SIOPEL criteria, patients with hepatoblastoma are stratified into risk groups based on diagnostic results. The allocation of patients into risk groups is based on the definition of the stage of the disease in the PRETEXT system (Pre-Treatment Extent of Disease - the spread of the tumor before treatment) and the level of alpha-fetoprotein (AFP)

Aim: was to present the main criteria of PRETEXT hepatoblastoma staging, based on results of magnetic resonance imaging (MRI).

Material and methods: study includes 74 patients with diagnosed hepatoblastoma aged 1 month to 14 years (median 3.1 years). All patients underwent MRI of the abdominal cavity before and after polychemotherapy (PCT) courses. MRI studies were performed on the scaner Magnetom Avanto (Siemens Healthcare) with a magnetic field strength of 1.5T

Results: hepatoblastoma staging was performed according to PRETEXT criteria. Stage I of the Pretext with lesion of one liver sector was revealed in 3 (4%) cases. Stage II of the Pretext - the presence of a tumor in two adjacent sectors was revealed in 26(35,1%) cases. Pretext III - the presence of a tumor in three adjacent sectors of the liver or in two non-adjacent liver sectors was identified in 23(31%) cases. Pretext IV - lesion of all liver sectors, was revealed in 22(29,7%) cases. Conclusions: MRI is a significantly informative method that allows to achieve data not only location, size, prevalence of the tumor process, but it also enables to give an accurate pre-operative stage evaluation using the PRETEXT system. Surgical removal of the tumor is the only way to achieve a complete cure, thus it is important to get an accurate image of the tumor, its anatomical location and determine the prevalence of the tumor process.

References  

1.      Men' T.H., Rykov M.Ju., Poljakov V.G. Zlokachestvennye novoobrazovanija u detej v Rossii: osnovnye pokazateli i tendencii. [Malignant neplasm in children in Russian Federation: tendensies and basic parameters]. Rossijskij onkologicheskijzhurnal. 2015;2:43-47 [ In Russ].

2.      Kaprin A.D., Starinskij V.V., Petrova G.V.. Zlokachestvennye novoobrazovanija v Rossii v 2015 godu (zabolevaemost' i smertnost') [Malignant neoplasms in Russian Federation in 2015 (morbidity and mortality)]. MNIOI im. P. A. Gercena. 2017; 250 s [In Russ]

3.      Hadzic N, Finegold MJ. Liver neoplasia in children. Clin Liver Dis. 2011; 15:443-462.

4.      Spector L.G., Birch J. The epidemiology of hepatoblastoma . Pediatr. Blood Cancer. 2012; 59(5):776-779.

5.      Tomlinson G.E., Kappler R. Genetics and epigenetics of hepatoblastoma. Pediatr Blood Cancer. 2012;59: 785-792

6.      Chung E.M., Lattin G.E. Jr, Cube R. et al. From the archives of the AFIP: pediatric liver masses: radiologic-pathologic correlation. Part 2. Malignant tumors. Radiographics. 2011;31:483-507.

7.      Meyers R.L. Tumors of the liver in children. Surgical Oncology. 2007;16:195-203.

8.      Jon Pritchard, Julia Brown, Elizabeth Shafford, Giorgio Perilongo, Penelope Brock, Claire Dicks-Mireaux, Jean Keeling, Angela Phillips, Anton Vos, Jack Plaschkes . Predictive Value of the Pretreatment Extent of Disease System in Hepatoblastoma: Results From the International Society of Pediatric Oncology Liver Tumor Study Group SIOPEL-1 Study. Journal of Clinical Oncology. 2005; 23(6):1245-52.

9.      Czauderna P. Hepatoblastoma throughout SIOPEL trials - clinical lessons learnt. Frontiers in Bioscience (Elite Ed). 2012; 4: 470-9.

10.    Roebuck D.J., Aronson D., Clapuyt Pet al.; International Childrhood Liver Tumor Strategy Group. 2005 PRETEXT: a revised staging system for primary malignant liver tumours of childhood developed by the SIOPEL group. PediatrRadiol. 2007; 37(2):123-32.

11.    Couinaud С. Liver anatomy: portal or biliary segmentation. Dig Surg. 1979; 16( 6):459-467.

12.    Couinaud C. The surgical anatomy of the liver revisited. Paris: Maugein&Cie, 1989:84-89. 96-101. 108-117.

13.    Kim Je. F., Filin A. V., Semenkov A. V. i dr. Hirurgija ochagovyh obrazovanij pecheni u detej: organosohranjajushhaja operacija ili transplantacija?[ Surgery of focal lesions of liver in children: organ-preserving intervention or transplantology?.] Klinicheskaja i jeksperimental'naja hirurgija. 2017;1:22-30. 

Abstract:

We performed the analysis of published data on the use of multislice computed tomography in diagnostics of coronary heart disease. The data on the development of the method, indicated that it its diagnostic efficiency is related to technological improvements, accompanied by the appearance of each successive generation of multislice computed tomography We described possibilities of using of scanners from 16 to 230-slice, devices with two sources of energy, advantages of «dual energy» regime application in the coronary disease diagnostics. Given constraints on the method diagnostic efficacy - artifacts associated with the movement and severe calcification. It is indicated that the implementation of the method in cardiology practice promotes its consideration as a promising alternative to invasive diagnostic coronary angiography, it is suggested becoming of further development of the technology that will allow multislice computed tomography to become the main method of diagnosis of coronary heart disease and other cardiovascular diseases.  

References 

1.    Paul J.F., Dambrin G., Caussin C. et al. Sixteen-slice computed tomography after acute myocardial infarction: from perfusion defect to the culprit lesion. Circulation. 2003; 108: 373-374.

2.    Sun Z., Choo G.H., Ng K.H. Coronary CT angiography: current status and continuing challenges. Br. J. Radiol. 2012; 85: 495-510.

3.    Costello P., Lobree S. Subsecond scanning makes CT even faster. Diag. Imaging. 1996; 18: 76-79.

4.    Taguchi K., Aradate H. Algorithm for image reconstruction in multi-slice helical CT. Med. Phys. 1998; 25: 550-561.

5.    Flohr T.G., Schaller S., Stierstorfer K. et al. Multidetector row CT systems and image-reconstruction techniques. Radiology. 2005; 235: 756-773.

6.    Haberl R., Tittus J., Bohme E. et al. Multislice spiral computed tomographic angiography of coronary arteries in patients with suspected coronary artery disease: an effective filter before catheter angiography? Am. Heart J. 2005; 149: 1112-1119.

7.    Goldman L.W. Principles of CT: multislice CT. J. Nucl. Med. Technol. 2008; 36: 57-68.

8.    Lewis M., Keat N., Edyvean S. 16 Slice CT scanner comparison report version 14, 2006. Available from: URL: http://www.impactscan.org/reports/Report06012.htm

9.    Achenbach S., Ropers D., Pohle F.K. et al. Detection of coronary artery stenoses using multi-detector CT with 16x0.75 collimation and 375 ms rotation. Eur. Heart J. 2005; 26: 1978-1986.

10.  Kuettner A., Beck T., Drosch T. et al. Image quality and diagnostic accuracy of non-invasive coronary imaging with 16 detector slice spiral computed tomography with 188 ms temporal resolution. Heart. 2005; 91: 938-941.

11.  Garcia M.J., Lessick J., Hoffmann M.H. Accuracy of 16-row mul-tidetector computed tomography for the assessment of coronary artery stenosis. JAMA. 2006; 296: 403-411.

12.  Flohr T.G., McCollough C.H., Bruder H. et al. First performance evaluation of a dual-source CT (DSCT) system. Eur. Radiol. 2006; 16: 256-268.

13.  Steigner M.L., Otero H.J., Cai T. et al. Narrowing the phase window width in prospectively ECG-gated single heart beat 320-detector row coronary CT angiography. Int. J. Cardiovasc. Imaging. 2009; 25: 85-90.

14.  Achenbach S., Marwan M., Schepis T. et al. High- pitch spiral acquisition: a new scan mode for coronary CT angiography. J. Cardiovasc. Comput. Tomogr. 2009; 3: 117-121.

15.  Ruzsics B., Lee H., Zwerner P. et al. Dual-energy CT of the heart for diagnosing coronary artery stenosis and myocardial ischemia-initial experience. Eur. J. Radiol. 2008; 18: 2414-2424.

16.  Jiang H.C., Vartuli J., Vess C. Gemstone-the ultimatum scintillator for computed tomography. Gemstone detector white paper. London: GEHealthcare. 2008: 1-8.

17.  Sun Z., Jiang W. Diagnostic value of multislice computed tomography angiography in coronary artery disease: a meta-analysis. Eur. J. Radiol. 2006; 60: 279-286.

18.  Pontone G., Andreini D., Bartorelli A. et al. Diagnostic accuracy of coronary computed tomography angiography: a comparison between prospective and retrospective electrocardiogram triggering. J. Am. Coll. Cardiol. 2009; 54: 346-355.

19.  Sun Z., Ng K.H. Diagnostic value of coronary CT angiography with prospective ECG-gating in the diagnosis of coronary artery disease: a systematic review and meta-analysis. Int. J. Cardiovasc. Imaging. 2012; 28: 2109-2119.

20.  Budoff M.J., Dowe D., Jollis J.G. et al. Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY (Assessment by Coronary Computed Tomographic Angiography of Individuals Undergoing Invasive Coronary Angiography) trial. J. Am. Coll. Cardiol. 2008; 52: 1724-1732.

21.  Miller J.M., Rochitte C.E., Dewey M. et al. Diagnostic performance of coronary angiography by 64-row CT. N Engl. J. Med. 2008; 359: 2324-2336.

22.  Alkadhi H., Stolzmann P., Desbiolles L. et al. Low-dose, 128-slice, dual-source CT coronary angiography: accuracy and radiation dose of the high-pitch and the step-and-shoot mode. Heart. 2010; 96: 933-938.

23.  Hou Y, Yue Y, Guo W. et al. Prospectively versus retrospectively ECG-gated 256-slice coronary CT angiography: image quality a

Abstract:

Aim: was to investigate possibilities of multislice computed tomography in estimation of stenosis degree in coronary arteries in patients with ischemic heart disease (IHD).

Materials and methods: we examined 64 patients (18 female, 46 male, mean age 62,4± 9,5 years), who primary had been admitted to hospital and had high risk of IHD; and those who had early diagnosed IHD of 1,2,3 and 4 functional class, they were hospitalized for condition correction. Mainly spreaded risk factor was arterial hypertention in 55 patients - (85,9%) with highest level 200/100 mm hg and minimal 140/80 mm hg. All patients underwent multislice computed tomography (MSCT) on the 256-slice tomography station «Somatom definition flash (Siemens, Germany)»: collimation 128 x 0,6, the temporal resolution of 75 ms and a spatial resolution of 0.33 mm, slice thickness of 0.6 mm, with simultaneous use of two tubes with different voltage (kV 120/100), the current mAs - with programs to reduce radiation exposure Care Dose - is calculated automatically according to the constitution of man.

Post-processing of obtained data was performed on a workstation Syngo Via, in the application of CT-Soronary with automatic longitudinal separation of each coronary artery In view of image quality was analyzed data from end-diastolic phase of the cardiac cycle (80% R-R), or evaluated complex of multiphase images. We analyze the state of the main arteries of the main coronary: left anterior descending artery, the circumflex artery and the right coronary artery (LAD, CA, RCA). We performed estimation of coronary artery stenosis of segments according to the American Heart Association (AHA). Results were displayed in percentage. Obtained data was compared with those obtained using the reference method - X-ray coronary angiography, which was performed according to standard protocol

Results: comparison of results of coronary angiography and MSCT using correlation analysis showed the presence of strong direct significant correlation coefficients in the evaluation of coronary artery disease according to two methods. It was demonstrated a high inter-operator and intraoperator reproducibility of MSCT in the study of vessels conditions. Following characteristics of the method related to the identification of coronary artery stenosis segments: sensitivity - 95.8%, specificity - 92.8%, diagnostic accuracy - 95.1%, positive predictive value - 97.9%, negative predictive value - 86.6 %.

It was concluded that the high importance of the method of MSCT in the diagnosis of cardiovascular diseases and the need for its widespread use in cardiology practice.  

References 

1.    Chazov E.I. Perspektivyi kardiologii v svete progressa fundamentalnoy nauki. [Prospects of Cardiology in light of the progress of fundamental science.] Ter. Archive. 2009; 9 : 5-8 [In Russ.]

2.    Данилов Н.М., Матчин Ю.Г. и др. Показания к проведению коронарной артериографии. Consilium Medicum. Болезни сердца и сосудов. 2006; 1(1). Danilov N.M., Matchin Yu.G. et al. Pokazaniya k provedeniyu koronarnoy arteriografii. Consilium Medicum. Bolezni serdtsa i sosudov. [Indications for coronary arteriography. Consilium Medicum heart disease and vascular. ]2006; 1(1) [In Russ.].

3.    Sun Z., Choo G.H., Ng K.H. Coronary CT angiography: current status and continuing challenges. Br. J. Radiol. 2012; 85: 495-510.

4.    Sun Z., Aziz YF., Ng K.H. Coronary CT angiography: how should physicians use it wisely and when do physicians request it appropriately. Eur. J. Radiol. 2012; 81: 684-687.

5.    Haberl R., Tittus J., Bohme E. et al. Multislice spiral computed tomographic angiography of coronary arteries in patients with suspected coronary artery disease: an effective filter before catheter angiography. Am. Heart J. 2005; 149: 1112-1119.

6.    Steigner M.L., Otero H.J., Cai T. et al. Narrowing the phase window width in prospectively ECG-gated single heart beat 320-detector row coronary CT angiography. Int. J. Cardiovasc. Imaging. 2009; 25: 85-90.

7.    Achenbach S., Marwan M., Schepis T. et al. High-pitch spiral acquisition: a new scan mode for coronary CT angiography. J. Cardiovasc. Comput. Tomogr. 2009; 3: 117-121.

8.    Budoff M.J., Dowe D., Jollis J.G. et al. Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY (Assessment by Coronary Computed Tomographic Angiography of Individuals Undergoing Invasive Coronary Angiography) trial. J. Am. Coll. Cardiol. 2008; 52: 1724-1732.

9.    Petcherski O., Gaspar T., Halon D. et al. Diagnostic accuracy of 256-row computed tomographic angiography for detection of obstructive coronary artery disease using invasive quantitative coronary angiography as reference standard. Am. J. Cardiol. 2013; 111: 510-515.

10.  De Graaf F.R., Schuijf J.D., Van Velzen J.E. et al. Diagnostic accuracy of 320-row multidetector computed tomography coronary angiography in the non-invasive evaluation of significant coronary artery disease. Eur. Heart J. 2010; 31: 1908-1915.

Abstract:

The main part of the research is given to radiodiagnostics of tubercolisis lesion of backbone (traditional x-ray, ultrasound diagnostics, computed tomography, magnetic resonance imaging). We have exmined 452 patients: 40 patients (8,8%) had cervical spine lesions, 185 patients (41%) - thoracic spine lesions, thoracic-lumbar spine - 75 patients (16,8%), lumbar spine - 141 patients (31,1%), lumbar-sacral spine - 11 patients (2,5%). It is especially marked that combination of lungs tuberculosis and spondylitis is higher not only in patients with antibiotic resistant infection but n patients with tuberculosis combined with AIDS.

References 

1.    Митусова Г.М. Лучевая диагностика туберкулезного спондилита у взрослых, осложненного неврологическими расстройствами. Дис. на соиск. к.м.н. С.-Пб. 2002.

2.    Советова Н.А., Савин И.Б., Мальченко О.В. и др. Лучевая диагностика внелегочного туберкулеза. Проблемы туберкулеза. 2006; 11: 7-9.

3.    Руководство по легочному и внелегочному туберкулезу. Под ред. Ю.Н. Левашева и Ю.М. Репина. ЭЛБИ-С.-Пб. 2008; 273-283.

4.    Васильев А.В. Современные проблемы туберкулеза в регионе Северо-Запада России. Проблемы туберкулеза. 1999; 3: 5-7.

5.    Лавров В.Н. Диагностика и лечение больных туберкулезным спондилитом. Проблемы туберкулеза. 2001; 4: 30-32.

6.    Гусева Н.И., Иванов В.М., Потапенко Е.И. и др. Иммунный статус больных активным туберкулезным спондилитом. Проблемы туберкулеза и болезней легких. 2003; 6: 25-28.

7.    Селюкова Н.В. Зонография в диагностике туберкулеза позвоночника на поликлиническом этапе. Проблемы туберкулеза и болезней легких. 2008; 11, 21-23.

8.    Мердина Е.В., Митусова Г.М., Советова Н.А. Ультразвуковая диагностика забрюшинных абсцессов при туберкулезе позвоночника. Проблемы туберкулеза. 2001; 4: 19-21.

9.    Лукьяненок П.И. Магнитно-резонансная томография в диагностике туберкулезного спондилита. Руководство для врачей. 2008.

10.  Щ Советова Н.А., Джанкаева О.Б., Кравцова О.С. и др. Туберкулезный спондилит взрослых в условиях генерализации инфекции и лекарственной резистентности возбудителя. Невский радиологический форум 2-5 апреля 2011 г. С.-Пб.: Научные материалы. 2011; 223-224.

11.  Шилова М.В. Туберкулез в России в 2009 г. М. 2009; 159-161.

Abstract:

Aim: was to analyse possibilities of multislice computed tomography in patients with coronary vessels' pathology

Results: we performed the analysis of published data on the use of multislice computed tomography in the coronary heart disease diagnostics. Data on the development of the method are presented: it is indicated that its diagnostic efficiency is related to technological improvements, accompanied by the appearance of each successive generation of multislice computed tomography The possibilities of using scanners from 16- to 230-slice scanners with two sources of energy, advantages of «dual energy» regime of application (dual-energy CT) in the coronary disease diagnostic are considered. Given constraints of the method diagnostic efficacy - artifacts associated with movements and severe calcification.

Conclusions: implementation of the method in cardiology practice can promote its consideration as a promising alternative to invasive diagnostic coronary angiography Further development of the technology can allow multislice computed tomography to become the main method of diagnosis of coronary heart disease and other cardiovascular diseases. 

References

1.     Paul J.F., Dambrin G., Caussin C. et al. Sixteen-slice computed tomography after acute myocardial infarction: from perfusion defect to the culprit lesion. Circulation. 2003; 108: 373-374.

2.     Sun Z., Choo G.H., Ng K.H. Coronary CT angiography: current status and continuing challenges. Br. J. Radiol. 2012; 85: 495-510.

3.     Costello P., Lobree S. Subsecond scanning makes CT even faster. Diag. Imaging. 1996; 18: 76-79.

4.     Taguchi K., Aradate H. Algorithm for image reconstruction in multi-slice helical CT. Med. Phys. 1998; 25: 550-561.

5.     Flohr T.G., Schaller S., Stierstorfer K. et al. Multidetector row CT systems and image-reconstruction techniques. Radiology. 2005; 235: 756-773.

6.     Haberl R., Tittus J., Bohme E. et al. Multislice spiral computed tomographic angiography of coronary arteries in patients with suspected coronary artery disease: an effective filter before catheter angiography Am. Heart J. 2005; 149: 1112-1119.

7.     Goldman L.W. Principles of CT: multislice CT. J. Nucl. Med. Technol. 2008; 36: 57-68.

8.     Lewis M., Keat N., Edyvean S. 16 Slice CT scanner comparison report version 14, 2006. Available from: URL: http://www.impactscan.org/reports/Report06012.htm

9.     Achenbach S., Ropers D., Pohle F.K. et al. Detection of coronary artery stenoses using multi-detector CT with 16 x 0.75 collimation and 375 ms rotation. Eur. Heart J. 2005; 26: 1978-1986.

10.   Kuettner A., Beck T., Drosch T. et al. Image quality and diagnostic accuracy of non-invasive coronary imaging with 16 detector slice spiral computed tomography with 188 ms temporal resolution. Heart. 2005; 91: 938-941.

11.   Garcia M.J., Lessick J., Hoffmann M.H. Accuracy of 16-row multidetector computed tomography for the assessment of coronary artery stenosis. JAMA. 2006; 296: 403-411.

12.   Steigner M.L., Otero H.J., Cai T. et al. Narrowing the phase window width in prospectively ECG-gated single heart beat 320-detector row coronary CT angiography. Int. J. Cardiovasc. Imaging. 2009; 25: 85-90.

13.   Flohr T.G., McCollough C.H., Bruder H. et al. First performance evaluation of a dual-source CT (DSCT) system. Eur. Radiol. 2006; 16: 256-268.

14.   Achenbach S., Marwan M., Schepis T. et al. High- pitch spiral acquisition: a new scan mode for coronary CT angiography. J. Cardiovasc. Comput. Tomogr. 2009; 3: 117-121.

15.   Ruzsics B., Lee H., Zwerner P. et al. Dual-energy CT of the heart for diagnosing coronary artery stenosis and myocardial ischemia-initial experience. Eur. J. Radiol. 2008; 18: 2414-2424.

16.   Jiang H.C., Vartuli J., Vess C. Gemstone - the ultimatum scintillator for computed tomography. Gemstone detector white paper.London: GE Healthcare, 2008: 1-8

17.   Mori       S., Endo M., Obata T. et al. Clinical potentials of the prototype 256-detector row CT-scanner. Acad. Radiol. 2005; 12: 148-154.

18.   Hoe J., Toh K.H. First experience with 320-row multidetector CT coronary angiography scanning with prospective electrocardiogram gating to reduce radiation dose. J. Cardiovasc. Comput. Tomogr. 2009; 3: 257-261.

19.   De Graaf F.R., Schuijf J.D., Van Velzen J.E. et al. Diagnostic accuracy of 320-row multidetector computed tomography coronary angiography in the non-invasive evaluation of significant coronary artery disease. Eur. Heart J. 2010; 31: 1908-1915.

20.   Sun Z., Jiang W. Diagnostic value of multislice computed tomography angiography in coronary artery disease: a meta-analysis. Eur. J. Radiol. 2006; 60: 279-286.

21.   Pontone G., Andreini D., Bartorelli A. et al. Diagnostic accuracy of coronary computed tomography angiography: a comparison between prospective and retrospective electrocardiogram triggering. J. Am. Coll. Cardiol. 2009; 54: 346-355.

22.   Sun Z., Ng K.H. Diagnostic value of coronary CT angiography with prospective ECG-gating in the diagnosis of coronary artery disease: a systematic review and meta-analysis. Int. J. Cardiovasc. Imaging. 2012; 28: 2109-2119.

23.   Budoff M.J., Dowe D., Jollis J.G. et al. Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY (Assessment by Coronary Computed Tomographic Angiography of Individuals Undergoing Invasive Coronary Angiography) trial. J. Am. Coll. Cardiol. 2008; 52: 1724-1732.

24.   Miller J.M., Rochitte C.E., Dewey M. et al. Diagnostic performance of coronary angiography by 64-row CT. N Engl. J. Med. 2008; 359: 2324-2336.

25.   Alkadhi H., Stolzmann P., Desbiolles L. et al. Low-dose, 128-slice, dual-source CT coronary angiography: accuracy and radiation dose of the high-pitch and the step-and-shoot mode. Heart. 2010; 96: 933-938.

26.   Hou Y, Yue Y, Guo W. et al. Prospectively versus retrospectively ECG-gated 256-slice coronary CT angiography: image quality and radiation dose over expanded heart rates. Int. J. Cardiovasc. Imaging. 2012; 28: 153-162.

27.   Hou Y, Ma Y, Fan W. et al. Diagnostic accuracy of low-dose 256-slice multidetector coronary CT angiography using iterative reconstruction in patients with suspected coronary artery disease. Eur. Radiol. 2014; 24: 3-11.

28.   Petcherski O., Gaspar T., Halon D. et al. Diagnostic accuracy of 256-row computed tomographic angiography for detection of obstructive coronary artery disease using invasive quantitative coronary angiography as reference standard. Am. J. Cardiol. 2013; 111: 510-515.

29.   Van Velzen J.E., De Graaf F.R., Kroft L.J. et al. Performance and efficacy of 320-row computed tomography coronary angiography in patients presenting with acute chest pain: results from a clinical registry. Int. J. Cardiovasc. Imaging. 2012; 28: 865-876.

30.   Pelliccia F., Pasceri V., Evangelista A. et al. Diagnostic accuracy of 320-row computed tomography as compared with invasive coronary angiography in unselected, consecutive patients with suspected coronary artery disease. Int. J. Cardiovasc. Imaging. 2013; 29: 443-452.

31.   Gaudio C., Pelliccia F., Evangelista A. et al. 320-row computed tomography coronary angiography vs. conventional coronary angiography in patients with suspected coronary artery disease: a systematic review and metaanalysis. Int. J. Cardiol. 2013; 168: 1562-1564.

32.   Li S., Ni Q., Wu H. et al. Diagnostic accuracy of 320-slice computed tomography angiography for detection of coronary artery stenosis: meta-analysis. Int. J. Cardiol. 2013;168: 2699-2705.

33.   Barrett J.F., Keat N. Artifacts in CT: recognition and avoidance. Radiographics. 2004; 24: 1679-1691.

34.   Earls J.P. How to use a prospective gated technique for cardiac CT. J. Cardiovasc. Comput. Tomogr. 2009; 3: 45-51.

35.   Leschka S., Stolzmann P., Schmid F.T. et al. Low kilovoltage cardiac dual-source CT: attenuation, noise, and radiation dose. Eur. Radiol. 2008; 18: 1809-1817.

36.   Ketelsen D., Thomas C., Werner M. et al. Dualsource computed tomography: estimation of radiation exposure of ECG-gated and ECG-triggered coronary angiography. Eur. J. Radiol. 2010; 73: 274-279.

37.   Dikkers R., Greuter M.J., Kristanto W. et al. Assessment of image quality of 64-row Dual Source versus Single Source CT coronary angiography on heart rate: a phantom study. Eur. J. Radiol. 2009; 70: 61-68.

38.   Hoffmann U., Moselewski F., Nieman K. et al. Non-invasive assessment of plaque morphology and composition in culprit and stable lesions in acute coronary syndrome and stable lesions in stable angina by multidetector computed tomography. J. Am. Coll. Cardiol. 2006; 47: 1655-1662.

39.   Sun Z. Cardiac CT imaging in coronary artery disease: Current status and future directions. Quant Imaging Med. Surg. 2012; 2: 98-105.

40.   Halpern E.J., Savage M.P., Fischman D.L., Levin D.C. Cost-effectiveness of coronary CT angiography in evaluation of patients without symptoms who have positive stress test results. AJR Am. J. Roentgenol. 2010; 194: 1257-1262.

41.   Sun Z., Aziz YF., Ng K.H. Coronary CT angiography: how should physicians use it wisely and when do physicians request it appropriately Eur. J. Radiol. 2012; 81: 684-687. 

Abstract:

Aim: was to improve the efficiency of diagnosis of patients with coronary heart disease, by estimating of possibilities of cardiac multislice computed tomography in comparison with coronary angiography.

Materials and methods: study included 64 patients (18 women and 46 men, mean age 62,4 ± 9,5 years) with a high risk of developing coronary heart disease. In 34 patients - myocardial infarction in anamnesis (18 patients - in pool right coronary artery in 16 patients - in left anterior descending artery). Clinics of angina pectoris - in 40 patients (functional class (FC) I - 10; FC II - 22, FC III - in 6, FC IV - 2 patients). Selection criteria: the absence of disease progression for at least 6 weeks, and at least 3 months of optimal treatment. All patients underwent cardiac MSCT at 256-slice CT scanner. Obtained data was compared with data of reference method - x-ray coronary angiography.

Results: comparison of MSCT coronary angiography with invasive data showed a high comparability of results of two methods in the evaluation of coronary artery disease. It was revealed that discrepancies between cardiac MSCT and CAG in detection of hemodynamically insignificant stenoses ranging from 0 to 4%, hemodynamically significant stenoses - from 0 to 2.6%, subtotal stenosis - from 0 to 1%, occlusions - 0%. The presence of strong correlations between data of cardiac MSCT and coronary angiography of stenosis, demonstrated the high quality of MSCT imaging of coronary artery segments in the examination with a variety of modes of application method.

Conclusion: multislice computed tomography is a highly effective method for diagnosing of structural and anatomic changes of coronary arteries in patients with coronary heart disease.

References

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