Abstract:

Aim: was to analyze own experience of differential diagnostics of cardiac tumors by using cardiac CT.

Materials and methods: 354 cardiac CT were made in «Fedorovich Klinikasi» in 2011-2017. The age of patients ranged from 5 month to 69 years (mean 27,2). There were 200(56,5%) men and 154 (43.5%) women. The study was carried out on MDCT scanners Brilliance 64 and Brilliance i-CT 256 (PHILIPS). Iodine containing contrast agent «Unihexol 350» was injected intravenously by means of «Ulrich» automatic injector.

Results: primary benign cardiac masses were detected in 10(2,8%) cases. Most of them were myxomas - 6 cases (60%), located in the left atrial cavity in 2 cases, in the mitral valve region - in 1, in the right atrium - in 2, and in the right ventricle - in 1case. Cardiac lipomas were detected in 2 (20%) patients. Papillary fibroelastoma of the aortic valve (1 case) and rhabdomyoma of the right

ventricle (1 case) also occurred in our study Intracardiac spreading of malignant neoplasms was noted in 5(1,4%) patients. Thrombosis of cardiac chambers was found in 7(2%) patients.

Conclusion: cardiac CT provides useful anatomical and functional information in evaluating cardiac masses, providing an accurate picture of the disease, allowing to assess localization and structure of the tumor, the condition of the tumor-free heart chambers, mediastinum, and lungs.

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Abstract:

Aim: was to increase diagnostic value of cardiac CTA (CCTA) by estimation of the CCTA informative value in CA (Coronary arteries) diseases and optimization of OOTA procedure for reducing of radiation dose (RD).

Materials and methods: CCTA informative value in CA diseases was assessed on the base of data of 200 patients (average age of patients was 60,4 (from 35 to 80 years), men/women ratio: 1.94:1(132/68). Parameters of coronary stenosis severities: its localization, extension, degree and characteristics of coronary stenosis. The study was performed with GE Optima 660 128-slice scanner and Missouri Ulrich injector with bolus injecting 60-100 ml of nonionic contrast media (350 mg/ml) at 4-6 ml/sec injector rate. For data processing used: «Auto Coronary Analysis» and «Auto Ejection Fraction» programs at - AW5 workstation.

Results: discovered various severity degrees of atherosclerotic lesions based stenosis intensity up to 50% (46 /23,5%), 50-60% (65/33%), 60-70% (35/17,9%), 70-80% (26/13,5%), 80% and more (23/11,8%). CCTA data coincided with conventional coronary angiography in 89% cases. RD decreasment was achieved by: pitch change depending on heart rate, scan area optimization (reduction), kV and mAc with radiation exposure decline in CCTA to 7,0-8,0 mSv In pitch value increasing to 1,48 - RD decreased to 45% (20 mSv). In prospective synchronization with ECG, RD decreased to 65% (7-12 mSv) as X-Ray tube radiates the highest RD at 70% cardiac cycle phase (120kV/180-200mAc), in other phases (80kV/100 mAc) RD values were lower.

Conclusion: CCTA is a valid non-invasive method in CA pathology diagnostics enabling accurate identification of stenosis location, extent, degree and characteristics. Scanning protocol individualization in CCTA enables significant reduce of RD.

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