Abstract:

Introduction: one of directions in development of intravascular diagnostic methods is creation of stations or development of methods that allow combining or uniting possibilities of different modalities. This approach makes it possible to overcome limitations inherent in each method of invasive vascular diagnostics, including angiography. This work is devoted to the analysis of possibilities and first results of using the SyncVision station (Philips Volcano), which allows, in various combinations, to carry out joint registration of angiography data, intravascular ultrasound (IVUS) and instantaneous blood flow reserve (iFR) in various combinations - a non-hyperemic version of fractional flow reserve study.

Aim: was to describe possibilities provided by the use of joint recording of data from angiography, IVUS and real-time instantaneous blood flow reserve, the technique for performing these procedures, as well as to analyze the application of these methods in a department with a large volume of intravascular studies.

Material and methods: the first experience in Russian Federation of the clinical use of the SyncVision station, which is an addition to the s5i intravascular ultrasound system (Philips Volcano), is presented. The station allows you to implement five options that expand the operator's ability to analyze study data and develop a treatment strategy directly at the operating table: co-registration of angiography and intravascular ultrasound (IVUS) data; co-registration of angiography data and instantaneous flow reserve (iFR); triple co-registration - angiography, IVUS and iFR; modification of the program for the quantitative calculation of coronary artery stenosis (QCA); real-time image enhancement software for interventional devices.

Results: studies using co-registration with angiography accounted for 21% of all IVUS procedures and 62,4% of iFR procedures. In 67,3% of all studies with angio-IVUS co-registration, the indication for this diagnostic variant was an extended lesion of artery, which required clarification of length of stenotic area, localization of reference segments, and diameter of artery at different levels. In 30 of these patients, triple co-registration was performed. To clarify the hemodynamic significance of lesion with an angiographically indeterminate or borderline picture, co-registration was performed in 13,2% of all cases, to study a bifurcation lesion with a significant difference in the reference segments and angiographically difficult to determine the entry of lateral branch - in 7,3%.

Based on results of triple co-registration, the decision to perform surgical treatment was made in 30 out of 42 patients (71,4%).

Conclusion: joint registration of IVUS data, coronary angiography, and instantaneous flow reserve (iFR) in real time, forms a new diagnostic modality that significantly expands possibilities of intraoperative examination and affects the planning or analysis of intervention results.

Abstract:

Introduction: the importance of intravascular diagnostic methods and the frequency of their use in clinical practice is steadily increasing. However, in the Russian Federation, studies on the analysis of possibilities of intravascular imaging or physiology are sporadic, and statistical data are presented only in very generalized form. This makes it relevant to create a specialized register dedicated to these diagnostic methods.

Aim: was to present the structure, tasks and possibilities of the Russian registry for the use of intravascular imaging and physiology based on results of the first year of its operation.

Material and methods: In total, in 2021, forms were filled out for 2632 studies in 1356 patients.

Studies included all types of intravascular imaging and physiology - intravascular ultrasound, optical coherence tomography, measurement of fractional flow reserve and non-hyperemic indices.

The registry's web-based data platform includes 14 sections and 184 parameters to describe all possible scenarios for applying these methodologies. Data entry is possible both from a stationary computer and from mobile devices, and takes no more than one minute per study. Received material is converted into Excel format for further statistical processing.

Results: 13 departments participated in the register, while the share of the eight most active ones accounted for 97,5% of all entered forms. On average, 1.9 studies per patient were performed, with fluctuations between clinics from 1,6 to 2,9. Studies of the fractional flow reserve accounted for 40% of total data array, intravascular ultrasound - 37%, optical coherence tomography - 23%. Of all studies, 80% were performed on coronary arteries for chronic coronary artery disease, 18% - for acute coronary syndrome, 2% were studies for non-coronary pathology. In 41% of cases, studies were performed at the diagnostic stage, without subsequent surgery. In 89,6% of cases, this was due to the detection of hemodynamically insignificant lesions, mainly by means of physiological assessment. In 72% of cases, the use of intravascular imaging or physiology methods directly influenced the tactics or treatment strategy - from deciding whether to perform surgery or not to choose the optimal size of instruments or additional manipulations to optimize the outcome of the intervention. In the clinics participating in the register, the equipment of all major manufacturers represented on the Russian market was used.

Conclusions: the design of the online registry database is convenient for data entry. Participation in the registry of most departments that actively and systematically use methods of intravascular imaging and physiology ensured the representativeness of obtained data for analysis in interests of both practical medicine and industry, as well as for scientific research in the field of intravascular imaging and physiology. The register has great potential for both quantitative and qualitative improvement.

Abstract:

Aim: was to assess the frequency, predominant localization and severity of atherosclerotic plaques in coronary arteries according to multidetector computed tomography (MDCT) in patients with suspicion on coronary heart disease (CHD).

Materials and methods: analysis of results of CT of coronary arteries (CT-CA) was carried out in 1590 patients. The average age was 53,9 ± 10,7 years. The number of men was 1133 (71,3%). Studies were carried out on 64- and 256-slice CT scanners.

Results: in patients with suspicion on coronary artery disease, atherosclerotic lesions of coronary arteries (CA) were not detected in 582 (36,6%) cases. Minimal and initial CA stenoses were observed in 80 (5%) and 416 (26,2%) patients, respectively. Moderate CA stenoses were found in 236 (14,8%) patients. Severe coronary artery stenoses were detected in 183 patients (11,5%). CA occlusions were observed in 84 (5,3%) cases. Most often, the stenotic process was detected in proximal segments of coronary arteries, in particular, in the left anterior descending artery.

Conclusions: MDCT makes it possible to determine in detail the severity and nature of atherosclerotic coronary lesions, as well as to assess the predominant location of plaques.

References

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Abstract:

Introduction: the main methods for diagnosing cardiac neoplasms, allowing to determine the localization, size, involvement of heart structures, to suggest the nature of the pathological process and to plan treatment tactics, are: echocardiography (EchoCG), contrast multispiral computed coronary angiography (MSCT CAG), magnetic resonance imaging (MRI) and positron emission computed tomography (PET CT). At the same time, any additional information about the pathological process can improve the quality of diagnosis and treatment. So, for example, selective coronary angiography (CAG), which in this case can be performed to clarify the coronary anatomy and exclude concomitant coronary atherosclerosis, in hands of attentive and experienced specialist of endovascular diagnostic and treatment methods can make a significant contribution to understanding the nature of blood supply of heart neoplasm, thereby bringing closer the formulation of the correct diagnosis and, ultimately, improving results of surgical treatment.

Aim: was to study the nature of blood supply of heart myxoma based on results of a detailed analysis of data of selective coronary angiography in patients with this pathology.

Material and methods: since 2005, 20 patients underwent surgery to remove heart myxoma. The average age of patients was 56,6 + 8,0 (43-74) years. According to data of ultrasound examination, sizes of myxomas ranged from 10 to 46 mm in width and from 15 to 71 mm in length (average size ? 25,6 ? 39,1 mm). In 2/3 of all cases (15 out of 20,75%), the fibrous part of the inter-atrial septum (fossa oval region) was the base of myxomas. In 8 of 20 (40%) cases, tumor prolapse into the left ventricle through structures of the mitral valve was noted in varying degrees. In order to exclude coronary pathology, CAG was performed in 14 cases, in the rest - MSCT CAG.

Results: of 14 patients with myxoma who underwent selective coronary angiography, 12 (85,7%) patients had distinct angiographic signs of vascularization. In all 12 cases, the sinus branch participated in the blood supply of myxoma, begins from the right coronary artery (RCA) in 10 cases: in 7 case it begins from proximal segment of the RCA and, in 3 cases, from the posterior-lateral branch (PLB) of the RCA. In one case, the source of blood supply of neoplasm was the sinus branch extending from PLB of dominant (left type) circumflex artery of the left coronary artery (PLB CxA LCA). In one case, the blood supply to the neoplasm involved branches both from the RCA and CxA, mainly from the left atrial branch of CxA. Moreover, in all 12 cases, sinus branch formed two branches: branch of sinus node itself and left atrial branch. It was the left atrial branch that was the source of blood supply of myxoma. Analysis of angiograms in patients with myxoma of LA showed that left atrial branch in terminal section formed a pathological vascularization in the LA projection, accumulating contrast-agent in the capillary phase (MBG 3-4). In addition to newly formed vascularization, lacunae of irregular shape were distinguished, the size of which varied from 2 to 8 mm along the long axis. In 8 cases, hypervascular areas with areas of lacunar accumulation of contrast-agent showed signs of paradoxical mobility and accelerated onset of venous phase. In two cases, there were distinct angiographic signs of arteriovenous shunt. In 2 cases (when the size of the myxoma did not exceed 15-20 mm according to EchoCG and CT), angiographic signs allowing to determine the presence of LA myxoma were not so convincing: there was no lacunar accumulation of contrast-agent; small (up to 10 mm) hypervascular areas were noticed, the capillary network of which stood out against the general background of uniform contrasting impregnation and corresponded to MBG grade 1-2.

Conclusion: according to our data, angiographic signs of vascularization of myxomas are detected in most cases with this pathology (85,7%). The source of blood supply, in the overwhelming majority of cases, is branch of coronary artery, which normally supplies the structure of the heart, on which the basement of the pathological neoplasm is located. The aforementioned angiographic signs characteristic of myxomas deserve the attention of specialists in the field of endovascular diagnosis and treatment and should be described in details in protocols of invasive coronary angiography.

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https://doi.org/10.1093/icvts/ivy217

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4.     Gupta PN, Sagar N, Ramachandran R, Rajeshekharan VR. How does knowledge of the blood supply to an intracardiac tumour help? BMJ Case Rep. 2019; 12(2): 225900.

https://doi.org/10.1136/bcr-2018-225900

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https://doi.org/10.1002/ca.23527

Abstract:

Introduction: the problem of restenosis prevention and its early detection is very important in patients who underwent coronary intervention with bare-metal stent (BMS) implantation in acute coronary syndrome (ACS). But when is it necessary to perform elective coronary angiography in order not to miss possible restenosis development? This question needs to be answered.

Aim: was to define the correct period to perform elective coronary angiography after bare-metal stent implantation in acute coronary syndrome.

Material and methods: the study included 124 patients who underwent coronary intervention with BMS implantation in ACS, in period of 1-14 months before current admission. All patients included in this study had indications for repeating coronary angiography and were diagnosed hemodynamically relevant in-stent restenosis. No risk factors of restenosis were revealed at these patients.

Results: average time of restenosis detection was 7,9±1,99 months. Average percent of restenosis among all included patients was 68,6±13,1%. We also revealed direct correlation of percent of restenosis with time of restenosis detection (r=0,5785, p <0,05). Correlation between time and percentage of restenosis and stent type or TIMI grade, was also estimated in this study.

Conclusion: according to results of our study, there are good reasons to repeat coronary angiography in 7-9 month after BMS implantation in ACS, even if patients have no risk factors of restenosis.

References

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7.     Goncharov AI, Kokov LS, Likharev AYu. Otsenka effektivnosti stentirovaniya koronarnyh arterij razlichnymi tipami stentov u bol'nyh IBS. Mezhdunarodnyj zhurnal intervencionnoj kardioangiologii. 2009; 19: 23-24 [In Russ].

Abstract:

Background: clinical case of a rarely encountered pathology (0.1-3.5%) in cardiac surgery, such as the aneurysm of the left coronary artery (LCA), is presented. It was detected and analyzed by coronary angiography and coronary CT angiography

Aim: was to show possibilities of radiation research methods in identifying and evaluating of coronary artery aneurysms.

Materials and methods: a 67-year-old patient was referred to the Federation National Center of Cardiovascular Surgery (Penza) for follow-up examination (coronary angiography) and to decide on the choice of management due to the presence of critical aortic valve stenosis. Performed coronary angiography and subsequent coronary CT angiography for demonstrate the topography of the aneurysm.

Results: according to the data of coronary angiography at the region of trifurcation of the LCA or the anterior descending artery, intermediate and circumflex arteries a large-sized aneurysm is visualized. Due to coronary CT angiography data, the one is located at a distance of 1.0 cm from the entrance of the LCA in the area of trifurcation. It's presented by an aneurysmal dilatation of a rounded shape 1.3 cm in diameter with locally calcific walls.

Conclusion: coronary angiography and coronary CT angiography made it possible to identify anc examine individual morphological features of the anatomy of the coronary artery aneurysm, as well as demonstrate and take apart its topography to clearly, which in turn made it possible to rationally determine the management of the patient.

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Abstract:

Aim: was to evaluate the efficacy of MSCT in assessment of long-term graft patency after coronary artery bypass graft surgery (CABG).

Material and methods: 25 patients with multi-vessel coronary artery disease were included in the research. To assess the 5-year graft patency, MSCT arteriography was performed.

Results: a total of 96 grafts (22 left internal thoracic artery (LITA) and 74 saphenous venous grafts (SVG)) were analyzed using MSCT There were 12 venous sequential grafts and 19 venous Y-shaped grafts determined. During the assessment of graft patency, 13 occlusions of venous grafts and 1 hemodynamically significant stenosis were detected. Occlusion and hemodynamically significant stenosis of mammary grafts were not observed.

Conclusion: MSCT arteriography, allows to determine occlusive and hemodynamically significant stenoses of SVG. Results of study shows the prevalence of SVG occlusions and stenosis over arterial grafts. CT angiography can be highly informative for assessing the patency of grafts in late periods after CABG. 

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12.    Shimanovsky NL. Safety of iodine-containing radiopaque agents in the light of new recommendations from international associations of experts and clinicians. REJR. 2012; 2 (1): 12-19 [In Russ].

13.    Campbell PG, Teo KS, Worthley SG, Kearney MT, Tarique A, Natarajan A, Zaman AG. Non-invasive assessment of saphenous vein graft patency in asymptomatic patients. Br J Radiol. 2009 Apr; 82(976):291-5. doi: 10.1259/bjr/19829466.

14.    Frazier AA, Qureshi F, Read KM, Gilkeson RC, Poston RS, White CS. Coronary artery bypass grafts: assessment with multidetector CT in the early and late postoperative settings. Radiographics. 2005 Jul-Aug; 25(4): 881-896. Review.

15.    Tinica G, Chistol RO, Enache M, Leon Constantin MM, Ciocoiu M, Furnica C. Long-term graft patency after coronary artery bypass grafting: Effects of morphological and pathophysiological factors. Anatol J Cardiol. 2018 Nov;20(5):275-282. doi: 10.14744/AnatolJCardiol.2018. 51447.

16.    Drouin A, Noiseux N, Chartrand-Lefebvre C, Soulez G, Mansour S, Tremblay JA, Basile F, Prieto I, Stevens LM. Composite versus conventional coronary artery bypass grafting strategy for the anterolateral territory: study protocol for a randomized controlled trial. Trials. 2013 Aug 26; 14: 270. doi: 10.1186/1745-6215-14270.

17.    Deb S, Cohen EA, Singh SK, Une D, Laupacis A, Fremes SE RAPS Investigators. Radial artery and saphenous vein patency more than 5 years after coronary artery bypass surgery: results from RAPS (Radial Artery Patency Study). J Am Coll Cardiol. 2012 Jul 3;60(1):28-35. doi: 10.1016/j.jacc.2012.03.037.

Abstract:

Introduction: for assessment of the significance of coronary artery stenosis, it is necessary to determine the minimum area of the residual square of the vessel lumen (VLRS) that can provide adequate blood flow to myocardial needs. This value is called «threshold» or «borderline». Numerous studies on this issue using modern intravascular and isotope techniques, randomized clinical trials have shown that the values of the «borderline» value of VLRS for proximal coronary arteries are within 3-4 mml. According to the literature, the angiographic method for assessing the severity of stenosis is not sufficiently informative and unreliable. In this article, a combination of coronary angiography with use of balloon catheter is proposed, that allows to eliminate disadvantages of the angiographic method in solving the task is shown.

Aim: was to investigate possibilities of the method of determining the VLRS of coronary artery (CA) in the stenosis region and to assess its hemodynamic significance based on coronary angiography (CG) using a balloon catheter

Materials and methods: the essence of the proposed approach is the obstruction of the artery at the site of stenosis with a balloon catheter with a known cross-sectional area; the VLRS value in this case is equal to or smaller than the area of the balloon catheter. In case of obstruction of the artery by balloon catheter with a transverse area up to 4 mm2, stenosis was considered to be hemodynamically significant and revascularization was recommended; with preserved intensive blood flow, stenosis is considered hemodynamically insignificant.

Results: angiogram evaluation was performed in 120 patients with IHD with «intermediate» stenoses of proximal coronary arteries (from 40 to 70%) using the described technique. In 84% of cases, VLRS was estimated at 3,14 mm2 or less; in 8% of the VLRL was 3,86 mm2 or less. In such areas of coronary arteries, stenosis was considered hemodynamically significant. These patients underwent revascularization of the myocardium - balloon angioplasty and stenting of the coronary artery In 8% of cases, VLRS was more than 4 mm2, coronary stenosis in such cases was recognized as hemodynamically insignificant, and endovascular treatment was not performed in these patients.

Conclusion: the proposed approach for assessment of the area of the residual square of coronary artery lumen at the site of constriction provides an opportunity for an optimal choice of treatment tactics. 

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Abstract: 

Aim: was to give a literature review normal coronary anatomy, described patterns of anomalous coronary arteries by using multislice computed tomography (MSCT).

Materials and methods: 1104 computed tomography coronary angiography (CCTA) was made in «Fedorovich Clinikasi» for the period of 2011-2016. The age of patients ranged from 7 to 82 years. Men were 790 (71.5%), women - 314 (28.5%). The study was carried out on the multislice spiral CT scanners Brilliance 64 and Brilliance i-CT 256 (PHILIPS).

Results. In 32 (2,9%) cases we detected anatomical variations as conus artery high take-off of a coronary ostium, myocardial bridging, shepherd's crook deformation of right coronary artery 23 (2%) patients had coronary artery anomaly (CAA) as a single coronary artery, absence of circumflex artery, hypoplasia of coronary artery, intra-atrial location, origin from the opposite coronary sinus of Valsalva, separate discharge of the LAD and circumflex from aorta, Blunt-White-Garland syndrome, coronary fistulas, aneurysms of coronary arteries. When a CAA is found, the exact origin, course and its position with other cardiac structures must be described in detail.   

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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 

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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:

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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2.     Kokov L.S., Shutihina I.V., Timina I.E. Ispol'zovanie ul'trazvukovyh tehnologij v ocenke ateroskleroticheskih porazhenij sosudistoj stenki [The use of ultrasonic technology in the assessment of atherosclerotic lesions of the vascular wall.]. Molekuljarnaja medicina. 2013;4:15-25 [In Russ].

3.     Sinicyn V.E., Stukalova O.V., Docenko Ju.A. i dr. Kontrastnaja magnitno-rezonansnaja tomografija v ocenke rubcovyh porazhenij miokarda u bol'nyh IBS[Contrast magnetic resonance imaging in the evaluation of myocardial scarring lesions in patients with coronary artery disease.]. Diagnosticheskaja i intervencionnaja radiologija. 2009;3 (4):23-31 [In Russ].

4.     Fedotenkov I.S., Gagarina N.V., Veselova T.N., Sinicyn V.E., Ternovoj S.K. Kolichestvennyj analiz urovnja kal'cinoza koronarnyh arterij: sravnenie informativnosti mul'tispiral'noj komp'juternoj tomografii i jelektronno-luchevoj tomografii[Quantitative analysis of the level of calcification of the coronary arteries: comparison of informativeness of multislice computed tomography and electron beam tomography.]. Terapevticheskij arhiv. 2006;12:15-19 [In Russ].

5.     Ternovoj S.K., Veselova T.N., Sinicyn V.E. i dr. Rol' mul'tispiral'noj komp'juternoj tomografii v diagnostike infarkta miokarda [The role of multislice computed tomography in the diagnosis of myocardial infarction.]. Kardiologija. 2008; 1: 4-8 [In Russ].

6.     Sinicyn V.E., Ternovoj S.K., Ustjuzhanin D.V. i dr. Diagnosticheskoe znachenie KT-angiografii v vyjavlenii gemodinamicheski znachimyh stenozov koronarnyh arterij [The diagnostic value of CT angiography in the detection of hemodynamically significant stenoses of coronary arteries]. Kardiologija. 2008; 1: 9-14 [InRuss].

7.     Ustjuzhanin D.V., Veselova T.N., Sinicyn V.E. i dr. Cravnitel'nyj analiz diagnosticheskogo znachenija neinvazivnoj angiografii koronarnyh arterij s pomoshh'ju jelektronno-luchevoj i mul'tispiral'noj komp'juternoj tomografii [Comparative analysis of the diagnostic value of noninvasive coronary angiography using the electron beam and multislice computed tomography.]. Terapevticheskij arhiv. 2008; 4:12-15[In Russ].

8.     Veselova T.N., Merkulova I.N., Mironov V.M., Merkulov E.V., Ternovoj S.K., Ruda M.Ja. Neinvazivnaja ocenka ateroskleroticheskogo porazhenija koronarnyh arterij u bol'nyh s ostrym koronarnym sindromom metodom mul'tispiral'noj komp'juternoj tomografii[Noninvasive assessment of atherosclerotic lesions of coronary arteries in patients with acute coronary syndrome by multislice computed tomography.]. Medicinskaja vizualizacija. 2010; 4:100-109 [In Russ].

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.   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.

11.   Fedotenkov I.S., Veselova T.N., Ternovoj S.K., Sinicyn V.E. Rol' mul'tispiral'noj komp'juternoj tomografii v diagnostike kal'cinoza koronarnyh arterij [The role of multislice computed tomography in the diagnosis of coronary artery calcification]. Kardiologicheskij vestnik. 2007; 11 (XIV): 45-48 [In Russ].

12.   Ternovoj S.K., Nikonova M.Je., Akchurin R.S. i dr. Vozmozhnosti mul'tispiral'noj komp'juternoj tomografii (MSKT) v ocenke koronarnogo rusla i ventrikulografii v sravnenii s intervencionnoj koronaroventrikulografiej [Possibilities of multislice computed tomography (MSCT) in the evaluation of coronary arteries and ventriculography in comparison with interventional coronaroventriculography.]. Rossijskij jelektronnyj zhurnal luchevoj diagnostiki. 2013;3 (9): 28-36 [In Russ].

13.   Ternovoj S.K., Veselova T.N. Vyjavlenie nestabil'nyh bljashek v koronarnyh arterijah s pomoshh'ju mul'tispiral'noj kompjuternoj tomografii [Identification of unstable plaques in coronary arteries using a multislice computed tomography.]. Rossijskij jelektronnyj zhurnal luchevoj diagnostiki. 2014:4(13):7- 14 [In Russ].

14.   Sabarudin A., Sun Z. Coronary CT angiography: Diagnostic value and clinical challenges. World J. Cardiol. 2013;26;5(12):473-483.

15.   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(2):443-452.

16.   Obaid D.R., Calvert PA., Gopalan D. et al. Dualenergy computed tomography imaging to determine atherosclerotic plaque composition: a prospective study with tissue validation. J Cardiovasc Comput Tomogr. 2014; 8(3):230-237. [PubMed: 24939072]

17.   Gbaid D.R., CalvertPA., Gopalan D. et al. Atherosclerotic plaque composition and classification identified by coronary computed tomography: assessment of computed tomography-generated plaque maps compared with virtual histology intravascular ultrasound and histology. Circ Cardiovasc Imaging. 2013;6(5):655-664. [PubMed: 23960215] 

18.   Stehli J., Clerc O.F., Fuchs T.A. et al. Impact of monochromatic coronary computed tomography angiography from single-source dual-energy CT oncoronary stenosis quantification. J Cardiovasc Comput Tomogr. 2016;10(2):135-140.

19.   DanadI., Hartaigh B., Min J.K. Dual-energy computed tomography for detection of coronary artery disease. Expert Rev Cardiovasc Ther. 2015;13(12):1345- 1356.

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