AIM: To assess the attenuation of non-calcified atherosclerotic coronary artery plaques with computed tomography coronary angiography (CTCA). METHODS: Four hundred consecutive patients underwent CTCA (Group 1: 200 pat...AIM: To assess the attenuation of non-calcified atherosclerotic coronary artery plaques with computed tomography coronary angiography (CTCA). METHODS: Four hundred consecutive patients underwent CTCA (Group 1: 200 patients, Sensation 64 Cardiac, Siemens; Group 2: 200 patients, VCT GE Healthcare, with either Iomeprol 400 or Iodixanol 320, respectively) for suspected coronary artery disease (CAD). CTCA was performed using standard protocols. Image quality (score 0-3), plaque (within the accessible non-calcified component of each non-calcified/mixed plaque) and coronary lumen attenuation were measured. Data were compared on a per-segment/per-plaque basis. Plaques were classified as fibrous vs lipid rich based on different attenuation thresholds. A P < 0.05 was considered significant. RESULTS: In 468 atherosclerotic plaques in Group 1 and 644 in Group 2, average image quality was 2.96 ± 0.19 in Group 1 and 2.93 ± 0.25 in Group 2 (P ≥ 0.05). Coronary lumen attenuation was 367 ± 85 Hounsfield units (HU) in Group 1 and 327 ± 73 HU in Group 2 (P < 0.05); non-calcified plaque attenuation was 48 ± 23 HU in Group 1 and 39 ± 21 HU in Group 2 (P < 0.05). Overall signal to noise ratio was 15.6 ± 4.7 in Group 1 and 21.2 ± 7.7 in Group 2 (P < 0.01). CONCLUSION: Higher intra-vascular attenuation modifies significantly the attenuation of non-calcified coronary plaques. This results in a more difficult characterization between lipid rich vs fibrous type.展开更多
Background:The assessment of Fontan circuit’sflow is traditionally evaluated by multiple through-plane phase-contrast MRI acquisitions(2Dflow),while recently,a single volumetric 4D-flow MRI acquisition is emerging as a ...Background:The assessment of Fontan circuit’sflow is traditionally evaluated by multiple through-plane phase-contrast MRI acquisitions(2Dflow),while recently,a single volumetric 4D-flow MRI acquisition is emerging as a comprehensive tool for the hemodynamic evaluation in congenital heart diseases.Purpose:To compare 2D and 4D-flow MRI measurements in patients after Fontan palliation and to evaluate parameters affecting potential dis-agreement.Methods:39 patients after Fontan palliation(23 males,age 22±11 years)who underwent cardiac MRI with 2D and 4D-flow MRI acquisition were included in the study.In all patients,bloodflow quantification in the Fontan circuit and aorta by 2Dflow and by 4Dflow MRI acquisition blinding to the 2D results was per-formed.The agreement between 2D and 4D-flow MRI was calculated as the intraclass correlation coefficient(ICC).The mean absolute differences between 4D and 2Dflows were analyzed using linear regression models.Results:4D-flow MRI acquisition time was slightly lower than 2D(7.6±1.8 min vs.9.4±3.3 min,p=0.03).Flow was slightly predominant in the right pulmonary artery(58%of total pulmonaryflow).Conduit/tunnel-pul-monary arteriesflow accounted for 60%of the Fontan circuit.Agreement between 2D and 4D was overall good-to-excellent from ICC:0.81795%CI:0.637–0.907 to 0.93295%CI:0.866–0.965.There was no significant influ-ence of evaluated parameters on the agreement on 4D and 2Dflow.Conclusions:4D-flow MRI represents a valid tool in Fontan’sflow quantification.Further larger studies are needed to confirm our results and to evaluate the impact of advanced 4D-flow MRI parameters on the prognostic stratification in patients after Fontan palliation.展开更多
基金Supported by An unrestricted grant from GE Healthcare
文摘AIM: To assess the attenuation of non-calcified atherosclerotic coronary artery plaques with computed tomography coronary angiography (CTCA). METHODS: Four hundred consecutive patients underwent CTCA (Group 1: 200 patients, Sensation 64 Cardiac, Siemens; Group 2: 200 patients, VCT GE Healthcare, with either Iomeprol 400 or Iodixanol 320, respectively) for suspected coronary artery disease (CAD). CTCA was performed using standard protocols. Image quality (score 0-3), plaque (within the accessible non-calcified component of each non-calcified/mixed plaque) and coronary lumen attenuation were measured. Data were compared on a per-segment/per-plaque basis. Plaques were classified as fibrous vs lipid rich based on different attenuation thresholds. A P < 0.05 was considered significant. RESULTS: In 468 atherosclerotic plaques in Group 1 and 644 in Group 2, average image quality was 2.96 ± 0.19 in Group 1 and 2.93 ± 0.25 in Group 2 (P ≥ 0.05). Coronary lumen attenuation was 367 ± 85 Hounsfield units (HU) in Group 1 and 327 ± 73 HU in Group 2 (P < 0.05); non-calcified plaque attenuation was 48 ± 23 HU in Group 1 and 39 ± 21 HU in Group 2 (P < 0.05). Overall signal to noise ratio was 15.6 ± 4.7 in Group 1 and 21.2 ± 7.7 in Group 2 (P < 0.01). CONCLUSION: Higher intra-vascular attenuation modifies significantly the attenuation of non-calcified coronary plaques. This results in a more difficult characterization between lipid rich vs fibrous type.
基金The Institutional Review Board and Regional Committee(CEAVNO)approved the study(Study No.13756 approved in September 2018).
文摘Background:The assessment of Fontan circuit’sflow is traditionally evaluated by multiple through-plane phase-contrast MRI acquisitions(2Dflow),while recently,a single volumetric 4D-flow MRI acquisition is emerging as a comprehensive tool for the hemodynamic evaluation in congenital heart diseases.Purpose:To compare 2D and 4D-flow MRI measurements in patients after Fontan palliation and to evaluate parameters affecting potential dis-agreement.Methods:39 patients after Fontan palliation(23 males,age 22±11 years)who underwent cardiac MRI with 2D and 4D-flow MRI acquisition were included in the study.In all patients,bloodflow quantification in the Fontan circuit and aorta by 2Dflow and by 4Dflow MRI acquisition blinding to the 2D results was per-formed.The agreement between 2D and 4D-flow MRI was calculated as the intraclass correlation coefficient(ICC).The mean absolute differences between 4D and 2Dflows were analyzed using linear regression models.Results:4D-flow MRI acquisition time was slightly lower than 2D(7.6±1.8 min vs.9.4±3.3 min,p=0.03).Flow was slightly predominant in the right pulmonary artery(58%of total pulmonaryflow).Conduit/tunnel-pul-monary arteriesflow accounted for 60%of the Fontan circuit.Agreement between 2D and 4D was overall good-to-excellent from ICC:0.81795%CI:0.637–0.907 to 0.93295%CI:0.866–0.965.There was no significant influ-ence of evaluated parameters on the agreement on 4D and 2Dflow.Conclusions:4D-flow MRI represents a valid tool in Fontan’sflow quantification.Further larger studies are needed to confirm our results and to evaluate the impact of advanced 4D-flow MRI parameters on the prognostic stratification in patients after Fontan palliation.
