Showing papers by "Maros Ferencik published in 2004"
TL;DR: In this paper, the authors investigated the ability of multidetector spiral computed tomography (MDCT) to detect atherosclerotic plaque in nonstenotic coronary arteries.
Abstract: Background— We investigated the ability of multidetector spiral computed tomography (MDCT) to detect atherosclerotic plaque in nonstenotic coronary arteries Methods and Results— In 22 patients without significant coronary stenoses, contrast-enhanced MDCT (075-mm collimation, 420-ms rotation) and intravascular ultrasound (IVUS) of one coronary artery were performed A total of 83 coronary segments were imaged by IVUS (left main, 19; left anterior descending, 51; left circumflex, 4; right coronary, 9) MDCT data sets were evaluated for the presence and volume of plaque in the coronary artery segments Results were compared with IVUS in a blinded fashion For the detection of segments with any plaque, MDCT had a sensitivity of 82% (41 of 50) and specificity of 88% (29 of 33) For calcified plaque, sensitivity was 94% (33 of 36) and specificity 94% (45 of 47) Coronary segments containing noncalcified plaque were detected with a sensitivity of 78% (35 of 45) and specificity of 87% (33 of 38), but presence o
842 citations
TL;DR: For all coronary segments included, 16-slice MDCT has moderate diagnostic value for the detection of significant obstructive coronary artery stenosis in a population with a high prevalence of CAD and suggests a limited impact on clinical decision-making in high-risk populations.
Abstract: Background— In this study, we investigated the diagnostic value and limitations of multidetector computed tomography (MDCT)–based noninvasive detection of significant obstructive coronary artery disease (CAD) in a consecutive high-risk patient population with inclusion of all coronary segments. Methods and Results— In a prospective, blinded, standard cross-sectional technology assessment, a cohort of 33 consecutive patients with a positive stress test result underwent 16-slice MDCT and selective coronary angiography for the detection of significant obstructive CAD. We assessed the diagnostic accuracy of MDCT in a segment-based and a patient-based model and determined the impact of stenosis location and the presence of calcification on diagnostic accuracy in both models. Analysis of all 530 coronary segments demonstrated moderate sensitivity (63%) and excellent specificity (96%) with a moderate positive predictive value of 64% and an excellent negative predictive value (NPV) of 96% for the detection of sig...
429 citations
TL;DR: In 26 patients, 16-slice multidetector computed tomography (MDCT) with 0.75-mm collimation and intravascular ultrasound (IVUS) of 1 coronary artery were performed, and the mean luminal area and mean plaque area were slightly but significantly overestimated with MDCT.
Abstract: In 26 patients, 16-slice multidetector computed tomography (MDCT) with 0.75-mm collimation and intravascular ultrasound (IVUS) of 1 coronary artery were performed. At 100 sites within the coronary arteries, the measurement of cross-sectional luminal area and, if detectable, the cross-sectional area of atherosclerotic plaque was performed independently with IVUS and MDCT. The mean luminal area (r = 0.92), measured at 100 sites, and plaque area (r = 0.55), measured at 65 sites, were significantly correlated (p <0.001) between MDCT and IVUS. The mean luminal area and mean plaque area were slightly but significantly overestimated with MDCT. MDCT permits the noninvasive measurement of coronary cross-sectional luminal and plaque areas with moderate accuracy.
166 citations
TL;DR: Multi-detector row CT with retrospective ECG gating permits the detection and further characterization of acute myocardial infarction in a porcine model of complete coronary occlusion.
Abstract: PURPOSE: To assess the role of contrast material–enhanced retrospectively electrocardiographically (ECG) gated multi–detector row computed tomography (CT) in the detection of acute myocardial infarction in a porcine model of total coronary occlusion. MATERIALS AND METHODS: Seven Yorkshire farm pigs were studied with contrast-enhanced retrospectively ECG-gated multi–detector row CT 3 hours after total occlusion of the distal left anterior descending artery (n = 5) or the second diagonal branch (n = 2). Reformatted short-axis end-systolic and end-diastolic CT data sets were assessed for myocardial perfusion deficits, coronary occlusion, and abnormal myocardial wall motion. Perfusion deficits were compared with microsphere-determined blood flow and triphenyltetrazolium chloride (TTC)–stained tissue samples for infarct assessment by using Bland-Altman analysis and analysis of variance. RESULTS: Myocardial perfusion deficits, occlusion of the left anterior descending artery or second diagonal branch, and akine...
148 citations
TL;DR: Further evidence is provided for the notion that calcifications in those regions are associated and that MDCT can be used as a tool for the global assessment of vascular and valvular calcium.
Abstract: The epidemiology of and association between vascular and valvular calcium as quantified by multidetector computed tomography (MDCT) were studied in 416 elderly subjects with no history of coronary artery disease Coronary calcium (CC), descending thoracic aortic calcium (DTAC), aortic valve calcium (AVC), and mitral valve calcium (MVC) were present in 282 (68%), 214 (51%), 152 (37%), and 68 (16%) subjects, respectively Multiple logistic regression analysis showed that after adjusting for age and gender, subjects with AVC (odds ratio [OR] 23), MVC (OR 281), and DTAC (OR 279) were independently and significantly more likely to have CC Further evidence is provided for the notion that calcifications in those regions are associated and that MDCT can be used as a tool for the global assessment of vascular and valvular calcium
19 citations
TL;DR: This work systematically studied the thickness of the myocardium in the left ventricular apical region in patients without a history of myocardial infarction and with no hemodynamically significant coronary artery disease using contrast-enhanced multidetector spiral computed tomography with submillimeter collimation.
Abstract: We systematically studied the thickness of the myocardium in the left ventricular apical region in patients without a history of myocardial infarction and with no hemodynamically significant coronary artery disease, using contrast-enhanced multidetector spiral computed tomography with submillimeter collimation We confirmed previous pathology data and reliably detected a small confined region of the normal apical myocardium with a thickness of ≤3 mm, ie, the left ventricular thin point
15 citations
TL;DR: Computed tomography imaging may develop into a tool that can be integrated into the workflow in chest pain centers once appropriate studies have been performed, and several studies have demonstrated a high negative predictive value to rule out coronary artery stenoses.
Abstract: Suitable imaging methods to reliably rule out coronary artery disease as the underlying condition might be beneficially applied in the workup of patients with acute chest pain. The temporal and spatial resolution of computed tomgraphy and electron beam computed tomography has seen continuous improvements over the past years. Current scanner generations permit relatively reliable visualization of the coronary arteries and several studies have demonstrated a high negative predictive value to rule out coronary artery stenoses. Even though applications in the context of acute coronary syndromes have not yet been specifically evaluated, it seems likely that computed tomography imaging may develop into a tool that can be integrated into the workflow in chest pain centers once appropriate studies have been performed.
3 citations