کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3982027 1257713 2013 10 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Cardiac dual-source CT for the preoperative assessment of patients undergoing bariatric surgery
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی تومور شناسی
پیش نمایش صفحه اول مقاله
Cardiac dual-source CT for the preoperative assessment of patients undergoing bariatric surgery
چکیده انگلیسی

AimTo assess the diagnostic value of coronary dual-source computed tomography (DSCT) as a comprehensive, non-invasive tool in the preoperative cardiac evaluation of patients undergoing bariatric surgery.Materials and methodsThirty consecutive obese [average body mass index (BMI): 45 ± 7.6, range: 35–59] patients (24 women; six men; median age: 52 ± 15 years) were enrolled in this institutional review board (IRB)-approved, Health Insurance Portability and Accountability Act of 1996 (HIPAA)-compliant prospective study. Calcium scoring (CaS) and electrocardiography (ECG)-gated images of the coronary arteries were obtained with a large body habitus protocol (120 kV; 430 mAs; 100 ml iodinated contrast medium at 7 ml/s injection rate) on a DSCT machine. Qualitative (four-point: 1 = excellent to 4 = not delineable) coronary segmental analysis, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) measurements were performed. The presence and degree of vascular disease (four-grade scale: mild to severe) was correlated with CaS and cardiovascular (CV) risk stratification blood tests. In patients with severe stenosis (>70%), findings were compared with cardiac nuclear medicine imaging (single photon-emission computed tomography; SPECT) imaging.ResultsThe average HR, enhancement, and quality score were 64 ± 7 beats/min, 288 ± 66 HU and 1.8 ± .5, respectively. Ninety-three percent (417/450) of the coronary segments were rated diagnostic. The SNRs and CNRs were 17 ± 9 and 12 ± 7 for the right coronary artery; 17 ± 8 and 12 ± 7 for the left main coronary artery; 16 ± 9 and 11 ± 7 for the left anterior descending coronary artery; and 15 ± 7 and 10 ± 6 for the left circumflex coronary artery. Ten of the 30 patients (33%) demonstrated coronary artery disease (CAD) of which two (6%) showed three-vessel disease. Four (13%) patients showed severe disease: in three of which the presence of significant stenosis was confirmed by SPECT and by catheter angiography in the fourth patient. Neither the CaS, nor the CV risk stratification tests showed significant correlation with presence or degree of CAD (p > 0.05).ConclusionsCoronary DSCT is a robust alternative imaging tool in the preoperative assessment of patients undergoing bariatric surgery.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Clinical Radiology - Volume 68, Issue 3, March 2013, Pages e154–e163
نویسندگان
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