OBJECTIVETo assess the in-stent lumen visibility and image quality of coronary stents by dual-source computed tomography (DSCT) coronary angiography, and the diagnostic accuracy of DSCT in the detection of coronary in-stent restenosis.

METHODSDSCT was performed at 147 stents in 78 patients at an interval of (21.8?22.2) months after coronary stent implantation. Axial multi-planar reconstruction of the stents and curved-planar reconstruction through the median of the stents were evaluated for stent image quality on a 5-point scale, and the stent lumen diameters were detected. Thirty out of these 78 patients underwent conventional coronary angiography within one month after CT angiography. The patency of 60 stents were independently evaluated by two blinded readers.

RESULTSImage quality was good to excellent on average score (1.6?0.6) . Stent image quality score was correlated with stent diameter, stent location, and heart rate. All stents were assessable in lumen visibility with an average visible lumen diameter percentage of (72.2?12.2) %. Visible lumen diameter percentage was correlated with stent diameter and stent location. For the stents with calcified plaques, the visible lumen diameter percentage at the calcified site was significantly lower than that at the non-calcified site (P<0.001) . Compared with the conventional coronary angiography, 12 out of 14 in-stent stenoses were correctly detected. The sensitivity, specificity, positive predictive value, and negative predictive value for the detection of in-stent stenosis was 85.7%, 95.7%, 85.7%, and 95.7%, respectively. For stents whose diameter >0.275cm, the sensitivity, specificity, positive predictive value, and negative predictive value were all 100%. The agreement between CT findings and coronary angiography results was 93.3%, and it was correlated with stent diameter and heart rate.

CONCLUSIONSUsing a DSCT, coronary stent lumen is partially visible and the image quality is high. Stent diameter and location can influence the stent lumen visibility and image quality. DSCT has a high diagnostic accuracy for the detection of in-stent restenosis and may be a valuable modality for the follow-up of coronary artery stent patency."

Aged ; Coronary Angiography ; methods ; Coronary Restenosis ; diagnostic imaging ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Sensitivity and Specificity ; Stents ; Tomography, X-Ray Computed ; methods ; Vascular Patency

OBJECTIVETo investigate the protective effect of suppressive oligodeoxynucleotides (Sup ODN) on interferon-γ (IFN-γ) and signal transducers and activators of transcription (pSTAT4) expression of Silica-induced pulmonary inflammation in Mice.

METHODSSixty Balb/c mice were randomly divided into 4 groups, normal control group, silicious group, suppressive oligodeoxynucleotides (Sup ODN) group, control oligodeoxynucleotides (Con ODN) group. Except the normal control group injected normal saline, the rest groups were induced by the intratracheal instillation of 0.1 ml (5 g/L) of sterilized silica suspension. Sup ODN group and Con ODN group were treated by i.p. injection of 0.3 ml (1mg/mL) of suppressive or control ODN 3 h before silica administration. After 7 days, the animals were killed and levels of IFN-γ were detected by ELISA. The pathologic changes in lung tissues of mice were observed with HE staining. Expressions of IFN-γ and pSTAT4 in lung tissue were detected with immunohistochemistry and quantified by Image-Pro Plus 7.0.

RESULTSHE staining showed that the lung tissue of silicious group were damaged seriously than Sup ODN group. Compared with the normal control group (serum: (280.1±41.3) pg/ml, lung tissue: (0.249±0.373), IFN-γ increased in silicious group (serum: (886.3±81.7) pg/ml, lung tissue: (0.270±0.300) (P < 0.05). Compared with the normal control group and Con ODN group [(894.5±91.6) pg/ml], IFN-γ in the serum of Sup ODN group decreased significantly (P < 0.01). Compared with the silicious group , IFN-γ in lung tissue decreased in Sup ODN group (0.241±0.250) (P < 0.05). Compared with the normal control group (0.279±0.353), pSTAT4 in lung tissue increased significantly in silicious group (0.313±0.231) (P < 0.01). Compared with the silicious group, pSTAT4 in lung tissue decreased significantly in Sup ODN group (0.269±0.523) (P < 0.01).

CONCLUSIONSup ODN attained protective effect on Silica treated mice by suppressing expression of IFN-γ and pSTAT4.

Animals ; Female ; Inflammation ; metabolism ; Interferon-gamma ; metabolism ; Lung ; drug effects ; metabolism ; pathology ; Mice ; Mice, Inbred BALB C ; Oligodeoxyribonucleotides ; pharmacology ; Phosphorylation ; STAT4 Transcription Factor ; metabolism ; Silicon Dioxide ; toxicity

OBJECTIVETo investigate the clinical value of 64-slice spiral CT (64SCT) in assessing global left ventricular function in patients with old myocardial infarction (OMI), with magnetic resonance imaging (MRI) as the reference standard.

METHODSA total of 28 patients (23 men and 5 women) with OMI underwent contrast-enhanced 64SCT with retrospective electrocardiographic-gating, MRI, and transthoracic echocardiography (Echo). The data sets of 64SCT and MRI were reconstructed at both end-diastole and end-systole to measure left ventricular end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejective fraction (EF), and myocardial mass at end-diastole (MM). The data acquired with 64SCT and Echo were compared with the results obtained on MRI as the standard of reference respectively.

RESULTSThe parameters of global left ventricular function obtained with 64SCT were significantly correlated with the MRI data (r = 0.788-0.976, P < 0.001). EDV, ESV, SV, EF, and MM were slightly overestimated by 64SCT compared with MRI; however, there was no significant difference among the measurements. 64SCT was in good agreement with MRI. For the EDV, ESV, SV, and EF, the limits of agreement with Echo were significantly larger than with 64SCT compared with MRI (P < 0.05). The sensitivity, specificity, and accuracy of 64SCT to identify EF value less than 50% were 84.6%, 100% and 92.9%, respectively, whereas those of Echo were 61.5%, 66.7% and 64.3%, respectively. The accuracy of 64SCT was significantly higher than that of Echo (P < 0.01). There was a significantly larger overestimation of EDV, ESV, and SV with Echo than with 64SCT compared with MRI (P < 0.05), whereas EF was not significantly different.

CONCLUSIONSA strong correlation between 64SCT and MRI is found for all parameters. 64SCT agrees well with MRI, and allows more reliable and accurate evaluation of global left ventricular function in patients with OMI than Echo compared with MRI.

Adult ; Aged ; Echocardiography ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Myocardial Infarction ; diagnostic imaging ; physiopathology ; Tomography, Spiral Computed ; methods ; Ventricular Function, Left ; physiology

OBJECTIVETo determine the accuracy of dual-source CT (DSCT) coronary angiography (CAG) for the diagnosis of coronary artery disease (CAD) that induces perfusion defects at myocardial perfusion imaging (MPI) with single photon emission computed tomography (SPECT), by using SPECT and conventional CAG as the reference standard.

METHODSThirty-five patients with suspected or known CAD underwent both DSCT coronary angiography and MPI (using exercise or adenosine stress-rest protocol) with technetium-99m sestamibi SPECT. All the patients were beta-blockers-naïve before DSCT scan. The DSCT CAG studies were classified as having no stenosis, non-obstructive (< 50% luminal narrowing) stenosis, or obstructive (> or = 50% luminal narrowing) stenosis. MPI examinations were classified as showing normal or abnormal (reversible and/or fixed defects). A comparative regional analysis of coronary stenosis on DSCT versus myocardial perfusion on SPECT was made. In a subset of 20 patients, CAG was performed as a reference standard for CT angiography.

RESULTSOn the basis of the DSCT data, 98.4% of coronary segments were assessable. Twenty-seven branches were classified as having no stenosis, among which 85% had normal MPI. Nine branches showed non-obstructive stenosis and 69 branches showed at least one obstructive lesion. Only 50 (64%) branches with an abnormal DSCT had abnormal MPI; even in branches with obstructive stenosis on DSCT, 23 (33%) still had a normal MPI. By receiver operating characteristic curve analysis, at the optimal cutoff value of 58% stenosis, the sensitivity and specificity of DSCT to detect myocardial perfusion defect as defined by SPECT were 85% and 65%. In the subgroup compared with CAG, the sensitivity and specificity of DSCT to identify obstructive stenosis were 93% and 96%.

CONCLUSIONSDSCT and SPECT provide mutually complementary information on CAD. CT angiography can help rule out functionally relevant CAD, but has poor capability in predicting ischemia. DSCT provides high-quality diagnostic image without heartbeat controlling and has a high accuracy in detecting obstructive stenosis.

Aged ; Coronary Angiography ; methods ; Coronary Artery Disease ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Myocardial Ischemia ; diagnostic imaging ; Technetium Tc 99m Sestamibi ; Tomography, Emission-Computed, Single-Photon ; Tomography, X-Ray Computed

OBJECTIVETo investigate the value of multi-slice spiral computed tomography (MSCT) in the determination of global left ventricular function.

METHODSTwenty-nine patients with confirmed or suspected coronary heart diseases were imaged with a contrast-enhanced retrospective electrocardiogram (ECG) -gated technique on a 64-slice spiral CT scanner. The data sets were reconstructed at both end-diastolic and end-systolic phases in order to measure left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular stroke volume (LVSV), and left ventricular ejection fraction (LVEF). The results were compared with corresponding values obtained from conventional left ventriculography (LVG).

RESULTSLVEDV, LVESV, LVSV, and LVEF obtained with 64-slice spiral CT were significantly correlated with the LVG data (r = 0. 887-0.956, P < 0.001). According to the Bland-Altman approach, the mean differences for LVEDV, LVESV, LVSV, and LVEF were -2.3 ml, 4.1 ml, -6.4 ml, and - 3.5%, respectively. The limits of agreement for LVEDV, LVESV, LVSV, and LVEF were -27.2-22.4 ml, -10.2-18.4 ml, -26.4-13.6 ml, and -9.8%-3.0%, respectively.

CONCLUSIONMSCT has clinically acceptable agreement with LVG for the quantification of global left ventricular function.

Adult ; Aged ; Coronary Disease ; diagnostic imaging ; physiopathology ; Female ; Heart Ventricles ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Sensitivity and Specificity ; Tomography, Spiral Computed ; methods ; Ventricular Function, Left

OBJECTIVETo evaluate the clinical value of assessment of coronary stent patency by 64-slice spiral CT coronary angiography.

METHODSTotally 29 patients (59 stents) were investigated using a retrospective ECG-gated enhanced scan by 64-slice spiral CT at a mean interval of (28.4 +/- 21.2) months after coronary stent implantation. Axial multi-planar reconstruction (MPR) of the stents and curved-planar reconstruction (CPR) through the stents were evaluated for image quality on a 5-point scale (1 = excellent, 5 = uninterpretable) and lumen diameter. Stent lumen diameter was compared with the vessel diameter proximal of the stents to assess the in-stent lumen visibility. Conventional coronary angiography was performed in 5 patients, and 9 stents were evaluated.

RESULTSThe image quality was good to excellent on average (scores: 1.94 +/- 0.84), depending on heart rate, breath movement, and stent location. Stent lumen was visible, on average a percentage off (76.1 +/- 11.1)% of the lumen diameter. All the 9 stents were correctly detected as being patent, which was confirmed by conventional coronary angiography.

CONCLUSION64-slice spiral CT is a useful tool to assess the coronary stent patency.

Adult ; Aged ; Angioplasty, Balloon, Coronary ; Coronary Angiography ; methods ; Coronary Restenosis ; diagnostic imaging ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Stents ; Tomography, Spiral Computed ; methods ; Vascular Patency

OBJECTIVETo compare the image quality and visibility of arteries of 64-slice spiral coronary CT angiography (CTA) with those of 16-slice spiral coronary CTA, and to evaluate the diagnostic accuracy of 64-slice spiral CT for the assessment of coronary artery stenosis.

METHODSTotally 100 patients (Group A) with suspected coronary artery diseases (CAD) were examined by 64-slice spiral CT, 48 of whom also underwent conventional coronary angiography (CAG). Another 100 patients (Group B) with suspected CAD were studied by 16-slice spiral CT. Patients with a heart rate above 70 bpm received oral beta-blockers before the scan. Data were retrospectively analyzed and reviewed by two observers. Image quality was assessed by using a 3-point grading scale from excellent (1) to non-assessable (3) and the rate of displayed coronary branches was calculated. The left main artery (LM), left anterior descending artery (LAD), circumflex artery (CX), and right coronary artery (RCA) were screened for the presence of over 50% stenosis.

RESULTSThe mean heart rates of two groups showed no significant difference [(61 +/- 8) bpm vs. (61 +/- 7) bpm, P > 0.05]. The mean scan time of Group A was significantly shorter than that of Group B [(11.9 +/- 0.9) s vs. (22.2 +/- 1.1) s, P < 0.01]. In the evaluation of image quality, better results were obtained in Group A than in Group B (1.20 +/- 0.47 vs. 1.37 +/- 0. 63, P < 0.05). The visibility of proximal arteries was similar between two groups, while the visibility of some distal arteries and small branches was found higher in Group A than in Group B (LAD distal 92% vs. 48%, CX distal 98% vs. 89%, the first obtuse marginal (OMI) 93% vs. 84%, cone branch (CB) 86% vs. 71%, P < 0.05). Compared with CAG, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 64-slice spiral coronary CTA to identify over 50% stenosis were 94.9% (56/59), 93.2% (124/133), 86.2% (56/65), and 97.6% (124/127), respectively.

CONCLUSIONSWith higher temporal and spatial resolution, 64-slice spiral CT provides improved image quality and visibility of small branches as compared with 16-slice spiral CT. 64-slice spiral coronary CTA allows reliable non-invasive diagnosis of obvious coronary artery stenosis.

Aged ; Coronary Angiography ; methods ; Coronary Artery Disease ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Sensitivity and Specificity ; Tomography, Spiral Computed ; methods

Objective To evaluate the image quality of coronary CT angiography (CTA) and the diagnostic accuracy for the assessment of coronary artery stenosis with a 64-slice CT scanner.Methods 120 patients with suspected coronary artery disease were studied by ECG-gated 64-slice spiral CT (120 kV, 850 mAs,0.33 s-rotation time,0.6 mm collimation);60 of them also underwent conventional coronary angiography(CCA).Patients with heart rates above 70 bpm received oral?-blockade before the scan. Enhanced scan was performed with an intravenous injection of 60-70 ml contrast agent (370 mg l/ml) and 50 ml saline chaser bolus at 4 ml/s.Images were retrospectively reconstructed under different reformations multiplanar reconstruse-tion(MPR),maximum intensity projection(MIP)and volume rendering technology (VRT)and reviewed by two observers.Image quality was assessed using a 3-point grading scale(excellent, sufficient and non-diagnostic)and the visibility of coronary branches was evaluated.The left main,left anterior descending,left circumflex and right coronary arteries were screened for the presence of over 50% stenosis.Results Sixty-nine percent of the included patients received?-bloekade.The average heart rate was 61?8 bpm and the scan time was 11.9?1.3 s.In the evaluation of image quality with VRT images, 77% patients′images were excellent,18% sufficient,and 5% non-diagnostic.All of the first,most of the second and third,and parts of the fourth subsegment branches could be shown with MPR,MIP and VRT reconstruction images.MPR and MIP displayed better visualization than VRT in showing small branches. Compared with CCA,the sensitivity,specificity,positive and negative predictive value of CTA to identify over 50% stenosis were 93%,98%,87% and 99%,respectively.Conclusion 64-slice spiral CT coronary angiography is a noninvasive and fast method that allows reliable diagnosis of coronary artery stenosis with high image quality.

OBJECTIVETo compare the coronary artery bypass graft (CABG) imaging between 16-slice spiral CT and 64-slice spiral CT.

METHODSTotally 27 patients with CABG received multi-slice spiral CT imaging and the results were retrospectively analyzed. Among them, 8 patients received 16-slice spiral CT scanning, 19 patients received 64-slice spiral CT scanning.

RESULTSThe evaluability rates of 64-slice spiral CT in evaluating the proximal anastomosis, bypass graft, distal anastomosis, and distal blood vessel were 100%, 100%, 90.2%, and 93.9%, respectively, while those of 16-slice spiral CT were 92.3%, 95.2%, 90.0%, and 90.0%, respectively. The patency rates of the above four aspects of 64-slice spiral CT were 66.7%, 70.0%, 71.7%, and 70.0%, respectively, while those of 16-slice spiral CT were 83.3%, 85.0%, 83.3%, and 88.9% .

CONCLUSIONS64-slice spiral CT is superior to 16-slice spiral CT in CABG imaging. It can be used as a non-invasive tool for the post-operative follow-up of CABG.

Aged ; Coronary Angiography ; methods ; Coronary Artery Bypass ; Coronary Disease ; diagnostic imaging ; surgery ; Female ; Graft Occlusion, Vascular ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Postoperative Period ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, Spiral Computed ; methods

OBJECTIVETo assess lumen visibility of coronary stents by 64-slice computed tomography (CT) coronary angiography, and determine the value of 64-slice CT in non-invasive detecting of in-stent restenosis after coronary artery stent implantation.

METHODSTotally, 60 patients (54 males, aged 57.0+/-12.7 years) and 105 stents were investigated by 64-slice CT at a mean interval of 20.0+/-16.6 months after coronary stents implantation. Axial multi-planar reconstruction images of the stents and curved-planar reconstruction images through the median of the stents were reconstructed for evaluating stent image quality on a 5-point scale (1=excellent, 5=non-assessable), and stent lumen diameter was detected. Conventional coronary angiography was performed in 18 patients, and 32 stents were evaluated.

RESULTSImage quality was good to excellent on average (score 1.71+/-0.76). Stent image quality score was correlated to heart rate (r=0.281, P<0.01) and stent diameter (r=-0.480, P<0.001). All the stents were assessable in lumen visibility with an average visible lumen diameter percentage of 60.7%+/-13.6%. Visible lumen diameter percentage was correlated to heart rate (r=-0.193, P<0.05), stent diameter (r=0.403, P<0.001), and stent image quality score (r=-0.500, P<0.001). Visible lumen diameter percentage also varied depending on the stent type. In comparison with the conventional coronary angiography, 4 of 6 in-stent stenoses were correctly detected. The sensitivity and specificity for the detection of in-stent stenosis were 66.7% and 84.6%, respectively.

CONCLUSIONSUsing a 64-slice CT, the stent lumen is partly visible in most of the stents. And 64-slice CT may be useful in the assessment of stent patency.

Adult ; Aged ; Angioplasty, Balloon, Coronary ; Coronary Stenosis ; diagnostic imaging ; therapy ; Drug-Eluting Stents ; Female ; Humans ; Male ; Middle Aged ; Radiographic Image Interpretation, Computer-Assisted ; Retrospective Studies ; Tomography, X-Ray Computed