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This document discusses the promises and limitations of fast CT angiography for coronary artery imaging. It summarizes that CT techniques have improved over time, with multislice spiral CT now able to acquire images with high spatial resolution and good contrast in less than 500 ms. However, temporal resolution remains a challenge, especially at higher heart rates. CT coronary angiography has high negative predictive value for ruling out significant stenoses when image quality is sufficient, but it cannot replace cardiac catheterization and has limitations for patients with arrhythmias or unevaluable arteries. The detection of coronary plaque is also discussed as a potential role for CT, but accuracy and reproducibility require further study.
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CT Angiography presentation
This document outlines the protocol for performing CT angiography (CTA) from the cerebral arteries to the lower limbs. It discusses indications for CTA including aneurysms, stenosis, dissections, and more. The preparation, positioning, and scanning protocols are provided for CTA of the head to lower limbs as well as the subclavian arteries. Pediatric protocols are also summarized. The document concludes with examples of CTA findings and references.
Ct in cardiac emergency
CT scans are useful for evaluating patients presenting with cardiac emergencies like acute chest pain. Coronary CT angiography can effectively rule out obstructive coronary artery disease with high sensitivity and specificity. It allows for rapid diagnosis and safe discharge of low-to-intermediate risk patients. CT pulmonary angiography is also useful for evaluating pulmonary embolism with sensitivities from 53-100%. CT is fast, widely available, and can identify alternative cardiac and extracardiac causes of chest pain like aortic dissection. Recent guidelines give a class IIa recommendation for using coronary CT as an alternative to stress testing in appropriate patients.
Angio ct of heart and blood vessels
A CT angiogram uses X-rays and contrast dye to provide detailed pictures of the heart and blood vessels. It can diagnose and evaluate diseases of the blood vessels like injuries, aneurysms, and blockages. During the procedure, an IV catheter is inserted and contrast dye is injected to make the blood vessels appear bright white on the scans. CT angiography provides precise anatomical details and is less invasive than catheter angiography, though it does expose the patient to a small amount of radiation.
Cardiac ct how i do it september 2011
This document provides guidance on performing and interpreting coronary CT scans. It outlines steps for patient selection, protocols for calcium scoring and angiography images, and checklists for evaluating different anatomical areas. Key areas to examine include the coronary arteries, heart chambers, great vessels, lungs, mediastinum, abdomen, bones and skin/breasts. Specific pathological conditions are mentioned such as aneurysms, thrombi, stenoses, and valve abnormalities.
Mdct coronary
Cardiac CT and coronary CTA can play an important role in diagnosing cardiac patients. Coronary CTA is useful for ruling out obstructive coronary artery disease. Newer multislice CT scanners ranging from 4 to 320 slices allow for faster scanning times and better imaging of the heart. Proper patient preparation including beta blockers, fasting, and controlling heart rate are important for obtaining diagnostic images. Coronary CTA can detect obstructive coronary lesions, evaluate stents and grafts, and perform calcium scoring for risk stratification. It can also detect other cardiac abnormalities.
Cardiac ct ccta
Cardiac CT provides a noninvasive way to evaluate the coronary arteries and cardiac structure. It has largely replaced invasive coronary angiography due to improvements in temporal and spatial resolution allowing for clear images of the heart. Cardiac CT is indicated to rule out coronary artery disease in low-moderate risk patients, assess anomalies, evaluate grafts and stents, and aid in surgical planning. It has limitations including irregular heart rates over 80 bpm, high calcium scores, small vessels, and radiation exposure. Proper patient selection and preparation are important to optimize results.
Aarthi scan's
64 slice CT provides high resolution isotropic imaging that allows for improved diagnosis in cardiac, vascular, musculoskeletal and other applications. It provides advantages over older CT technologies such as reduced scan times allowing for single breathhold cardiac imaging. Cardiac applications include calcium scoring, assessment of coronary arteries and function. It is useful for evaluation of coronary artery disease in asymptomatic or symptomatic patients. Post processing techniques such as MIP and VRT allow sharp depiction of coronary arteries. While it has few disadvantages like artifacts from calcium and stents, 64 slice CT provides a non-invasive alternative to angiography for evaluation of many conditions.
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CT Angiography presentation
This document outlines the protocol for performing CT angiography (CTA) from the cerebral arteries to the lower limbs. It discusses indications for CTA including aneurysms, stenosis, dissections, and more. The preparation, positioning, and scanning protocols are provided for CTA of the head to lower limbs as well as the subclavian arteries. Pediatric protocols are also summarized. The document concludes with examples of CTA findings and references.
Ct in cardiac emergency
CT scans are useful for evaluating patients presenting with cardiac emergencies like acute chest pain. Coronary CT angiography can effectively rule out obstructive coronary artery disease with high sensitivity and specificity. It allows for rapid diagnosis and safe discharge of low-to-intermediate risk patients. CT pulmonary angiography is also useful for evaluating pulmonary embolism with sensitivities from 53-100%. CT is fast, widely available, and can identify alternative cardiac and extracardiac causes of chest pain like aortic dissection. Recent guidelines give a class IIa recommendation for using coronary CT as an alternative to stress testing in appropriate patients.
Angio ct of heart and blood vessels
A CT angiogram uses X-rays and contrast dye to provide detailed pictures of the heart and blood vessels. It can diagnose and evaluate diseases of the blood vessels like injuries, aneurysms, and blockages. During the procedure, an IV catheter is inserted and contrast dye is injected to make the blood vessels appear bright white on the scans. CT angiography provides precise anatomical details and is less invasive than catheter angiography, though it does expose the patient to a small amount of radiation.
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This document provides guidance on performing and interpreting coronary CT scans. It outlines steps for patient selection, protocols for calcium scoring and angiography images, and checklists for evaluating different anatomical areas. Key areas to examine include the coronary arteries, heart chambers, great vessels, lungs, mediastinum, abdomen, bones and skin/breasts. Specific pathological conditions are mentioned such as aneurysms, thrombi, stenoses, and valve abnormalities.
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Cardiac CT and coronary CTA can play an important role in diagnosing cardiac patients. Coronary CTA is useful for ruling out obstructive coronary artery disease. Newer multislice CT scanners ranging from 4 to 320 slices allow for faster scanning times and better imaging of the heart. Proper patient preparation including beta blockers, fasting, and controlling heart rate are important for obtaining diagnostic images. Coronary CTA can detect obstructive coronary lesions, evaluate stents and grafts, and perform calcium scoring for risk stratification. It can also detect other cardiac abnormalities.
Cardiac ct ccta
Cardiac CT provides a noninvasive way to evaluate the coronary arteries and cardiac structure. It has largely replaced invasive coronary angiography due to improvements in temporal and spatial resolution allowing for clear images of the heart. Cardiac CT is indicated to rule out coronary artery disease in low-moderate risk patients, assess anomalies, evaluate grafts and stents, and aid in surgical planning. It has limitations including irregular heart rates over 80 bpm, high calcium scores, small vessels, and radiation exposure. Proper patient selection and preparation are important to optimize results.
Aarthi scan's
64 slice CT provides high resolution isotropic imaging that allows for improved diagnosis in cardiac, vascular, musculoskeletal and other applications. It provides advantages over older CT technologies such as reduced scan times allowing for single breathhold cardiac imaging. Cardiac applications include calcium scoring, assessment of coronary arteries and function. It is useful for evaluation of coronary artery disease in asymptomatic or symptomatic patients. Post processing techniques such as MIP and VRT allow sharp depiction of coronary arteries. While it has few disadvantages like artifacts from calcium and stents, 64 slice CT provides a non-invasive alternative to angiography for evaluation of many conditions.
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CARDIAC_CT_PRESENTATION
Cardiac CT is a specialized type of CT scan used to image the heart. It works by rapidly taking multiple X-ray images as the patient is moved through the scanner, and uses techniques like ECG gating and beta blockers to slow the heart rate and improve images of the moving organ. Cardiac CT is useful for evaluating symptoms of chest pain or breathlessness when other tests are inconclusive, and can also check on surgical repairs like stents or bypass grafts. Good candidates are symptomatic or asymptomatic patients where heart disease needs ruling out, while arrhythmias, renal failure or an uncooperative patient are contraindications unless pre-treated.
Cardiac ct
Cardiac CT uses X-rays and computer technology to image the heart and coronary arteries. It can detect calcium buildup in arteries, assess coronary arteries via angiography, and evaluate heart function. The test involves injecting contrast dye and potentially heart rate control drugs. Images are taken rapidly during breath-holds to freeze heart motion. Cardiac CT can diagnose heart disease by identifying plaque and blockages without the risks of angiography.
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Coronary CT angiography allows for noninvasive imaging of the heart and coronary arteries. It can be used to evaluate patients with chest pain, assess coronary arteries after revascularization, and detect congenital coronary anomalies. The scan involves a non-contrast scan for calcium scoring followed by a contrast-enhanced scan. Proper patient preparation including beta-blockers and nitroglycerin is important. Images are analyzed using techniques like multiplanar reformation, maximum intensity projection, volume rendering and curved reformation to evaluate coronary artery anatomy and detect any stenosis.
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Non-invasive imaging plays an important role in the management of cardiovascular diseases. Different imaging modalities have advantages and limitations. Echocardiography is useful for assessing cardiac structure and function but limited for coronary artery disease evaluation. Nuclear imaging can evaluate perfusion and function but not coronary anatomy directly. CT and MRI can assess coronary anatomy in addition to function but CT involves radiation. The appropriate choice of imaging modality depends on the clinical question and no single test can replace all others for evaluating cardiovascular diseases. Integrating complementary information from different tests provides the most comprehensive assessment.
Ct angio ppt
CT provides noninvasive evaluation of cardiac structure and function. It uses ionizing radiation and reconstruction algorithms to form images. Advancements include increasing detector rows for wider coverage and shorter scan times. CT can assess coronary calcium scoring, coronary angiography, bypass graft/stent patency, cardiac morphology/function, and pericardial diseases. It is useful for diagnosing chest pain, coronary anomalies, and evaluating surgical candidates. Risks include radiation exposure and contrast nephropathy, so appropriate patient selection is important.
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This document discusses the evolution and advances in coronary CT angiography (CCTA) technology and its role in the assessment of coronary artery disease (CAD). Key points include:
- CCTA has advanced from early CT scanners with 4-minute scan times to modern multi-detector scanners that can image the entire heart in a single heartbeat.
- CCTA provides information on coronary artery anatomy, plaque characteristics, and has prognostic value when assessing coronary artery calcium scoring.
- CCTA has good accuracy for detecting CAD compared to invasive coronary angiography, especially for ruling out disease, though its role in asymptomatic patients is still unclear.
- CCTA is useful for evaluating coronary anomalies, bypass grafts,
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CT angiography plays an important role in diagnosing coronary artery anomalies. It provides detailed 3D images of the coronary arteries with high spatial and temporal resolution in a noninvasive manner. Proper patient preparation including beta blockers to lower heart rate and nitroglycerin to dilate arteries is important for optimal imaging. CT angiography can detect various types of anomalies such as anomalous coronary artery origins, fistulas, myocardial bridging, and duplication of arteries. It serves as a roadmap for cardiologists in guiding patient management.
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053 histologic evidence of spio accumulation in vulnerable plaques
053 histologic evidence of spio accumulation in vulnerable plaquesSociety for Heart Attack Prevention and Eradication
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CARDIAC_CT_PRESENTATION
Cardiac CT is a specialized type of CT scan used to image the heart. It works by rapidly taking multiple X-ray images as the patient is moved through the scanner, and uses techniques like ECG gating and beta blockers to slow the heart rate and improve images of the moving organ. Cardiac CT is useful for evaluating symptoms of chest pain or breathlessness when other tests are inconclusive, and can also check on surgical repairs like stents or bypass grafts. Good candidates are symptomatic or asymptomatic patients where heart disease needs ruling out, while arrhythmias, renal failure or an uncooperative patient are contraindications unless pre-treated.
Cardiac ct
Cardiac CT uses X-rays and computer technology to image the heart and coronary arteries. It can detect calcium buildup in arteries, assess coronary arteries via angiography, and evaluate heart function. The test involves injecting contrast dye and potentially heart rate control drugs. Images are taken rapidly during breath-holds to freeze heart motion. Cardiac CT can diagnose heart disease by identifying plaque and blockages without the risks of angiography.
Basics of CCTA
Coronary CT angiography allows for noninvasive imaging of the heart and coronary arteries. It can be used to evaluate patients with chest pain, assess coronary arteries after revascularization, and detect congenital coronary anomalies. The scan involves a non-contrast scan for calcium scoring followed by a contrast-enhanced scan. Proper patient preparation including beta-blockers and nitroglycerin is important. Images are analyzed using techniques like multiplanar reformation, maximum intensity projection, volume rendering and curved reformation to evaluate coronary artery anatomy and detect any stenosis.
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Non-invasive imaging plays an important role in the management of cardiovascular diseases. Different imaging modalities have advantages and limitations. Echocardiography is useful for assessing cardiac structure and function but limited for coronary artery disease evaluation. Nuclear imaging can evaluate perfusion and function but not coronary anatomy directly. CT and MRI can assess coronary anatomy in addition to function but CT involves radiation. The appropriate choice of imaging modality depends on the clinical question and no single test can replace all others for evaluating cardiovascular diseases. Integrating complementary information from different tests provides the most comprehensive assessment.
Ct angio ppt
CT provides noninvasive evaluation of cardiac structure and function. It uses ionizing radiation and reconstruction algorithms to form images. Advancements include increasing detector rows for wider coverage and shorter scan times. CT can assess coronary calcium scoring, coronary angiography, bypass graft/stent patency, cardiac morphology/function, and pericardial diseases. It is useful for diagnosing chest pain, coronary anomalies, and evaluating surgical candidates. Risks include radiation exposure and contrast nephropathy, so appropriate patient selection is important.
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This document discusses the evolution and advances in coronary CT angiography (CCTA) technology and its role in the assessment of coronary artery disease (CAD). Key points include:
- CCTA has advanced from early CT scanners with 4-minute scan times to modern multi-detector scanners that can image the entire heart in a single heartbeat.
- CCTA provides information on coronary artery anatomy, plaque characteristics, and has prognostic value when assessing coronary artery calcium scoring.
- CCTA has good accuracy for detecting CAD compared to invasive coronary angiography, especially for ruling out disease, though its role in asymptomatic patients is still unclear.
- CCTA is useful for evaluating coronary anomalies, bypass grafts,
Coronary CT
The document provides an overview of coronary CT angiography (CCTA). It discusses recent advances in CCTA technology including perfusion imaging, spectral imaging, and fractional flow reserve CT (FFR-CT). The anatomy and physiology of the coronary arteries is described. The document outlines the equipment, indications, procedures, and post-processing techniques used in CCTA. It also discusses calcium scoring, artifacts, case studies, radiation dose, and limitations of CCTA.
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CT angiography plays an important role in diagnosing coronary artery anomalies. It provides detailed 3D images of the coronary arteries with high spatial and temporal resolution in a noninvasive manner. Proper patient preparation including beta blockers to lower heart rate and nitroglycerin to dilate arteries is important for optimal imaging. CT angiography can detect various types of anomalies such as anomalous coronary artery origins, fistulas, myocardial bridging, and duplication of arteries. It serves as a roadmap for cardiologists in guiding patient management.
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Thoracic aortic aneurysms can occur in the ascending aorta, aortic arch, or descending aorta. They are generally asymptomatic but can potentially rupture or dissect, leading to death. Surgical repair is recommended for thoracic aortic aneurysms over 5.5 cm in the ascending aorta or over 6.5 cm in the descending aorta, or if the aneurysm is growing rapidly. Both open surgical graft replacement and endovascular stent grafting are options for repair, with endovascular approaches having shorter recovery but risk of complications like endoleaks. Untreated thoracic aortic aneurysms have high mortality from rupture.
Usefulness of new imaging techniques
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This document discusses computed tomography angiography (CTA) and its applications in cardiology. CTA uses computed tomography to visualize blood vessels throughout the body, including coronary arteries. Coronary CTA can detect plaque buildup in coronary arteries without being invasive. Current multidetector CT systems can acquire high-resolution images of the heart within 20 seconds while the patient holds their breath. Coronary CTA provides diagnostic information but also exposes patients to radiation. It is most useful for evaluating cardiac symptoms in low-to-intermediate risk patients.
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This document summarizes the role of the immune system in atherosclerosis. It finds that:
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This document provides an overview of the new VP.org website and its goals of promoting research on vulnerable plaque (VP). Key points:
1) The website will include an online library called "Atheroline" with medical literature and multimedia about atherosclerosis and VP.
2) A toolbar will provide one-click access to VP-related information resources.
3) Members can customize "Personal VP Watch" alerts on new science, patents, and industry news.
4) An upcoming VP symposium is announced to bring together researchers and industry. The overall aim is to accelerate VP detection and treatment to ultimately eradicate heart attacks.
Jay cohn md aha 04 aeha conf
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2) Mice vaccinated against IL-12 developed less atherosclerosis with more stable plaque phenotypes.
3) Vaccinated plaques had reduced inflammation, as shown by decreased IFN-γ staining.
045 how can we identify the plaque at risk of rupture or thrombosis
045 how can we identify the plaque at risk of rupture or thrombosisSociety for Heart Attack Prevention and Eradication
1. Temperature measurements of living carotid plaques showed heterogeneity, with differences over 0.3°C seen in all specimens and over 2°C in some. Hotter plaques correlated with inflammatory cells and thin caps.
2. Plaque pH also showed heterogeneity and inversely correlated with temperature. Lipid-rich plaques were acidic while calcified plaques were alkaline.
3. These measurements of temperature and pH heterogeneity could provide information on plaque vulnerability and prognosis when used along with other imaging techniques.236 complement inhibitor
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221 images of 3 mice
Atherosclerotic plaque contains iron positive cells such as subendothelial macrophages. Macrophages accumulate in the layers of arteries and contribute to the formation of atherosclerotic plaque. The presence of iron positive macrophages is a characteristic of atherosclerotic plaque buildup in arteries.
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I. Optical coherence tomography (OCT) is a new imaging technique that uses near-infrared light to provide high resolution cross-sectional images of tissue. OCT offers 10-20 times higher resolution than intravascular ultrasound (IVUS).
II. Early studies show OCT can visualize features of coronary plaques in living patients, such as thin fibrous caps, better than IVUS. This suggests OCT may help identify vulnerable plaques at risk of rupturing.
III. Researchers are exploring using catheter-based OCT to image plaques throughout the coronary arteries and determine if OCT can distinguish active, inflamed plaques.
Vp watch2002
I. This document discusses various animal models that have been used to study atherosclerosis and plaque rupture, including quail, pigeons, chickens, dogs, monkeys, pigs, rats, rabbits, and mice. It provides details on the types of lesions developed and similarities to human disease for each model.
II. The double knockout LDL/apoE mice are highlighted as offering improvements in studying clinical complications of atherosclerosis like human heart disease. However, it is unclear how closely they model vulnerable plaques.
III. Questions are raised about how closely the coagulation systems of these animal models resemble humans and whether any model fully captures repeated plaque ruptures and the role of aging in natural history as seen in humans.
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The document summarizes a meeting on vulnerable plaque research between UT-THI and Rice Coalition. It provides background on vulnerable plaque, describing it as dangerous forms of fat buildup in the arterial wall that can rupture or induce thrombosis. It reviews the history of research in this area dating back to the 19th century, and profiles the many contributors to the field. The remainder discusses emerging techniques for detecting vulnerable plaque, both invasive methods like intravascular ultrasound and non-invasive methods like MRI. The goal is to better identify high-risk plaque and prevent heart attacks.
235 does cd40 link atherosclerosis to thrombosis
This document discusses the role of CD40 and its ligand CD40L in atherosclerosis and thrombosis. It reports that CD40L plays multiple roles in inflammatory processes in atherosclerotic plaques by inducing cytokine production, stabilizing platelet-rich thrombi, and inhibiting re-endothelialization after injury. Studies show CD40L is expressed on immune cells like lymphocytes and platelets and activates CD40 on endothelial cells and macrophages in plaques. High levels of soluble CD40L in the blood may be associated with increased cardiovascular risk. CD40L is suggested as a potential marker of plaque vulnerability and predictor of prognosis in acute coronary syndrome patients.
Non invasive detection of vulnerable plaque using spio enhanced mri
Non invasive detection of vulnerable plaque using spio enhanced mriSociety for Heart Attack Prevention and Eradication
This document discusses a study on detecting vulnerable plaque using SPIO enhanced MRI. It begins by defining vulnerable plaque as atherosclerotic plaques that can suddenly form blood clots and lead to heart attacks and strokes. It then discusses different types of vulnerable plaque and how plaque morphology alone may not determine outcomes. The study aims to image both plaque morphology and activity using MRI with SPIO contrast agents that can identify inflammation, leaky blood vessels, and intra-plaque hemorrhage. In vitro experiments show macrophages effectively take up SPIO particles, reducing T2 relaxation time, and produce reactive oxygen species upon phagocytosis. In vivo studies in atherosclerotic mice also show SPIO uptake in arterial walls. The goal is to non-059 can oct catheter see plaque macrophages
- Optical coherence tomography (OCT) is a high-resolution imaging technique analogous to ultrasound that uses near-infrared light instead of sound waves. OCT was originally developed for eye imaging and can now be adapted for catheter-based coronary artery imaging.
- Ex vivo studies have shown that OCT, with its 10-20 micron resolution, can characterize atherosclerotic plaque components like fibrous tissue, lipid pools, and calcification. It can also quantify macrophage content in plaque caps.
- In vivo porcine and human studies demonstrate OCT's feasibility for imaging normal coronary arteries, stents, and plaque types like lipid-rich plaques with higher resolution than IVUS. This suggests OCT may be able to completely replace
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053 histologic evidence of spio accumulation in vulnerable plaques
053 histologic evidence of spio accumulation in vulnerable plaques
045 how can we identify the plaque at risk of rupture or thrombosis
045 how can we identify the plaque at risk of rupture or thrombosis
Non invasive detection of vulnerable plaque using spio enhanced mri
Non invasive detection of vulnerable plaque using spio enhanced mri
Similar to 072 ct angiography
Stephanes talk aeha
Emerging CT technologies are improving cardiac imaging capabilities. Multi-detector spiral CT has increased slices from 4 to 64, improving spatial resolution but still limited by cardiac motion. Future technologies aim to image the whole heart in one beat through faster rotation and more slices to reduce motion artifacts. However, simply adding slices does not solve resolution and radiation issues. Significant advances in temporal resolution, better software, and single heart beat imaging are needed to optimize cardiac CT imaging.
Lecture vienna september 16 2005
This document summarizes the use of noninvasive MDCT imaging of the coronary arteries. It discusses the challenges of imaging small, rapidly moving coronary vessels. MDCT allows for successful coronary imaging with temporal resolution of 330-400ms, spatial resolution of 0.4-0.75mm, coverage of the heart in a single breath hold of 8-14 seconds. Sensitivity for detecting coronary stenosis is 80-86% for 4-16 slice MDCT and specificity is 90-97%. Potential clinical applications include decreasing invasive angiograms, improving risk assessment, detecting anomalies, and evaluating bypass grafts. Larger clinical trials are still needed to determine the impact on patient management.
Acute brain attack 911
The document provides guidelines for diagnosing and managing different types and severities of acute brain attacks or strokes. It discusses classifying strokes as TIA, mild, moderate or severe based on symptoms. For TIA and mild strokes, the guidelines recommend emergent diagnostic tests like CT scan and treating conditions like high blood pressure. For moderate strokes, the priorities are supportive care, monitoring vitals, diagnostics like blood tests and CT scan. The guidelines provide recommendations for diagnosing the type of stroke and identifying underlying causes through further diagnostic testing.
121 non invasive imaging of coronary arteries
CT, MRI, and EBCT are competing techniques for non-invasive coronary artery imaging, each with advantages and disadvantages. MR angiography has improved in recent years but still has limited spatial and temporal resolution and high costs. Studies have shown CT and EBCT can detect coronary artery calcium and accurately characterize plaque, with EBCT able to predict coronary events. Multi-slice CT has increasing diagnostic accuracy for coronary stenosis compared to invasive angiography. Advances in CT and MRI continue to improve non-invasive assessment of coronary arteries and plaque.
121 non invasive imaging of coronary arteries
CT, MRI, and EBCT are competing techniques for non-invasive coronary artery imaging, each with advantages and disadvantages. MR angiography has improved in recent years but still has limited spatial and temporal resolution and high costs. Studies have shown CT and EBCT can detect coronary artery calcium and accurately characterize plaque, with EBCT able to quantify plaque burden. Multi-slice CT has increasing diagnostic accuracy for coronary stenosis compared to invasive angiography. Advances in CT and MRI continue to improve non-invasive assessment of coronary arteries and plaque components.
Cardiac CT.pptx
Cardiac CT and MRI can be used to evaluate the heart and coronary arteries. Cardiac CT uses calcium scoring to detect calcifications and assess risk of heart events. Coronary CT angiography uses contrast injection and ECG-gating to obtain images of the coronary arteries and detect stenoses. Retrospective and prospective ECG-gating techniques are used to optimize image quality while reducing radiation dose. Cardiac MRI provides better soft tissue definition than CT but poorer coronary artery imaging. It uses dark blood spin echo sequences and white blood gradient echo sequences to obtain anatomical and functional images of the heart without radiation.
Cardiac CT
This presentation deals with the image reconstruction, technique, artifacts and radiation risk associated with cardiac ct scanning.
Spect ct -dan berman
SPECT/CT shows promise for atherosclerosis imaging by combining anatomical CT imaging of plaque volume with molecular SPECT imaging of plaque activity. SPECT could potentially image multiple molecular processes simultaneously, such as apoptosis, oxidized LDL, or inflammation. Recent advances in SPECT technology include improved resolution, sensitivity, and the ability to perform dynamic cardiac SPECT to quantify blood flow and endothelial function. Pairing molecular SPECT imaging with anatomical CT may allow characterization of plaque vulnerability beyond quantification of volume. However, further developments are still needed including new tracers, multimodality technology, and software.
Berman shape 05 fin
SPECT/CT shows promise for atherosclerosis imaging by combining anatomical CT imaging of plaque volume with molecular SPECT imaging of plaque activity. SPECT could potentially image multiple molecular processes simultaneously, such as apoptosis, oxidized LDL, or inflammation. Recent advances in SPECT technology include improved resolution, sensitivity, and the ability to perform dynamic cardiac SPECT to quantify blood flow and endothelial function. Combined structural and molecular imaging may allow more accurate risk assessment and monitoring of treatment response than anatomical methods alone. However, further developments are still needed, including new tracers approved for human use.
Ec ic bypass
1. The history of cerebral revascularization began in 1942 with various techniques being developed through the 1970s including EDAMS, CCA-ICA bypass, and STA-MCA bypass.
2. Revascularization can be direct, using vessel to vessel anastomoses, or indirect, promoting new capillary formation. Direct techniques provide immediate flow but require a recipient vessel over 1mm, while indirect revascularization relies on collateral formation.
3. Common indications for revascularization include moyamoya disease, complex aneurysms, skull base tumors, and cerebral ischemia. However, recent studies found no benefit for revascularization over medical management for treating ischemia.
introduction
The document discusses coronary artery stenosis analysis using CT coronary angiography. It provides background on CT imaging and describes advances in multislice CT technology that have improved cardiac imaging. Key aspects covered include axial vs helical scanning, prospective vs retrospective gating, spatial and temporal resolution, radiation dose, and anatomy of the coronary arteries.
magnetic resonance angiography
1. Magnetic resonance angiography (MRA) is a non-invasive imaging technique that uses magnetic resonance imaging to visualize blood vessels and evaluate vascular anatomy and blood flow without using ionizing radiation or iodinated contrast material.
2. There are different MRA techniques including time-of-flight MRA, phase contrast MRA, and contrast-enhanced MRA. Time-of-flight MRA relies on differences in flowing and stationary blood signal while phase contrast MRA assesses velocity and direction of flow. Contrast-enhanced MRA uses gadolinium contrast to improve vessel depiction.
3. MRA has various clinical applications for evaluating carotid and intracranial arterial stenosis, aneurysms,
Upper Extrem CT Venography_Hallett_2017_sm.pdf
CT venography is a technique used to assess venous anatomy and determine patency. It can be performed using direct or indirect methods. Direct CTV involves slowly infusing diluted contrast directly into veins of interest. Indirect CTV uses a larger bolus of full-strength contrast followed by a delayed scan to image recirculating contrast in the veins. CTV provides non-invasive evaluation of venous anatomy from the upper extremities to the pelvis with good spatial resolution and ability to combine with arterial imaging. It is useful for evaluating issues like deep vein thrombosis, thoracic outlet syndrome, and superior vena cava syndrome.
Tcd sandeep.ppt.oct 2009.ppt
Transcranial Doppler (TCD) uses ultrasound to evaluate blood flow velocity in the brain's intracranial arteries. It is a noninvasive technique that uses probes placed on the head to transmit ultrasound pulses through thin parts of the skull and detect the Doppler shift of reflected signals from moving blood. TCD allows evaluation of conditions like stenosis, occlusion, vasospasm, and collateral flow. It can be used to monitor blood flow during surgery or in intracranial hemorrhage. Interpretation requires identifying vessels based on depth, direction of flow, and spatial relationships to other vessels. The vertebrobasilar system can be more difficult to evaluate due to anatomical variability.
TRANS-CRANIAL DOPPLER
Trans-Cranial Doppler (TCD) is a non-invasive ultrasound technique used to evaluate cerebral blood flow velocities. There are two main types of TCD devices - non-duplex devices which identify arteries "blindly" based on Doppler shift and duplex devices which combine Doppler with B-mode imaging to directly visualize arteries. TCD allows evaluation of intracranial steno-occlusive disease, vasospasm, aneurysms, and other conditions. It can detect elevated velocities indicative of stenosis but has limitations including operator dependence and inability to image distal arteries. TCD is useful for monitoring conditions like sickle cell disease where elevated velocities increase stroke risk.
Nguyen khoi viet cardiac mri for the evaluation of ischemic heart disease jfi...
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Cardiac MRI can be used to evaluate ischemic heart disease through various techniques:
1) Stress perfusion MRI can detect myocardial ischemia with high sensitivity and specificity compared to other modalities like SPECT.
2) Dobutamine stress MRI evaluates cardiac function and wall motion abnormalities under stress, identifying areas of ischemia.
3) Delayed enhancement MRI precisely determines infarct size and identifies viable versus non-viable tissue for evaluating prognosis and treatment.
Cardiac MRI provides a comprehensive non-invasive approach for assessing ischemic heart disease.Snm 09 Presentation Hkb
This study compared the results of 82Rb PET/CT myocardial perfusion imaging (MPI) to cardiac catheterization for 36 obese patients at St. Joseph's Hospital in Wisconsin. 32 of the 36 MPI scans matched the catheterization results, confirming the diagnostic quality of 82Rb PET/CT MPI. The higher gamma energy of 82Rb allows for higher quality images in obese patients compared to conventional MPI methods. 82Rb PET/CT MPI takes less time than other protocols, improving patient experience and clinic throughput.
Vascular Ultrasound
Fundamentals of Vascular Ultrasound.
Looking at the basics of carotid, lower extremity arterial, renal, celiac, SMA studies, as well as touching on venous insufficiency. Part I of series.
Carotid artery disease
The document describes the anatomy of the carotid arteries and their branches, evaluation and imaging of carotid artery disease, and treatment strategies including lifestyle modifications to reduce risk factors, carotid endarterectomy to remove plaques from significantly stenotic arteries, and outcomes data from clinical trials on endarterectomy for symptomatic and asymptomatic carotid stenosis. Imaging modalities like carotid duplex ultrasound, CTA, and MRA are described for evaluating the degree of carotid stenosis. The benefits of carotid endarterectomy are greater for symptomatic high-grade stenosis while more moderate for asymptomatic disease.
Carotid artery diseases and carotid stenting
This document discusses carotid artery disease and carotid stenting procedures. It provides background on carotid artery atherosclerosis and how vulnerable plaques can lead to strokes. It then summarizes recommendations for imaging the carotid arteries, managing asymptomatic and symptomatic carotid stenosis medically or with endovascular techniques. Key steps in carotid stenting procedures are outlined, including access methods, angiography, and delivery of protection devices and stents. Risk factors, anatomy, and techniques are discussed to help plan the optimal approach.
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Nguyen khoi viet cardiac mri for the evaluation of ischemic heart disease jfi...
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AHA SHAPE Symposium 2017 Dr. Naghavi Presentation
AHA SHAPE Symposium 2017 Dr. Naghavi PresentationSociety for Heart Attack Prevention and Eradication
This document discusses developing an artificial intelligence system to predict short-term cardiovascular disease (CVD) events. The goal is to eradicate unexpected heart attacks by predicting risk similar to hurricane forecasts. Existing studies are cited that show over 50% of heart attacks are first symptoms of underlying disease. The document outlines previous work by SHAPE to define vulnerable patients and release guidelines. It proposes using machine learning on existing cohort data to develop algorithms predicting heart attacks within 12 months, and validate the system. The hope is this can trigger preventative actions and add over 10 years to life expectancy. Funding is needed to implement the proposed "Machine Learning Vulnerable Patient Project".AHA SHAPE Symposium 2017 Dr. Kloner Presentation
Triggers of cardiovascular events can include physical and emotional stress. Stress from events like earthquakes, blizzards, intense sporting games, and overexertion from activities like snow shoveling have been shown to increase the risk of acute cardiovascular outcomes like myocardial infarction. While modern therapies have improved cardiovascular health, research continues to show temporary increases in cardiovascular mortality associated with highly emotional sporting events even in recent years. Managing risk factors, reducing stress, and utilizing preventative therapies may help reduce the impact of triggers on cardiovascular health.
AHA SHAPE Symposium 2017 Dr. Greenland Presentation
AHA SHAPE Symposium 2017 Dr. Greenland PresentationSociety for Heart Attack Prevention and Eradication
The document introduces the All of Us Research Program, which aims to collect health data from one million Americans to advance precision medicine research. It was announced by President Obama in 2015. The program receives funding from the federal government and private partners. It collects various types of health data from participants through surveys, health records, samples, and devices. The data is stored and shared securely while protecting privacy. The goal is to generate new medical discoveries and more personalized healthcare through collaboration between researchers and participants.AHA SHAPE Symposium 2017 Dr. Yen Presentation
A machine learning model outperformed the ACC/AHA Pooled Cohort Equations Risk Calculator in detecting high-risk asymptomatic individuals and recommending statin treatment for cardiovascular disease prevention in the Multi-Ethnic Study of Atherosclerosis. The machine learning model used support vector machines and data augmentation to derive a CVD risk predictor from nine variables in the MESA study population. It demonstrated higher sensitivity, specificity, and AUC compared to the ACC/AHA risk calculator, recommending statin treatment for fewer individuals while missing fewer cardiovascular events.
AHA SHAPE Symposium 2017 Dr. Slomka Presentation
This document discusses machine learning applications in cardiac imaging presented by Piotr Slomka. It describes how machine learning can improve image analysis, diagnosis, and risk prediction. Machine learning combines multiple data points like imaging and clinical data to predict outcomes. Deep learning can perform tasks like image segmentation. Machine learning provides quantitative scores that predict disease, need for intervention, or patient outcomes to help clinicians. The goal is to integrate machine learning into clinical decision making.
Vu lplaque1 pasterkamp
This document summarizes a post-mortem study examining the prevalence of inflammatory cells in non-ruptured atherosclerotic plaques. The study found that moderate or heavy staining for macrophages was present in 45% of femoral artery cross-sections and 84% of femoral arteries had at least one cross-section with moderate/heavy inflammation. There was no observed relationship between the degree of inflammation in the left and right coronary arteries within individuals, indicating the level of local inflammation is locally determined with little predictive value for other arteries.
Vulnerable plaque vulnerable patient
The document provides guidelines for defining vulnerable plaque and vulnerable patients from the Association for Eradication of Heart Attack. It outlines major and minor histopathological and clinical criteria for vulnerable plaque including active inflammation, thin fibrous cap with large lipid core, endothelial denudation, and stenosis. Potential screening and diagnostic methods are discussed at the plaque, systemic, and blood levels ranging from non-invasive imaging to intravascular techniques. Different types of vulnerable plaque that can cause acute coronary events are also categorized.
Vulnerable plaque overview
Vulnerable plaque refers to dangerous forms of atherosclerotic plaques that can rupture or induce thrombosis, disrupting blood flow. The document discusses the history and research around vulnerable plaque, including pioneers in the field and emerging techniques to detect vulnerable plaque such as intravascular ultrasound, optical coherence tomography, and magnetic resonance imaging. It summarizes that vulnerable plaques are typically characterized by a thin fibrous cap, large lipid core, and presence of macrophages.
Vulnerable patient talk in poland
The document summarizes research on vulnerable plaques and markers of vulnerability. It finds that ruptured plaques are the most common type of culprit lesion, accounting for around 70% of cases. Major criteria for defining vulnerable plaque include outward remodeling, endothelial dysfunction, and a thin fibrous cap with a large lipid core. Both plaque morphology and activity need to be assessed to identify vulnerability.
Vulnerable patient slides without movies
This document contains a summary of a presentation on vulnerable patient syndrome. It includes PowerPoint slides and videos on defining and identifying vulnerable plaques and patients. It thanks sponsors for their support of the educational event. The slides define vulnerable plaques as those likely to rupture in the future, causing heart attacks, and provide criteria for identifying them based on morphology and activity. Biomarkers and conditions that increase plaque and myocardial vulnerability are also summarized. The presentation outlines a pyramid approach for screening, diagnosing, and treating vulnerable patients annually to help reduce heart attacks and their high costs.
Vulnerable patient mar 04
This document discusses triggers for sudden cardiac arrest (SCA) and death (SCD). It notes that over 2/3 of SCD cases are unable to be predicted due to a lack of well-established risk factors. While population risk factors can identify at-risk groups, they cannot predict risk for individuals. The document explores various biological, anatomical, and environmental factors that can precipitate fatal arrhythmias and discusses how the timing of transient initiating events is critical for the development of ventricular tachyarrhythmias. It emphasizes that myocardial electrophysiological processes likely determine the onset or lack of VT/VF/SCD and that immediate access to automated external defibrillators is needed to save lives.
Vulnerable (thrombogenic blood
This document summarizes presentations from symposia on vulnerable plaque and discusses the relationship between plaque, blood, and patients in atherothrombosis. It notes that multiple factors like diabetes, smoking, and hyperlipidemia can make blood more thrombogenic and moderate the severity of acute events after plaque rupture. Statins, aspirin, and other drugs that target tissue factor or thrombin pathways may be promising antithrombotic agents by inhibiting thrombosis initiation and propagation.
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The document discusses vulnerable plaque and challenges in detecting and treating it. It describes various imaging techniques for detecting vulnerable plaque such as thermography, MRI, CT angiography, and optical coherence tomography. However, it notes that while these can identify high-risk features, it remains unclear what exactly defines vulnerable plaque and whether imaging findings truly correlate with risk. The document also notes that while statins reduce events, the relationship between plaque burden and events is unclear, and better defining and detecting the disease is still needed before new therapies can be developed.
Vuln plaque poster burke
1) The study examined 92 hearts from patients with severe coronary artery disease who died suddenly. The hearts were sectioned and plaque types were classified.
2) The number of "vulnerable" plaques, particularly thin cap atheromas, was highest in hearts of patients who died from acute plaque rupture and lowest in those with incidental disease.
3) Thin cap atheromas and other unstable plaque types were concentrated in the proximal coronary segments, similar to the distribution of plaque ruptures. The study suggests vulnerable plaques contribute to acute coronary syndromes and are non-uniformly distributed within the coronary arteries.
Vp watch editorial_slide 25short-
1) Drug-coated stents, particularly those coated with sirolimus, have shown promise in reducing restenosis compared to bare metal stents. Sirolimus inhibits cell proliferation and has been shown in studies to reduce intimal hyperplasia and restenosis in animal models by 50% or more.
2) A study by Suzuki et al. found that a sirolimus-coated stent reduced restenosis by 50% through inhibiting cellular proliferation in a dose-dependent manner compared to a bare metal stent. Adding dexamethasone to the coating did not provide additional benefit.
3) If results of the RAVEL clinical trial showing "zero" restenosis out to 5 years
Vp watch editorial_slide25
This document discusses drug-coated stents for preventing restenosis. It summarizes a study showing that stents coated with sirolimus via a polymer matrix reduced restenosis by 50% by inhibiting cell proliferation. Adding dexamethasone provided no additional benefit. Other studies also showed sirolimus inhibits smooth muscle cell proliferation. If results of the RAVEL trial showing "zero" restenosis at 210 days hold true long-term, sirolimus-coated stents may become the standard therapy for coronary revascularization. Questions are raised about whether coating vulnerable plaques could be a primary treatment and if multiple vulnerable plaques would all be stented.
Vp watch editorial_slide25short-
1) Drug-coated stents, particularly those coated with sirolimus, have shown promise in reducing restenosis compared to bare metal stents. Sirolimus inhibits cell proliferation and has been shown in studies to reduce intimal hyperplasia and restenosis in animal models by 50% or more.
2) A study by Suzuki et al. found that a sirolimus-coated stent reduced restenosis by 50% through inhibiting cellular proliferation in a dose-dependent manner compared to a bare metal stent. Adding dexamethasone to the coating did not provide additional benefit.
3) If results of the RAVEL clinical trial showing "zero" restenosis out to 5 years
Vp symposium31602
Trans-Blood Vision is a patented infrared technique that uses short-wave infrared wavelengths to see directly through blood. It has the potential to find vulnerable plaque lesions without first entering them, determine their size and surface characteristics in high resolution, and look at their material constituents both on and below the surface. While it cannot provide direct visual guidance for therapy or penetrate as deeply as ultrasound, combining it with augmentative technologies could allow for real-time multi-mode detection, analysis, and therapy guidance of vulnerable plaque lesions. The document concludes that Trans-Blood Vision warrants significant investigation, possibly in combination with other emerging technologies.
Vpschoenhagen
This study used intravascular ultrasound to examine arterial remodeling and plaque characteristics in 131 patients with either stable angina or recent unstable symptoms. Patients with unstable presentations had greater plaque burden at the culprit lesion despite similar luminal narrowing, and a greater extent of positive arterial remodeling compared to those with stable angina. The culprit lesions in unstable patients also showed a higher rate of echolucent plaque morphology. This suggests that bulky, remodeled plaques may be more vulnerable to rupture, leading to acute coronary syndromes. Further prospective study is needed to better understand the relationship between clinical presentation and plaque features.
Vp meeting orlando2003_new template
The document discusses ways to improve prediction of coronary events beyond the traditional Framingham Risk Score (FRS). It finds that adding C-reactive protein (CRP) measurement to the FRS results in a better model that significantly improves risk prediction, especially for those at intermediate risk. Measuring coronary artery calcium via scanning also seems to enhance prediction over the FRS alone. However, these findings require replication in other patient populations before firmly concluding CRP and calcium scoring can modify physician interpretation of patient risk based on the FRS.
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072 ct angiography
- 1. Fast CT Angiography on a Fast Track to Your Practice: Promises and Limitations S. Achenbach Department of Radiology, Massachusetts General Hospital Department of Cardiology, University of Erlangen
- 2. Coronary artery imaging: - small diameters (~1-4 mm) - complex anatomy - rapid motion
- 3. CT Techniques - High spatial resolution - Good contrast - Problem: temporal resolution
- 4. Electron Beam Tomography (EBT) 50 - 100 ms image acquisition time 1.5 mm - 3.0 mm slice thickness
- 5. Electron Beam Tomography (EBT) CT coronary imaging feasible Limitations: 1.5 -3.0 mm slice thickness X-ray power „e-Speed“: 1.5 mm slice thickness 50 ms temporal resolution
- 6. Multislice spiral CT with retrospective ECG gating - Tube rotation: 420-500 ms - Data acquisition in 4-16 slices simultaneously 4 slice CT: ~1.3 mm slices 16 slice CT: ~0.75 mm slices
- 9. MSCT 4 Slice
- 10. EBT
- 11. MSCT 16 slice
- 12. MSCT 16 slice
- 13. MSCT 16 slice
- 14. MSCT 16 slice
- 15. MSCT 16 slice
- 16. n Sens. Spec. n.e. Schmermund JACC 1998 28 82% 88% 12% Reddy Radiology 1998 23 88% 79% 8% Achenbach N Engl J Med 1998 125 92% 94% 25% Ropers Z Kardiol 2000 118 90% 82% 24% Achenbach Heart 2000 36 92% 91% 20% Nieman Lancet 2001 31 81% 97% 27% Achenbach Circulation 2001 64 91% 84% 32% Knez Am J Cardiol 2001 42 78% 98% 6% Kopp Eur Heart J 2002 102 86% 96% 16% Becker JCAT 2003 28 78% 71% 11% Nieman Heart 2002 53 82% 93% 30% Nieman Circulation 2002 59 95% 86% 7% Ropers Circulation 2003 77 93% 92% 12%
- 17. MSCT: Heart Rate < 60/min desirable: oral ß-blockade to all patients EBT/MSCT: Coronary calcium
- 18. LIMITATIONS: Contrast, radiation Sinus rhythm Unevaluable arteries Accuracy = 100% Diagnostic tool with high negative predictive value (~95%) if image quality is sufficient
- 19. CT to replace cardiac cath? „A man with a hammer sees a lot of things that need to be hammered.“ (A radiologist/cardiologist with a spiral CT ...)
- 20. Clinical Indications for MSCT? ... Not for screening ... Not in patients with typical symptoms ... Possibly in patients with relatively low likelihood of signficant stenosis (atypical symptoms, equivocal stress test ...)
- 21. > 20% „rule out“ coronary angiograms
- 22. 100 patients prior to valve surgery: All 36 patients with stenoses identified by EBT. 54 patients: stenoses ruled out.
- 24. Bypass Grafts: EBT 4-slice MSCT 16 slice MSCT
- 25. Nieman et al, Circulation 2002 STENT?
- 26. Detection of Plaque 4- slice MSCT Schröder et al. JACC 2001
- 27. Detection of Plaque 16-slice MSCT
- 28. Detection of Plaque Potential role in risk assessment? - Accuracy / Quantification? - Reproducibility? - Progression over time? - Prognostic value?
- 29. „Fast CT Coronary Angiography“: - Technical issues Heart rate, technology, protocols - „Coronary Angiography“ Potential role to rule out stenoses - „Plaque imaging“? (Potential role for risk stratification)