The present study aimed to identify the patency achieved by a bi-directional Glenn shunt procedure by shaded volume rendering (VR) images using electron-beam computed tomography (EBCT). A Damus Kay-Stanzel type procedure was performed on a female with hypoplastic left heart syndrome who later received a bi-directional Glenn shunt to increase pulmonary blood flow. In considering the characteristics of the bi-directional Glenn shunt procedure, in which the superior vena cava is connected to the right pulmonary artery, an early phase acquisition protocol with injection of contrast material from the right cubital vein using the step volume scan mode of EBCT was planned to acquire blood flow information. Excellent spatial resolution volume data of the heart and great vessels was obtained from which 3-dimensional images were made. Bi-directional Glenn shunt flow could be observed directly and the complex morphology and relationships between adjacent structures were revealed by 3-dimensional VR imaging. The combination of EBCT and VR can provide useful information to evaluate congenital heart diseases.

Adult↗

PubMed2001

Utility of three-dimensional volume rendering images using electron-beam computed tomography to evaluate possible causes of ischemia from an anomalous origin of the right coronary artery from the left sinus of valsalva.

The present study evaluated the usefulness of 3-dimensional volume rendering (VR) images using electron-beam computed tomography (EBCT) in determining the possible causes of ischemia resulting from the anomalous origin of the right coronary artery (RCA) from the left sinus of Valsalva, which coursed between the ascending aorta and pulmonary trunk. Such anomalies could cause ischemia or sudden death without obstructive coronary artery disease. The suggested mechanism is either compression causing closure of the slit-like orifice of the anomalous artery as the aorta dilates with exertion or compression of the anomalous artery by the aorta and pulmonary trunk as it courses between these 2 arteries, which dilate with exercise. A 17-year-old male underwent EBCT coupled with a 100-ml intravenous injection of iodinated contrast medium. Data were reconstructed into 3-dimensional images through VR to evaluate the shape of the orifice and the spatial relationship of the RCA, ascending aorta and pulmonary trunk. Perspective VR showed the shape of the orifice of the left main trunk, which was not slit-like, and cut-plane VR showed the spatial relationship of both the lumen and the surface of the RCA, ascending aorta and pulmonary trunk, providing information on whether the ascending aorta or pulmonary trunk would compress the RCA and cause ischemia.

Adolescent↗

PubMed2000

Usefulness of three-dimensional visualization of coronary arteries using electron-beam computed tomography data with volume rendering.

Three-dimensional images of the coronary arteries using electron-beam computed tomography (EBCT) data with shaded surface rendering makes it possible to achieve images easily with a short reconstruction time. However, a lower threshold is required to estimate vessel diameters and there is a quantitative problem compared with conventional coronary arteriography. In combination with volume rendering, EBCT may be useful to detect the normal coronary artery wall, the major components of the atherosclerotic plaque (lipid, fibrous connective tissue and calcium). EBCT scans offer a new, non-invasive alternative to conventional coronary arteriography for diagnosis of coronary artery disease.

Aged↗

PubMed2000

Qualitative blood flow differentiation: depiction of a left to right cardiac shunt across a ventricular septal defect using electron-beam computed tomography.

Three-dimensional imaging using electron-beam computed tomography (EBCT) has been used to assess static anatomical information in heart disease. With volume rendering, differences in objects can be distinguished through selection of the shape of opacity and color curves for CT values. If there is a difference between the CT values for arterial and venous blood, differences in opacity and color between them can be set. In a newborn baby with a left to right cardiac shunt across the ventricular septal defect (VSD), EBCT could depict arterial blood crossing the VSD into the right ventricle.

Heart Septal Defects, Ventricular↗

PubMed1999

Analysis of the treatment of acute myocardial infarction using ambulance records in Japanese cities.

By means of ambulance records, the current state of medical services for the treatment of acute myocardial infarction (AMI) was investigated in Chiba City and Ichihara City, Japan. From all patients transported by ambulance personnel in 1992 (n=31,191), 388 patients who were admitted within 2 weeks after the onset were studied. Types of admitting institution, diagnoses, medical treatments and prognoses were investigated. According to medical records, 168 patients fulfilled the criteria of definite AMI and were admitted alive. Percutaneous transluminal coronary angioplasty (PTCA) and recanalization (PTCR) were performed on 54 and 6 patients, respectively. The hospital case-fatality rates were lower in the patients who underwent emergency PTCA or PTCR than in the others. Emergency PTCA or PTCR, and admission to coronary care units (CCU) or institutions equipped with coronary angiography, decreased the fatality risk, even after considering age, sex, and disease severity. These results show the importance of the selection of institutions for AMI patients. Because 40% of definite AMI patients were sent to institutions without CCU, it is essential that enough CCU are available through an improvement in cooperation between the various types of institutions, and in the proper transfer of AMI patients to CCU

Adult↗