SEARCH · PubMed Health

Results for “Angiography”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 55 records · Page 3Linked to original sources

PubMed2005

Malpractice in invasive cardiology: is angiography of abdominal aorta or subclavian artery appropriate in patients undergoing coronary angiography? A meta analysis.

BACKGROUND: Identification of peripheral vascular disease by angiography in patients undergoing coronary angiography may be considered as malpractice but sometimes seems to be justified under clear entry criteria. The present mata-analysis is aimed to analyze the appropriateness and results of screening angiography of subclavian or abdominal aorta performed at the time of coronary angiography. METHODS: A search of published literature for peripheral angiography in patients undergoing coronary angiography over the last 10 years was performed using the MEDLINE database. No language restriction was employed. Only studies enrolling more than 100 patients for abdominal aortography and 50 patients for subclavian/internal mammary artery angiography were considered. Reference lists from identified studies were also reviewed to identify other potentially relevant references. RESULTS: Twenty-nine studies were retrieved: 8 articles about subclavian artery (SA) and internal mammary (IMA) angiography and 21 about renal (RA) and aortoiliac (AOI) angiography. The total number of patients enrolled was 27,936. Nine studies out of 29 were prospective. Defined entry criteria were reported in 24 out of 29 studies. Significant SA and IMA stenosis were reported in 5.5 and 9% of patients, respectively. RA stenosis >50% was present in 12.7% of patients with CAD. Finally, undetected AOI disease was reported in 35.5% of patients undergoing coronary angiography. Mean complication rate was 0.8 +/- 0.6%. Predictors of SA and IMA stenosis were unclear. Age, multi-risk profile, multi-vessel CAD, history of PVD or carotid disease, severe hypertension, unexplained renal dysfunction or decreased creatinine clearance have been reported most frequently as predictors of RA and AOI disease in patients undergoing coronary angiography. CONCLUSIONS: Consistent evidence of appropriateness of renal angiography in selected patients undergoing coronary angiography have been produced in literature. IMA and AOI angiography seem to be not justified unless they are part of SA in patients scheduled for arterial conduit with brachial differential pressure, thoracic irradiation or surgery, or of abdominal angiography to detect RA stenosis in laboratories with radiological digital peripheral equipment.

Aorta, Abdominal↗

PubMed2005

Contrast-enhanced MR angiography of peripheral arteries including pedal vessels at 1.0 T: feasibility study with dedicated peripheral angiography coil.

PURPOSE: To prospectively determine feasibility of contrast material-enhanced magnetic resonance (MR) angiography of the peripheral arteries from distal aorta to pedal arteries with a 1.0-T system and a dedicated phased-array coil. MATERIALS AND METHODS: Twenty-seven patients with peripheral arteriosclerotic occlusive disease underwent contrast-enhanced MR angiography with an automatic moving-table technique. In addition, lower-leg and pedal arteries were examined without table movement (hybrid technique). Two radiologists independently reviewed MR angiograms to assess image quality and grade stenosis in 13 segments per leg. Each was blinded to patients' clinical data. Twenty-five of the patients also underwent conventional angiography. Stenosis grade at conventional angiography was assessed by two radiologists in consensus. Interobserver variability for stenosis grade at MR angiography was calculated with Cohen kappa test. Specificity and sensitivity of MR angiography in detection of stenosis of more than 50% and occlusion were calculated for both observers. The study was approved by the local ethics committee. RESULTS: In 14 of the 27 patients, hybrid technique was superior to moving-table technique because there was less venous overlap (11 patients), fewer motion artifacts (one patient), or both (two patients). In nine patients, there was no difference between techniques; in four patients, moving-table technique was superior. Stenosis grade was analyzed in 698 segments with MR angiography and in 638 segments with both conventional and MR angiography. Kappa analysis of interobserver agreement with MR angiography yielded a score of 0.84. For the 638 segments evaluated with both conventional and MR angiography, observers 1 and 2 assigned same grade of stenosis with both modalities in 558 and 555 segments, respectively. Sensitivity for stenoses greater than 50% and occlusion was 94.4% and 91.1% for observers 1 and 2, respectively, and specificity was 90.6% and 91.3%. More distal runoff vessels were shown with MR angiography in seven cases and with conventional angiography in two cases. CONCLUSION: Contrast-enhanced MR angiography of the peripheral vessels with a 1.0-T system and dedicated peripheral angiography coil is feasible, and in some cases, it provides additional information compared with conventional angiography.

Aged↗

PubMed1996

Variability of magnetic resonance angiography and computed tomography angiography in grading middle cerebral artery stenosis.

BACKGROUND AND PURPOSE: Magnetic resonance angiography and computed tomography angiography are new, noninvasive methods to provide images of the cerebral vasculature. The reliability of magnetic resonance angiography and computed tomography angiography when used to grade middle cerebral artery stenosis remains to be established. We sought to study the interobserver and intraobserver variabilities of magnetic resonance angiography and computed tomography angiography in grading middle cerebral artery stenosis. METHODS: A total of 50 middle cerebral arteries in 25 patients were studied with magnetic resonance angiography and computed tomography angiography. All patients had a history of ischemic stroke. The films were read independently by two observers on separate occasions. Films were shown again to the same observer 4 weeks after the first reading. The degree of middle cerebral artery stenosis was categorized into four grades: normal/mild, moderate, severe, and occluded. The interobserver and intraobserver variabilities were calculated by the kappa statistic method. RESULTS: Interobserver variability for grading middle cerebral artery stenosis was good (kappa = 0.78) for magnetic resonance angiography and moderate (kappa = 0.51) for computed tomography angiography. There was perfect agreement between two observers in 86% of the vessels shown in magnetic resonance angiography and in 76% of the vessels shown in computed tomography angiography. Intraobserver variability for both imaging methods was good, with the kappa value in the range of 0.70 to 0.76. CONCLUSIONS: Our results suggest that according to our protocol, magnetic resonance angiography is more reliable than computed tomography angiography in grading middle cerebral artery stenosis.

Adult↗

PubMed2003

Multi-Slice CT angiography in diagnosing total versus near occlusions of the internal carotid artery: comparison with catheter angiography.

BACKGROUND AND PURPOSE: To determine the accuracy of multislice computed tomographic (CT) angiography in diagnosing total versus near occlusions of the internal carotid artery (ICA). METHODS: Fifty-seven ICA total or near occlusions identified by catheter angiography were studied with multislice CT angiography 1 to 3 days after catheter angiography. CT angiography in diagnosing total versus near occlusions was analyzed by 2 radiologists independently. The results were compared with those of catheter angiography. RESULTS: Catheter angiography depicted 31 total occlusions, including 10 without a stump, 19 with a stump <2 cm, and 2 with a stump >2 cm. Among them, 22 had a downward extent of the retrograde ICA flow at or above the carotid siphon, 8 at the carotid canal, and 1 at the distal cervical ICA. Catheter angiography depicted 26 near occlusions, including 21 with a tight stenosis at the proximal third cervical ICA, 1 at the middle third, and 4 at the carotid canal or siphon. CT angiography correctly depicted all total and near occlusions. In total occlusions, the length of the stump and the retrograde flow were all accurately described by CT angiography. In near occlusions, the sites of tight stenoses were also correctly identified by CT angiography. CONCLUSIONS: Multislice CT angiography had an excellent correlation with catheter angiography in diagnosing total versus near occlusion of the ICA. It may be considered as a substitute of catheter angiography in confirming the ultrasonographic results in diagnosing total versus near occlusions of the ICA.

Adult↗

PubMed2006

Evaluation of renal arteries in living renal donors: comparison between MDCT angiography and gadolinium-enhanced 3D MR angiography.

PURPOSE: The purpose of this study was to clarify and compare the accuracy of contrast-enhanced computed tomography (CT) angiography using multidetector-row helical CT (MDCT angiography) and gadolinium-enhanced MR angiography using three-dimensional Fourier transformation gradient-echo sequence (3D MR angiography) for preoperative evaluation of renal arteries in living renal donors. MATERIALS AND METHODS: A total of 42 living renal donor candidates underwent both MDCT angiography and 3D MR angiography before digital subtraction angiography (DSA). Each MDCT angiogram and 3D MR angiogram was prospectively interpreted, and the findings were compared with the DSA results. RESULTS: MDCT angiography identified all of the 12 supernumerary arteries detected by DSA, whereas 3D MR angiography identified only 8. MDCT angiography identified all of the 19 proximal arterial branches detected by DSA, whereas 3D MR angiography identified only 16. CONCLUSION: A more accurate depiction of renal arteries in living renal donors can be achieved with MDCT angiography than with 3D MR angiography.

Adult↗

PubMed1997

Hemodynamic significance of renal artery stenosis: digital subtraction angiography versus systolically gated three-dimensional phase-contrast MR angiography.

PURPOSE: To compare digital subtraction angiography with three-dimensional phase-contrast magnetic resonance (MR) angiography in detection of significant renal artery stenosis. MATERIALS AND METHODS: Sixteen patients underwent digital subtraction angiography and systolically gated three-dimensional phase-contrast MR angiography within 1 week. Scoring of stenosis on MR angiograms was based on presence and length of a flow void and quality of flow signal intensity in the distal part of the artery. Intraarterial pressure measurement was the reference standard for hemodynamically significant renal artery stenosis. RESULTS: MR angiography depicted two of five patent accessory arteries. Comparison of digital subtraction angiography and MR angiography with intraarterial pressure measurements was possible in 25 main renal arteries. In 13 arteries, a pressure gradient of more than 15 mm Hg was found. Digital subtraction angiography depicted 10 of these stenoses (sensitivity, 77%; specificity, 92%). A flow void was present at MR angiography in eight stenoses (sensitivity, 62%; specificity, 83%). In 12 of the stenosed vessels, distal flow signal intensity was impaired at MR angiography (sensitivity, 92%; specificity, 75%). There was no difference between the two modalities (P > .05) in grading hemodynamic significance of renal artery stenosis. CONCLUSION: Systolically gated MR angiography and digital subtraction angiography are equally effective in depicting hemodynamically significant stenoses in the main renal arteries. MR angiography, however, is not adequate in depiction of accessory renal arteries.

Adult↗

PubMed2003

Multislice computerized tomography angiography in the evaluation of intracranial aneurysms: a comparison with intraarterial digital subtraction angiography.

OBJECT: The goal of this study was to assess the diagnostic accuracy of computerized tomography (CT) angiography performed with the aid of multislice technology (MSCT angiography) in the investigation of intracranial aneurysms, by comparing this method with intraarterial digital subtraction (IADS) angiography. METHODS: Fifty consecutive adult patients, who successively underwent MSCT angiography (four rows) and IADS angiography of intracranial vessels, were prospectively identified. The MSCT angiography studies consisted of 1.25-mm slices, with 0.8-mm reconstruction intervals, a pitch of 0.75, and timing determined by a test bolus. Two neuroradiologists, who were blinded to the initial interpretation of the MSCT angiograms as well as to those of the IADS angiograms, independently reviewed the MSCT angiograms for the detection and characterization of intracranial aneurysms. Forty-nine intracranial aneurysms were identified in 40 patients; 33 of these lesions were responsible for subarachnoid hemorrhage. The sensitivity, specificity, and accuracy of MSCT angiography in the detection of intracranial aneurysms were 94.8, 95.2, and 94.9%, respectively, on a per-aneurysm basis and 99, 95.2, and 98.3%, respectively, on a per-patient basis. Interobserver agreement was 98%. There was an excellent correlation between aneurysm size assessed using MSCT angiography and that determined by IADS angiography (slope = 0.916, r = 0.877, p < 0.001); however, 2 mm stood as the cutoff size below which the sensitivity of MSCT angiography was statistically lower. That method displayed great accuracy in characterizing the morphological characteristics of the aneurysm. CONCLUSIONS: Multislice CT angiography is an accurate and robust noninvasive screening test for intracranial aneurysms. It performs better than that reported for single-slice CT angiography. Introduction of eight- and especially 16-row MSCT angiography will provide further progression through thinner slices, a lower pitch, and a purely arterial phase.

Angiography, Digital Subtraction↗

PubMedDate not supplied

CT angiography of Takayasu arteritis: comparison with conventional angiography.

PURPOSE: To compare computed tomography (CT) angiography with conventional angiography in the evaluation of the extent of disease in the aorta and its major branches in patients with Takayasu arteritis. MATERIALS AND METHODS: Both conventional (digital subtraction) and CT angiography were performed in 10 patients with Takayasu arteritis. The luminal abnormalities were assessed with both conventional angiography and maximum intensity projection (MIP) CT angiography. Transverse images from CT angiography also were used to assess mural changes, which were not assessed with conventional angiography. RESULTS: Conventional angiography revealed 51 sites of luminal abnormalities. In five patients (50%), both conventional and MIP CT angiography depicted the same number of involved sites. At 36 of the 51 sites (71%), the estimation of luminal changes was the same for both modalities. In all patients, the transverse images provided additional mural findings in the aorta and its major branches. The integrated information provided by CT angiography, including MIP and transverse images, depicted more extensive disease than conventional angiography. CONCLUSION: CT angiography including MIP and transverse images has advantages over conventional angiography in the evaluation of disease extent by providing additional mural information in Takayasu arteritis.

Adult↗

PubMed2003

Impact of cardiac service availability on case-selection for angiography and survival associated with angiography.

OBJECTIVE: To examine whether availability of cardiac services at the admitting hospital affects case-selection for angiography and one-year survival following angiography, within groups of patients who have similar clinical need for angiography according to published criteria. STUDY SETTING: Elderly Medicare beneficiaries (37,788) discharged with a diagnosis of acute myocardial infarction (AMI) from hospitals in seven U.S. states between February 1994 and July 1995. We focused on patients who were eligible to receive angiography 12 or more hours after symptom onset. DATA COLLECTION: Data were abstracted from patient's medical records, Medicare National Claims Standard Analytic Files, Health Care Financing Administration (HCFA) Provider of Service File and Health Insurance Master File. METHODS: Admitting hospitals were classified as offering no cardiac services, angiography only, or revascularization. Case-selection differences across these three types of hospitals were examined by comparing relative risk of receiving angiography for various patient and hospital characteristics. Relative differences in one-year survival rate, comparing patients who received angiography to those who did not, were estimated within each hospital type and clinical need category (necessary, appropriate, or uncertain) after matching on propensity to receive angiography. PRINCIPAL FINDINGS: Compared to patients for whom angiography was deemed necessary, the relative risk of receiving angiography among those for whom it was deemed of uncertain benefit was 0.58, 0.79, and 0.92 (p-value of homogeneity test < 0.001) at hospitals offering no cardiac services, angiography only, and revascularization, respectively. There was no significant difference in survival following angiography across hospital types, overall as well as within clinical need categories. CONCLUSIONS: Despite increased case selection at hospitals with on-site cardiac services, there was no evidence of increase in the survival rate associated with angiography use at these hospitals.

Aged↗

PubMed1994

Comparison of magnetic resonance angiography, duplex ultrasound, and digital subtraction angiography in assessment of extracranial internal carotid artery stenosis.

The results of a prospective study comparing ultrasound, intra-arterial digital subtraction angiography, and magnetic resonance angiography in the assessment of the degree of extracranial internal carotid artery stenosis are reported in patients with symptoms of recent carotid territory ischaemia. A total of 70 patients and 137 vessels were examined by all three techniques. The results obtained by each technique were reported blind. The mean difference (SD) for the comparison of magnetic resonance angiography and digital subtraction angiography was -0.7 (14)%, for ultrasound and digital subtraction angiography 3.1 (15)%, and for magnetic resonance angiography and ultrasound -3.8 (15)%. The level of agreement was greater for the more tightly stenosed vessels. With the assumption that the results of the digital subtraction angiogram reflect the true situation, the sensitivity and specificity in the detection of > or = 30% stenoses were 93% and 82% with ultrasound and 89% and 82% with magnetic resonance angiography; for stenoses > or = 70% 93% and 92% with ultrasound and 90% and 95% with magnetic resonance angiography; and for stenoses of 70-99% 89% and 93% with ultrasound and 86% and 93% with magnetic resonance angiography. For occlusion the values were 93% and 99% with ultrasound and 80% and 99% with magnetic resonance angiography. Increased sensitivity and specificity were obtained when analysis was confined to those vessels in which ultrasound and magnetic resonance angiography were in agreement over classification. It is thus possible to accurately categorize the degree of stenosis of the extracranial internal carotid artery from a combination of ultrasound and magnetic resonance angiography. The adoption of this combination for the investigation of patients before carotid endarterectomy removes the risk associated with conventional angiography and represents an important advance in the management of carotid stenosis.

Adult↗

PubMed2001

Noninvasive imaging of living related kidney donors: evaluation with CT angiography and gadolinium-enhanced MR angiography.

OBJECTIVE: This study was performed to determine whether noninvasive imaging with CT angiography and MR angiography in the preoperative investigation of living, related kidney donors provides sufficient information for the surgeon. MATERIALS AND METHODS: Eighty consecutive potential living kidney donors were investigated. Fifty patients underwent CT angiography and 30 underwent MR angiography before donor nephrectomy. CT was performed using 3-mm collimation with a pitch of 1.6 after the injection of 150 mL of nonionic contrast medium. The axial data, multiplanar reconstructions, and maximum intensity projections were reviewed. MR angiography was performed on a 1-T magnet using a contrast-enhanced three-dimensional gradient echo technique. Maximum intensity projections and axial reformations were reviewed. Imaging findings were compared with the surgical results in 54 patients. RESULTS: CT angiography and MR angiography were 100% sensitive in identifying the main renal arteries and renal veins. CT angiography visualized 37 of the 40 arteries identified at surgery, for a detection rate of 93%. MR angiography visualized 18 of the 20 arteries identified at surgery, a detection rate of 90%. CONCLUSION: CT angiography and MR angiography are suitable for the noninvasive investigation of living kidney donors and provide all the information required by the surgeon. Both methods may miss small accessory renal arteries. MR angiography does not use potentially toxic contrast material or radiation and is the preferred investigation, with CT angiography reserved for patients unable to tolerate MR imaging.

Adult↗

PubMed2002

Three-dimensional helical computerized tomography angiography in the diagnosis, characterization, and management of middle cerebral artery aneurysms: comparison with conventional angiography and intraoperative findings.

OBJECT: Middle cerebral artery (MCA) aneurysms can be difficult to detect and characterize. The authors describe the utility and impact of helical computerized tomography (CT) angiography for the evaluation of aneurysms in this location, and compare this modality with digital subtraction (DS) angiography and intraoperative findings. METHODS: Two hundred fifty-one patients with suspected cerebral aneurysms underwent CT angiography. Two-dimensional multiplanar reformatted images and three-dimensional CT angiograms were examined by two independent readers in a blinded fashion. Results were compared with findings on DS angiograms to determine the relative efficacy of these modalities in the detection and characterization of aneurysms. Questionnaires completed by neurosurgeons and endovascular therapists were used to determine the impact of CT angiograms on aneurysm management. Twenty-eight patients harboring 31 MCA aneurysms and 26 patients without aneurysms were identified using CT angiography. The sensitivity of CT angiography and DS angiography for MCA aneurysms was 97%; both techniques showed 100% specificity. In 76% of evaluations, the CT angiography studies provided information not available on DS angiography examinations. For the characterization of aneurysms, CT angiography was rated superior (72%) or equal (20%) to DS angiography in 92% of cases evaluated (p < 0.001). Computerized tomography angiography was evaluated as the only study needed for patient triage in 82% of cases (p < 0.001), and as the only study needed for treatment planning in 89% of surgically treated (p < 0.001) and in 63% of endovascularly treated cases (p < 0.001). The information acquired on CT angiograms changed the initial treatment plan in 24 (67%) of these 36 complex lesions (p < 0.01). The aneurysm appearance intraoperatively was identical or nearly identical to that seen on CT angiograms in 17 (89%) of 19 of the surgically treated cases. CONCLUSIONS: Computerized tomography angiography has unique advantages over DS angiography and is a viable alternative to the latter modality in the diagnosis, triage, and treatment planning in patients with MCA aneurysms.

Adult↗

PubMed1997

Common carotid artery bifurcation: preliminary results of CT angiography and color-coded duplex sonography compared with digital subtraction angiography.

OBJECTIVE: The purpose of this study was to compare the abilities of color-coded duplex sonography, CT angiography, and selective digital subtraction angiography to reveal disease requiring surgery in patients with occlusive disease of the carotid bifurcation. MATERIALS AND METHODS: Fifty-six carotid arteries in 28 patients who had 48 carotid stenoses and symptomatic cerebrovascular disease were prospectively studied by selective digital subtraction angiography, color-coded duplex sonography, and CT angiography. CT data were displayed in maximum intensity projection. The degree of stenoses revealed were graded as mild, moderate, severe, and occluded according to North American Symptomatic Carotid Endarterectomy Trial criteria. The results of CT angiography and color-coded duplex sonography were correlated with the gold standard of digital subtraction angiography. RESULTS: Grading of stenoses on CT angiography agreed with grading of stenoses on digital subtraction angiography in 89% of cases. All high-grade stenoses and occlusions revealed on CT angiography were correctly interpreted by all observers. For stenoses revealed by color-coded duplex sonography and digital subtraction angiography, observers' agreement was 75%. Two severe stenoses were incorrectly graded as occluded by the interpreter of the color-coded duplex sonograms. Also, one occluded carotid artery was misdiagnosed as moderate stenosis. CONCLUSION: Our results indicate that CT angiography is superior to color-coded duplex sonography for evaluating carotid disease and determining disease requiring surgery. CT angiography warrants further investigation in a larger group of patients.

Angiography, Digital Subtraction↗

PubMed2000

Comparing contrast-enhanced breath-hold MR angiography and conventional angiography in the evaluation of mesenteric circulation.

OBJECTIVE: Our aim was to compare the results of gadolinium-enhanced breath-hold MR angiography with those of conventional angiography for the study of mesenteric circulation. SUBJECTS AND METHODS: MR angiography and digital subtraction angiography were prospectively performed in 33 patients referred for hepatic, pancreatic, or mesenteric disease. MR angiography was performed with four three-dimensional acquisitions at 0, 30, 60, and 90 sec after injection of 0.1 mmol/kg of gadolinium. Selective conventional angiography was used as the standard of reference. RESULTS: A pure arterial angiogram (one on which veins could not be visualized) was obtained in 27 patients during the second or third acquisition. By subtracting the arterial phase from an arteriovenous phase (third or fourth acquisition) we obtained a pure venous angiogram (one on which arteries could not be visualized) in 28 patients. Agreement was good or excellent for the hepatic artery (kappa = 0.78), the superior mesenteric artery (kappa = 0.65), the splenic artery (kappa = 0.70), the portal vein (kappa = 1.0), the superior mesenteric vein (kappa = 0.88), and the splenic vein (kappa = 0.75). Agreement was poor, and vessels were better shown by conventional angiography, for the intrahepatic arteries (kappa = 0.006) and the branches of the superior mesenteric artery (kappa = 0.14). MR angiography and conventional angiography revealed 29 and 27 portosystemic collaterals, respectively. CONCLUSION: Dynamic breath-hold contrast-enhanced MR angiography compared favorably with conventional angiography in preoperative assessment of the proximal mesenteric arteries and in the evaluation of portal hypertension; however, conventional angiography is still necessary to evaluate distal arteries.

Adult↗

PubMed2002

Revealing in-stent stenoses of the iliac arteries: comparison of multidetector CT with MR angiography and digital radiographic angiography in a Phantom model.

OBJECTIVE: Our objective was to evaluate the detectability of in-stent stenoses in iliac artery stents using multidetector CT angiography in comparison with MR angiography and digital radiographic angiography. MATERIALS AND METHODS: Ten different metallic stents (made of steel, nitinol, tantalum, or cobalt) were implanted in plastic tubes (8 mm). The stent lumina were partially obstructed by wax (CT density, -30 H) resulting in 50-60% in-stent stenoses. The tubes were filled with diluted contrast material (25 mmol/L of gadopentetate dimeglumine or 6 mg I/mL of iodinated contrast material) and placed in a plastic container filled with oil or water, respectively. CT angiography was performed on a four-detector CT scanner (detector collimation, 4 x 1 mm; slice thickness, 1.25 mm; table feed, 4 mm per rotation). MR angiography was performed on a 1.5-T system with a three-dimensional gradient-echo sequence (TR/TE, 4.6/1.8; flip angle, 30 degrees; slice thickness, 1.88 mm). Axial and longitudinal reformations of CT and MR imaging data were evaluated regarding the in-stent attenuation and signal intensity, the visible lumen diameter inside the stent, and the delineation of the stenoses. For comparison, digital radiographic angiography was performed as the gold standard. RESULTS: The degree and character of stent-related artifacts differed in CT angiography and MR angiography. In CT angiography, only the tantalum stent caused artifacts that obscured the stenosis; in all other cases, the stenoses were visible. In MR angiography, depiction of stenoses was impaired in two steel stents but possible in the tantalum and most nitinol stents. CONCLUSION: CT angiography is suited for detection of relevant stenoses in steel, cobalt-based, and nitinol stents. MR angiography is superior only in tantalum products.

Angiography↗

PubMed2000

Comparison of fluorescein angiography and indocyanine green angiography for imaging of choroidal neovascularization in hemorrhagic age-related macular degeneration.

PURPOSE: To compare fluorescein angiography and indocyanine green angiography for imaging of choroidal neovascularization located under subretinal hemorrhage, in age-related macular degeneration. METHODS: In a retrospective study, 30 eyes of 30 consecutive patients with hemorrhagic age-related macular degeneration were evaluated with fluorescein angiography and indocyanine green angiography. In each eye, areas of macular hemorrhage, choroidal neovascularization, and total lesion (hemorrhage plus choroidal neovascularization) were measured, and the choroidal neovascularization was categorized as classic, occult, or mixed on fluorescein angiography, and as hot spot, plaque, or combined lesion on indocyanine green angiography. Results of the two techniques were compared for the ability to identify a laser-treatable lesion. RESULTS: Fluorescein angiography showed fluorescence in most cases (28, 93.3%). In 23 cases (76.6%), the fluorescence pattern was compatible with occult choroidal neovascularization. Indocyanine green angiography revealed defined patterns of fluorescence in 27 cases (90%): 12 hot spots, seven plaques, and eight combined hot spots and plaques. Twenty lesions (66.6%) detected by indocyanine green angiography were considered eligible for laser therapy. Nine of them (45%) were extrafoveal. CONCLUSIONS: Indocyanine green angiography is beneficial for imaging choroidal neovascularization located under subretinal hemorrhage. Choroidal neovascularization demonstrated on indocyanine green angiography may be considered eligible for laser treatment. Therefore, indocyanine green angiography should be considered in cases of hemorrhagic age-related macular degeneration.

Choroid↗

PubMed2006

MR angiography and CT angiography of the artery of Adamkiewicz: state of the art.

It is very important to assess the artery of Adamkiewicz before repair of the thoracoabdominal or descending thoracic aorta. Several studies have demonstrated the feasibility and advantages of noninvasive assessment of the artery of Adamkiewicz with magnetic resonance (MR) angiography and multi-detector row computed tomographic (CT) angiography. Recent advances in MR angiography and CT angiography have led to changes in the detectability of this artery. In the present study, both MR angiography and CT angiography were performed without complications for preoperative evaluation of 30 patients who underwent repair of the thoracoabdominal or descending thoracic aorta. MR angiography provided detection rates as high as 93% and 80% with the morphologic "hairpin turn" criterion and the anatomic "continuity" criterion, respectively. Sixteen-detector row CT angiography provided detection rates as high as 83% and 60%, respectively. Use of both MR angiography and CT angiography provided higher detection rates of 97% and 90%, respectively. The collateral pathways were depicted in seven cases (23%). MR angiography is superior for depiction of the artery of Adamkiewicz, especially when it arises from the false lumen of a dissecting aneurysm. CT angiography has a wide field of view and allows depiction of significant collateral pathways associated with the internal thoracic artery and intercostal arteries.

Adult↗

PubMed2006

16-MDCT coronary angiography versus invasive coronary angiography in acute chest pain syndrome: a blinded prospective study.

OBJECTIVE: The purpose of our study was to prospectively evaluate the usefulness of CT coronary angiography versus invasive coronary angiography for the detection of clinically significant coronary artery disease in patients hospitalized for acute chest pain syndrome. SUBJECTS AND METHODS: Sixty-six consecutive patients (52 men and 14 women; average age, 57 +/- 11 [SD] years) who were hospitalized for acute chest pain syndrome underwent CT coronary angiography and invasive coronary angiography within an average time interval of 4 days. ECG-gated CT coronary angiography was performed with a 16-MDCT scanner (0.42-sec rotation time, 16 x 0.75 mm detector collimation). Beta-blockers were not administered routinely, and thus the average heart rate was 71 +/- 11 beats per minute. CT coronary angiographic images were evaluated concurrently by two radiologists, who were blinded to invasive coronary angiography results, for stenoses having a diameter of 50% or more, using a 15-segment classification, including all segments 2 mm or more in diameter. The consensus interpretation was compared with results of invasive coronary angiography. RESULTS: CT coronary angiography was technically successful in 59 patients (89%). After exclusion of 20 (3.1%) of 649 coronary segments, which were classified as nonevaluable by CT coronary angiography, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CT coronary angiography for identifying significant coronary artery disease in the remaining 629 coronary segments were 80% (68/85), 89% (482/544), 52% (68/130), 97% (482/499), and 87% (550/629), respectively. The overall accuracy for the main vessels (left main, left anterior descending, left circumflex, and right coronary arteries) was 93%, 88%, 86%, and 86%, respectively. CONCLUSION: CT coronary angiography using a 16-MDCT scanner enables accurate noninvasive detection of significant coronary artery disease in patients hospitalized for acute chest pain syndrome. Furthermore, relative high sensitivity and specificity of CT coronary angiography can be achieved without pharmacologic manipulation of patient heart rates.

Acute Disease↗