The early detection of atherosclerotic vascular lesions is very important for diagnostic and interventional purposes. Traditionally, Digital Subtraction Angiography (DSA) is considered the reference diagnostic technique, but recently several new non-invasive procedures have been developed, like Doppler US, CT-angiography and MR-Angiography (MRA). MRA has progressively gained acceptance as a valid alternative. At present, the use of fast sequence and contrast injection allows to acquire segmental volumes within a few seconds (10-20s), with high diagnostic quality and accuracy. The systemic distribution of atherosclerosis requires the use of techniques which can assess the arterial system as exhaustively as possible. A MRA scanning protocol including all arteries from the epiaortic branches to the calf has recently been proposed with encouraging preliminary results. In this article, the relevant technical concepts in MRA and the present most important clinical findings are reported and discussed, including the proposed technique for a whole-body MR angiographic assessment of the atherosclerotic patient.

Arteriosclerosis↗

PubMedDate not supplied

Diagnostic accuracy of 16-row multislice CT angiography in the evaluation of coronary segments.

PURPOSE: To evaluate the diagnostic accuracy of 16-row multislice spiral computed tomography coronary angiography (16-MSCT-CA) for the non-invasive assessment of significant coronary artery stenosis. MATERIALS AND METHODS: We enrolled 40 patients (36 male, aged 59+/-11 yrs) with suspected obstructive coronary artery disease and a heart rate <65 bpm during the scan. The 16-MSCT-CA (Sensation 16, Siemens, Forchheim, Germany) was performed with electrocardiographically-gated technique after the intravenous administration of 100 ml of iodinated contrast material followed by a saline bolus chaser. The scan parameters were: collimation 16 x 0.75 mm, rotation time 0.42 s, feed/rot. 3 mm (pitch 0.25), 120 kVp, 500 mAs. All coronary segments = or >2 mm in diameter were evaluated by two independent observers for the presence of significant coronary artery stenosis (= or >50%). Consensus reading was compared to quantitative coronary angiography. RESULTS: The average heart rate was 55+/-6 bpm. Of the 428 segments of = or >2.0 mm diameter 92 were significantly diseased. Without exclusion of any branches (428), the sensitivity, specificity, positive, and negative predictive values to identify = or >50% obstructed segments were 95.7% (88/92), 95.8% (322/336), 86.3% (88/102), and 98.8% (322/326), respectively. No occluded left main, left anterior descending, circumflex or right coronary artery segments remained undetected. CONCLUSIONS: 16-MSCT-CA in a selected low-heart-rate patient population provides high diagnostic accuracy in the evaluation of significant coronary artery stenosis.

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