• Clinical and Experimental Pediatrics
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• v.58 no.12
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• pp.501-504
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• 2015

We present the case of a 5-year-old child with coronary complications due to Kawasaki disease; this patient unintentionally underwent both dual-source computed tomography (DSCT) coronary angiography and invasive coronary angiographic examination in 2 months. This case highlights the strong consistency of the results between DSCT coronary angiography and invasive coronary angiography. Compared to conventional invasive coronary angiography, DSCT coronary angiography offered additional advantages such as minimal invasiveness and less radiation exposure.

• Journal of the Korean Society of Radiology
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• v.13 no.7
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• pp.1005-1014
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• 2019

The purpose of this study is to evaluate the usefulness of coronary computed tomography angiography of coronary artery disease for the purpose fo health screening according to gender and age. In addition the association between hematological factors (Glucose, total cholesterol, visceral fat, body mass index, triglycerides, high density lipoprotein (HDL), low density lipoprotein (LDL)) and coronary artery disease is investigated. A retrospective analysis of coronary computed tomography angiography with 299 subjects showed that the detection rate of coronary artery disease was higher in men over 50 years of age and it was statistically significant. In particular, the prevalence rate of men (37.9%) was about 2 times higher than that of women (17.0%). Glucose and HDL as hematological factors associated with coronary artery disease were statistically significant. The prevention and management of coronary artery disease seems to require the control of glucose and high density lipoprotein (HDL). Although it is not statistically significant with other hematological factors, the need for management of coronary artery disease was identified. the coronary computed tomography angiography of coronary artery has higher radiation doses than other CT scans. Therefore, for the purpose of screening, coronary computed tomography angiography should be considered in consideration of the sex and age of the examinee, and detection of coronary artery disease through other non-invasive tests should be prioritized over coronary computed tomography angiography.

• Journal of Chest Surgery
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• v.39 no.1 s.258
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• pp.42-47
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• 2006

Background: The new Multidetector Computed Tomography (MDCT) is useful in visualization of complex coronary artery anatomy. We investigated usefulness comparing of invasive coronary angiography with noninvasive MDCT in judgment of functional degree of coronary arteries grafts after coronary artery bypass graft operation. Material and Method: We analyzed the patency of 52 conduits from 15 patients whom consented to take both 32 Channel MDCT and coronary angiography from November 2003 to November 2004. Comparisons were performed for sensitivity, specificity, positive prediction value and negative prediction value between coronary angiography and 3 dimensional reconstruction image using MDCT. Result: The average graft used was 3.4 $\pm$ 0.8 per patient. Average heart rate during MDCT was 86/minute (Range, 60$\∼$110/minute) without administration of $\beta$-blocker. All patients could hold breath as much as necessary. The average graft patency obtained through corollary angiography was 96.2$\%$. In MDCT group, the sensitivity, the specificity, the positive predictive value and the negative predictive value for diagnosis was 100$\%$, 98.0$\%$, 100$\%$ and 66.6$\%$ respectively. Conclusion: The effectiveness of 32 Channel MDCT may be compared to coronary angiography in grasping about patency and bloodstream of graft conduits after coronary artery bypass graft. Also MDCT has the advantage of noninvasiveness and inexpensiveness compared to coronary angiography.

• ETRI Journal
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• v.39 no.5
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• pp.662-671
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• 2017

Coronary artery disease (CAD) is a major cause of death in the world. As a non-invasive imaging modality, computed tomography angiography (CTA) is now usually used in clinical practice for CAD diagnosis. Precise quantification of coronary stenosis is of great interest for diagnosis and treatment planning. In this paper, a novel cluster method based on a Modified Student's t-Mixture Model is applied to separate the region of vessel lumen from other tissues. Then, the area of the vessel lumen in each slice is computed and the estimated value of it is fitted with a curve. Finally, the location and the level of the most stenoses are captured by comparing the calculated and fitted areas of the vessel. The proposed method has been applied to 17 clinical CTA datasets and the results have been compared with reference standard degrees of stenosis defined by an expert. The results of the experiment indicate that the proposed method can accurately quantify the stenosis of the coronary artery in CTA.

• Korean Journal of Radiology
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• v.25 no.6
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• pp.518-539
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• 2024

Coronary computed tomography angiography (CCTA) has emerged as a pivotal tool for diagnosing and risk-stratifying patients with suspected coronary artery disease (CAD). Recent advancements in image analysis and artificial intelligence (AI) techniques have enabled the comprehensive quantitative analysis of coronary atherosclerosis. Fully quantitative assessments of coronary stenosis and lumen attenuation have improved the accuracy of assessing stenosis severity and predicting hemodynamically significant lesions. In addition to stenosis evaluation, quantitative plaque analysis plays a crucial role in predicting and monitoring CAD progression. Studies have demonstrated that the quantitative assessment of plaque subtypes based on CT attenuation provides a nuanced understanding of plaque characteristics and their association with cardiovascular events. Quantitative analysis of serial CCTA scans offers a unique perspective on the impact of medical therapies on plaque modification. However, challenges such as time-intensive analyses and variability in software platforms still need to be addressed for broader clinical implementation. The paradigm of CCTA has shifted towards comprehensive quantitative plaque analysis facilitated by technological advancements. As these methods continue to evolve, their integration into routine clinical practice has the potential to enhance risk assessment and guide individualized patient management. This article reviews the evolving landscape of quantitative plaque analysis in CCTA and explores its applications and limitations.

• Journal of the Korean Society of Radiology
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• v.81 no.2
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• pp.250-271
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• 2020

Assessment of myocardial ischemia in patients with stable angina is important in deciding whether to treat coronary artery disease and in predicting clinical outcome. The fractional flow reserve is a standard reference for the diagnosis of myocardial ischemia, but this procedure has limitations because of its invasiveness. Coronary computed tomography angiography (CCTA) is now an established tool in the anatomic diagnosis of coronary artery disease; however, there are limits to the diagnosis of hemodynamically important stenosis that causes myocardial ischemia. In order to address this problem, studies using quantification of coronary atherosclerotic plaques, myocardial perfusion, and noninvasive calculation of fractional flow reserve based on CCTA have been actively conducted and recognized for their diagnostic value. In this review, several imaging techniques of CCTA used to assess myocardial ischemia are described.

• Journal of radiological science and technology
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• v.34 no.4
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• pp.315-321
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• 2011

The goal of this study is to reduce patient exposure dose by providing image quality and radiation dose according to inspection methods. Volume Computed Tomography Dose Index(CTDIvol) and Dose Length Product(DLP) of prospective and retrospective ECG gating snapshot segment of Coronary CT angiography(CTA) were measured each snapshot segment methods. CT number, noise, uniformity, and resolution were also measured using phantom under the same condition of coronary CTA. The results showed that CT number, noise, uniformity and resolution are similar to each other. In terms of CTDIvol and DLP, however, measurement dose of prospective ECG gating snapshot segment was lower than the retrospective case by 37.5% and 40.3%. Therefore, it is highly recommended that in the coronary CTA, prospective ECG gating scan mode should be chosen to reduce patient dose.

• Korean Journal of Radiology
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• v.20 no.5
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• pp.719-728
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• 2019

Objective: To investigate the diagnostic validity of coronary computed tomography angiography (cCTA) in vasospastic angina (VA) and factors associated with discrepant results between invasive coronary angiography with the ergonovine provocation test (iCAG-EPT) and cCTA. Materials and Methods: Of the 1397 patients diagnosed with VA from 2006 to 2016, 33 patients (75 lesions) with available cCTA data from within 6 months before iCAG-EPT were included. The severity of spasm (% diameter stenosis [%DS]) on iCAGEPT and cCTA was assessed, and the difference in %DS (Δ%DS) was calculated. Δ%DS was compared after classifying the lesions according to pre-cCTA-administered sublingual nitroglycerin (SL-NG) or beta-blockers. The lesions were further categorized with %DS ≥ 50% on iCAG-EPT or cCTA defined as a significant spasm, and the diagnostic performance of cCTA on identifying significant spasm relative to iCAG-EPT was assessed. Results: Compared to lesions without SL-NG treatment, those with SL-NG treatment showed a higher Δ%DS (39.2% vs. 22.1%, p = 0.002). However, there was no difference in Δ%DS with or without beta-blocker treatment (35.1% vs. 32.6%, p = 0.643). The significant difference in Δ%DS associated with SL-NG was more prominent in patients who were aged < 60 years, were male, had body mass index < 25 kg/m², and had no history of hypertension, diabetes, or dyslipidemia. Based on iCAG-EPT as the reference, the per-lesion-based sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of cCTA for VA diagnosis were 7.5%, 94.0%, 60.0%, 47.1%, and 48.0%, respectively. Conclusion: For patients with clinically suspected VA, confirmation with iCAG-EPT needs to be considered without completely excluding the diagnosis of VA simply based on cCTA results, although further prospective studies are required for confirmation.

• Journal of the Korean Society of Radiology
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• v.83 no.1
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• pp.3-27
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• 2022

Cardiac CT has been proven to provide diagnostic and prognostic evaluation of coronary artery disease for cardiovascular risk stratification and treatment decision-making based on rapid technological development and various research evidence. Coronary CT angiography has emerged as a gateway test for coronary artery disease that can reduce invasive angiography due to its high negative predictive value, but the diagnostic specificity is relatively low. However, coronary CT angiography is likely to overcome its limitations through functional evaluation to identify the hemodynamic significance of coronary artery disease by analyzing myocardial perfusion and fractional flow reserve through cardiac CT. Recently, studies have been actively conducted to incorporate artificial intelligence to make this more objective and reproducible. In this review, functional imaging techniques of cardiac computerized tomography are explored.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.1
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• pp.125-135
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• 2020

Purpose : Obesity indices are major predictive markers for coronary artery stenosis, but there are few studies about the relationship between obesity indices and coronary artery stenosis in the Korean population. Therefore, we analyzed the association between obesity indices and coronary artery stenosis among health-screen examinees. Methods : This study included 99 males and females who visited a health-examination center. The obesity indices included body mass index (BMI), waist circumference (WC), visceral adipose tissue (VAT), visceral adipose tissue/subcutaneous adipose tissue ratio (V/S ratio). All subjects had their degree of coronary artery stenosis measured using coronary computed tomography angiography (CCTA). A multiple logistic regression test was conducted to analyze the association between obesity indices and coronary artery stenosis. Results : This study was taken by multiple logistic regression test adjusted by age, sex, smoking status, frequency of alcohol drinking/week and frequency of exercise/week. The adjusted odds ratio for the presence of coronary artery stenosis for subjects with abdominal obesity (abdominal obesity defined as a waist circumference ≥ 90 cm in males; ≥ 85 cm in females) was 6.263 (95 % confidence interval (CI) 1.974-19.869), for subjects with visceral obesity by visceral adipose tissue (visceral obesity defined as a visceral adipose tissue ≥ 100) was 11.430 (95 % CI 3.044-42.928). Conclusion : In this study of adults, WC and VAT were independent predictors of coronary artery stenosis. These results suggest that WC and VAT may be useful markers of coronary artery stenosis.