Multidetector Computed Tomography Angiography (MD-CTA) of Coronary Artery Bypass Grafts - Update 2017. 2018

Florian Jungmann, and Tilman Emrich, and Peter Mildenberger, and Anna Lena Emrich, and Christoph Düber, and K F Kreitner
Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg University Mainz, Germany.

Coronary artery bypass grafting (CABG) is still an important therapeutic approach in the treatment especially of advanced coronary artery disease. In this study, we elucidate the current role of multidetector computed tomography angiography (MD-CTA) in imaging patients after CABG surgery. This study is based on recent reports in the literature (2007 - 2016) on imaging of CABG using 64-slice MD-CT scanners and beyond. We included 13 reports that compared ECG-gated MD-CTA with conventional invasive coronary angiography (ICA) as the reference standard for the assessment of graft patency and for the detection of > 50 % stenoses. These studies had to provide absolute values for true-positive, true-negative, false-positive and false-negative results or at least allow calculation of these numbers. In total, 1002 patients with 2521 bypass grafts were the basis for this review. The sensitivity and specificity for the assessment of graft patency or the detection of > 50 % graft stenosis were 97.2 % and 97.5 %, respectively. The negative and positive predictive values were 93.6 % and 99 %, respectively. By using prospective ECG-gating and an increasing pitch factor, the radiation dose exposure declined to 2.4 mSv in the latest reports. ECG-gated MD-CTA provides a fast and reliable, noninvasive method for assessing patients after CABG. The most substantial benefit of the newest CT scanner generations is a remarkable reduction of radiation dose exposure while maintaining a still excellent diagnostic accuracy during recent years. · MD-CTA using 64-slice MDCT scanners and beyond is a reliable, noninvasive method for evaluating CABGs.. · Technical advances such as prospective ECG-gating, iterative reconstruction algorithms and high-pitch scanning lead to a remarkable drop-down in radiation dose exposures as low as 2.4 mSv.. · Despite significant dose reductions, MD-CTA could maintain a high diagnostic accuracy in evaluating CABGs in recent years.. · Jungmann F, Emrich T, Mildenberger P et al. Multidetector Computed Tomography Angiography (MD-CTA) of Coronary Artery Bypass Grafts - Update 2017. Fortschr Röntgenstr 2018; 190: 237 - 249.

UI MeSH Term Description Entries
D007091 Image Processing, Computer-Assisted A technique of inputting two-dimensional or three-dimensional images into a computer and then enhancing or analyzing the imagery into a form that is more useful to the human observer. Biomedical Image Processing,Computer-Assisted Image Processing,Digital Image Processing,Image Analysis, Computer-Assisted,Image Reconstruction,Medical Image Processing,Analysis, Computer-Assisted Image,Computer-Assisted Image Analysis,Computer Assisted Image Analysis,Computer Assisted Image Processing,Computer-Assisted Image Analyses,Image Analyses, Computer-Assisted,Image Analysis, Computer Assisted,Image Processing, Biomedical,Image Processing, Computer Assisted,Image Processing, Digital,Image Processing, Medical,Image Processings, Medical,Image Reconstructions,Medical Image Processings,Processing, Biomedical Image,Processing, Digital Image,Processing, Medical Image,Processings, Digital Image,Processings, Medical Image,Reconstruction, Image,Reconstructions, Image
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D011829 Radiation Dosage The amount of radiation energy that is deposited in a unit mass of material, such as tissues of plants or animal. In RADIOTHERAPY, radiation dosage is expressed in gray units (Gy). In RADIOLOGIC HEALTH, the dosage is expressed by the product of absorbed dose (Gy) and quality factor (a function of linear energy transfer), and is called radiation dose equivalent in sievert units (Sv). Sievert Units,Dosage, Radiation,Gray Units,Gy Radiation,Sv Radiation Dose Equivalent,Dosages, Radiation,Radiation Dosages,Units, Gray,Units, Sievert
D003327 Coronary Disease An imbalance between myocardial functional requirements and the capacity of the CORONARY VESSELS to supply sufficient blood flow. It is a form of MYOCARDIAL ISCHEMIA (insufficient blood supply to the heart muscle) caused by a decreased capacity of the coronary vessels. Coronary Heart Disease,Coronary Diseases,Coronary Heart Diseases,Disease, Coronary,Disease, Coronary Heart,Diseases, Coronary,Diseases, Coronary Heart,Heart Disease, Coronary,Heart Diseases, Coronary
D006083 Graft Occlusion, Vascular Obstruction of flow in biological or prosthetic vascular grafts. Graft Restenosis, Vascular,Vascular Graft Occlusion,Vascular Graft Restenosis,Graft Restenoses, Vascular,Occlusion, Vascular Graft,Restenosis, Vascular Graft
D000072226 Computed Tomography Angiography A non-invasive method that uses a CT scanner for capturing images of blood vessels and tissues. A CONTRAST MATERIAL is injected, which helps produce detailed images that aid in diagnosing VASCULAR DISEASES. Angiography, CT,Angiography, Computed Tomography,CT Angiography,Angiographies, CT,Angiographies, Computed Tomography,CT Angiographies,Computed Tomography Angiographies,Tomography Angiographies, Computed,Tomography Angiography, Computed
D000465 Algorithms A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. Algorithm
D001026 Coronary Artery Bypass Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion. Aortocoronary Bypass,Bypass, Coronary Artery,Bypass Surgery, Coronary Artery,Coronary Artery Bypass Grafting,Coronary Artery Bypass Surgery,Aortocoronary Bypasses,Artery Bypass, Coronary,Artery Bypasses, Coronary,Bypass, Aortocoronary,Bypasses, Aortocoronary,Bypasses, Coronary Artery,Coronary Artery Bypasses
D012680 Sensitivity and Specificity Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed) Specificity,Sensitivity,Specificity and Sensitivity
D017023 Coronary Angiography Radiography of the vascular system of the heart muscle after injection of a contrast medium. Angiography, Coronary,Angiographies, Coronary,Coronary Angiographies

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