Impact of multi-detector row computed tomography on the tactics of cardiovascular surgery: from qualitative evaluation to quantitative assessment.
OBJECTIVE
We assessed the role of multi-detector row computed tomography in cardiovascular surgery.


METHODS
The efficacy of multi-detector row computed tomography was assessed concerning the graft patency of coronary artery bypass, arterial atheromatous degeneration, small vessel imaging, and left ventricular volume measurement. Images were reconstructed using both the volume-rendering and the maximum-intensity-profile methods. Arterial atherosclerotic degeneration was assessed by aortic wall volume and aortic calcification volume.


RESULTS
In the assessment of bypass graft patency, multi-detector row computed tomography showed a 98% correct positive ratio with sensitivity and specificity of 98% and 100%, respectively. Atheromatous degeneration showed matching results in more than 70% of cases compared with intraoperative findings. More than 92% of arterial branches with diameters of 3 mm or greater were detected by preoperative multi-detector row computed tomography images, though only 6% of branches with diameters of 2 mm or less could be visualized. There was a positive linear correlation between left ventricular volumes determined by multi-detector row computed tomography and those calculated from cine angiography.


CONCLUSIONS
Multi-detector row computed tomography clearly visualized coronary bypass grafts and aortic arterial branches, providing detailed vascular images. Atheromatous degeneration assessed by multi-detector row computed tomography was equivalent with intraoperative findings in more than 70% of cases. Left ventricular volumes measured by multi-detector row computed tomography correlated closely with those determined by cine-angiography. Multi-detector row computed tomography is an efficient and promising modality in cardiovascular surgery.
Imagawa
Hiroshi
H
Second Department of Surgery, Ehime University School of Medicine, Ehime, Japan.
Kawachi
Kanji
K
Takano
Shinji
S
Tsunooka
Nobuhiro
N
Shikata
Fumiaki
F
Haraigawa
Toyoaki
T
Hosoi
Satoshi
S
Mochizuki
Teruhito
T
Higaki
Jitsuo
J
Nakano
Susumu
S
D002306:Cardiac Volume; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014654:Vascular Patency