title: A 16-slice multidetector computed tomography protocol for evaluation of the gastroepiploic artery grafts in patients after coronary artery bypass surgery.
abstract: Arterial coronary bypass grafts [internal mammary arteries and gastroepiploic artery (GEA)] are in widespread use for coronary surgery. Since selective catheterisation of the GEA graft to monitor patency, is often unsuccessful, a non-invasive protocol to visualise the GEA-graft from origin to anastomosis is presented using 16-slice multidetector computed tomography (MDCT). Twenty-six male patients (mean age 58.1+/-6.7 years) with GEA grafts were scanned according to a protocol of an ECG-synchronised cardiac scan followed by a thoracoabdominal scan. To terminate the scan at the correct anatomical level, the lowest level of the GEA was coded based on the lumbar vertebrae level. Scores ranging from one (excellent) to four (bad) were assigned to evaluate visualisation quality of the grafts. GEA grafts were assessable in 62% of the thoracoabdominal scans and 69% of the cardiac scans. On average, the lowest part of the GEA corresponded with a level between L1 and L2, in two cases in the upper part of L3. Mean visualisation score in the thoracoabdominal scans and cardiac scans was good (respectively 1.4+/-0.6 and 1.4+/-1.0). Sixteen-slice MDCT is a promising alternative for catheterisation in evaluating patency of GEA grafts, using the presented protocol with thoracoabdominal scan including L3 for complete coverage of the GEA graft.
authors.affiliation: Department of Radiology, University Medical Center Groningen, Hanzeplein 1, PO Box 30001, 9700 Groningen, The Netherlands. j.dorgelo@rad.umcg.nl
authors.forename: J
authors.initials: J
authors.lastname: Dorgelo
authors.forename: T P
authors.initials: TP
authors.lastname: Willems
authors.forename: P M A
authors.initials: PM
authors.lastname: van Ooijen
authors.forename: G F V
authors.initials: GF
authors.lastname: Panday
authors.forename: P W
authors.initials: PW
authors.lastname: Boonstra
authors.forename: F
authors.initials: F
authors.lastname: Zijlstra
authors.forename: M
authors.initials: M
authors.lastname: Oudkerk
mesh_terms: D002985:Clinical Protocols; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods; D001026:Coronary Artery Bypass / Q000379:methods*; D004562:Electrocardiography; D005500:Follow-Up Studies; D024405:Gastroepiploic Artery / Q000637:transplantation*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007479:Iopamidol / Q000031:analogs & derivatives; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011856:Radiographic Image Enhancement / Q000379:methods; D011860:Radiography, Abdominal; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014654:Vascular Patency / Q000502:physiology
chemical_list: D003287:Contrast Media; C057937:iomeprol; D007479:Iopamidol